Shaun Cardiff

Critical and creative reflective inquiry: surfacing narratives to enable learning and inform action

Narratives are being increasingly used in nursing and action research. In this participatory action research study, nurse leaders of an acute care of the older person unit collectively, critically and creatively reflected on lived experiences in order to explore the concept of person-centred leadership within their own practice. This paper describes a critical and creative reflective inquiry (CCRI) structure and processes, as well as participant evaluations. CCRI has a three-phased structure: descriptive, reflective, critical/emancipatory. Reflectivity moves from ‘consciousness’ to ‘critical consciousness’ as participants critique and gain insight into their being within context. In the descriptive phase one participant shares a narrative, supported by group members applying the principles of narrative interviewing. As the narrator distances self from the narrative the reflective phase opens, where individuals creatively express their interpretation of the narrative shared. Collective and critical reflection begins as group members dialogue interpretations. As mutual understandings emerge, these are further contested and theorised in the critical/emancipatory phase. Both perspective and practice transformations were expressed within the CCRI space and observed outside it. The CCRI method created a communicative space for leaders to critically reflect, feel supported and develop knowledge and skills that they could immediately apply to daily leadership practice. Skilled facilitation was found to be essential for enabling learning and efficacy and the use of creative expression enriched the inquiry, offering new and unexpected insights. In conclusion, CCRI offers action researchers and participants a new method to explore (new) concepts relevant, and intended, to improve practice.

Actieonderzoek: de praktijk centraal

A ctieonderzoek is een vorm van wetenschappelijk praktijkgericht onderzoek. Het draagt bij aan kennis die relevant is voor of toepasbaar is in de praktijk doordat het ingaat op vraagstukken uit de praktijk, bij professionals, cliënten of organisaties. Typerend voor actieonderzoek is dat het zowel gericht is op verandering van praktijken én op het ontwikkelen van kennis omtrent die verandering.1 Dit kan betrekking hebben op diverse processen: a) de ontwikkeling of het leren van (groepen) personen of professionals; b) verbetering van praktijken (zoals methodieken, procedures of werkculturen) en/of; c) veranderingen in organisaties of (fysieke) leefomgevingen. Kenmerkend voor actieonderzoek is dat het veranderdoel (de ‘actie’) centraal staat en het kennisdoel secundair is. Dit in tegenstelling tot de meeste andere vormen van onderzoek die worden uitgevoerd. VORmeN Er zijn diverse vormen van actieonderzoek. De verschillen zitten in de doelen, de opvattingen die eraan ten grondslag liggen en de mate waarin het onderzoek participatief van aard is. We gaan verder in op de vorm die in het laatste decennium steeds meer aandacht krijgt: participatief actieonderzoek.2 Kenmerkend is de actieve deelname van direct belanghebbenden in diverse onderdelen van het actieonderzoek. Er wordt geen onderzoek gedaan ‘over’ of ‘voor’ de praktijk, maar samen met belanghebbenden uit die praktijk. Zij brengen zelf de vragen en kwesties naar voren.

Person-centred leadership: A relational approach to leadership derived through action research

AIMS AND OBJECTIVES How does person-centred leadership manifest in clinical nursing. BACKGROUND Person-centred practice fosters healthful relationships and is gaining increasing attention in nursing and health care, but nothing is known about the influence of a person-centred approach to leadership practice. Most leadership models used in nursing were originally developed outside of nursing. DESIGN A 3-year participatory action research study where participant leaders planned, researched and learned from their practice development. METHODS After an orientation phase, four action spirals focused on: critical and creative reflective inquiries into leadership practice change; leading the implementation and evaluation of a new nursing system; facilitating storytelling sessions with staff; and annually reflecting on personal leadership change. Multiple data gathering methods offered insight into leadership development from several perspectives. RESULTS Critical and creative thematic data analysis revealed a set of attributes, relational processes and contextual factors that influenced the being and becoming of a person-centred leader. Comparing the findings with nursing leadership literature supports a conceptual framework for person-centred leadership. CONCLUSIONS Person-centred leadership is a complex, dynamic, relational and contextualised practice that aims to enable associates and leaders achieve self-actualisation, empowerment and well-being. RELEVANCE TO CLINICAL PRACTICE This study and its conceptual framework is of relevance to practitioners, educationalists and researchers interested in developing a relational approach to nurse leadership and person-centred cultures.

A Kaleidoscope of Hope: Exploring Experiences of Hope Among Service Users and Informal Carers in Health Care Contexts.

Background: There is a large and diverse literature on the concept of hope in health care. This literature covers a broad spectrum of perspectives, from philosophical, conceptual, and theoretical analysis through to attempts at measuring the concept of hope with differing health care users. Aims: To explore the concept of hope through the secondary analysis of existing data sets, with the intention of understanding hope in the context of person-centeredness. Research Question: What is the experience of hope among service users and informal carers in different health care contexts? Method: Secondary analysis of data derived from three research studies. Findings: We identified four key themes that together illustrate what we describe as a kaleidoscope of hope, reinforcing the view that there is no one presentation of hope and that practitioners must engage authentically with service users to determine the most effective and appropriate intervention strategies. Conclusions: Hope is not a singular phenomenon, and in the context of person-centered practice there is a need for practitioners to engage authentically with service users and listen carefully to what may bring hope for them.