Fundamentals of Person-Centred Healthcare Practice

ABOUT THE EDITORS Brendan McCormack is Head of the Division of Nursing, Occupational Therapy and Art Therapies; Associate Director, Centre for Person-centred Practice Research, Queen Margaret University, Edinburgh, Scotland; and Honorary Nurse Consultant, Erskine Care, Scotland. Tanya McCance is Mona Grey Professor of Nursing, Institute of Nursing and Health Research, Ulster University, Northern Ireland; Adjunct Professor, University of Wollongong, Australia; and Visiting Professor, Queen Margaret University, Edinburgh, Scotland. Cathy Bulley is a Reader in the School of Health Sciences at Queen Margaret University, Edinburgh, Scotland; Co-Director of the Centre for Health, Activity and Rehabilitation Research (CHEARR); and Lead for the Accelerating Scholarship, Innovation and Research Engagement (DPPR-ASPIRE). Donna Brown is a Lecturer of Nursing, Postgraduate Tutor for the Institute of Nursing and Health Research, and Course Director for BSc(Hons)/PGDip/MSc Developing Practice in Healthcare Programme, in the School of Nursing, Ulster University, Northern Ireland. Ailsa McMillan is a Senior Lecturer of Nursing, Division of Nursing, Queen Margaret University, Edinburgh, Scotland. Suzanne Martin is a Professor of Occupational Therapy and Head of School Health Sciences at Ulster University, Northern Ireland. She is a Fellow of the College of Occupational Therapists UK and a panel member for the National Institute for Health Research.

• List of contributors xviiForeword xxiAcknowledgement xxiiiEditor Biographies xxvIntroduction xxviiSection 1 The Person in Person‐Centred Practice 1Chapter 1 The person in person‐centred practice 3Brendan McCormack, Tanya McCance, and Jan DewingIntroduction 4Who am I? 4What does it mean to be a person? 6Personhood 7Persons, personhood and person‐centred practice 10Conclusion 10Summary 11References 11Further reading 11Chapter 2 What is person‐centredness? 13Brendan McCormack, Tanya McCance, and Suzanne MartinIntroduction 14The values of person‐centredness 15Person‐centredness and related concepts 16Person‐centred practice 17Person‐centred culture 19Conclusions 20Summary 20References 21Further reading 22Chapter 3 The Person‐centred Practice Framework 23Tanya McCance and Brendan McCormackIntroduction 24What is person‐centred practice? 24Introducing the Person‐centred Practice Framework 25Prerequisites 26The practice environment 27Person‐centred processes 29Person‐centred outcomes 29Applying the framework in practice 30Conclusions 30Summary 30References 31Further reading 32Chapter 4 Knowing self 33Donna Brown and Savina TropeaIntroduction 34Understanding and defining self: different perspectives 34Different aspects of self 35The journey through ‘knowing self’: tools and approaches 36The importance of self‐knowledge for developing healthful cultures 37Using reflection to know self 38Creating the conditions to know self and others 38Conclusion 39Summary 39References 40Chapter 5 Flourishing as humans 41Brendan McCormack, Tanya McCance, and Jan DewingIntroduction 42What is human flourishing? 43Conditions for human flourishing 45A resting place 49Summary 49References 50Further reading 50Chapter 6 Professionalism and practising professionally 51Caroline Gibson, Kath MacDonald, and Deirdre O’DonnellIntroduction 52Practising professionally 52Standards for professional practice 53Maintaining professional standards 54Legal and ethical responsibilities 55Person‐centredness, professionalism and organisational structures 56Creating person‐centred cultures 57Conclusion 58Summary 58References 60Chapter 7 The future nurse, midwifery and allied health professional 61Suzanne Martin, Charlotte McArdle, and Ed JesudasonIntroduction 62Professionalism and person‐centredness 63Step 1 – Build the initial team 65Step 2 – Identify what we can do 65Step 3 – Co‐create the vision 65Step 4 – Co‐design the solution 65Step 5 – Co‐delivery 66Step 6 – Co‐evaluate 66Challenges to professionalism 66Curricula content 67Conclusion 69Summary 69Acknowledgements 70References 70Further reading 70Section 2 Being Person‐centred 71Chapter 8 Communicating and relating effectively 73Duncan Pentland, Helen Riddell, and Lindsey ReganIntroduction 74Framing communication – definitions and basic concepts 75Fundamental ideas in person‐centred communication 76Strategies for putting person‐centred communication into action 79Conclusion 80Summary 81References 81Further reading 81Chapter 9 Systems to support person‐centred decision making 83Amanda Stears and Dawn JanschIntroduction 84What is decision making? 84Service user perspectives 86Person‐centred decision making 87The value of shared decision making 88Multidisciplinary team 88Organisational decision making 90Summary 91References 92Further reading 92Chapter 10 Connecting with others 93Brighide Lynch, Derek Barron, and Lesley McKinlayIntroduction 94Relationship with self: emotional intelligence 95Relationship with colleagues 97Relationships with the person and their family 98Conclusion 100Summary 100References 100Further reading 101Chapter 11 The physical environment 103Suzanne Martin, Assumpta Ryan, and Fiona MacleanIntroduction 104Ward layout and room type 105Acoustic environment (noise reduction) 105Lighting (natural daylight and artificial light) 106Views, exposure and access to nature 106How can a better environment be provided to service users? 109Conclusion 110Summary 110References 110Further reading 111Chapter 12 Working with persons’ beliefs and values 113Suzanne Martin, Lisa Luhanga, and Catherine WellsIntroduction 114Beliefs, values and person‐centredness 114Personal beliefs and values 115Professional values 115Respecting all beliefs and values 116Contemporary considerations and challenges 117Beliefs and values in person‐centred practice 118Conclusion 119Summary 119References 119Further reading 120Chapter 13 Engaging meaningfully and effectively 121Ailsa Espie, Georgios Tsigkas, and Donna BrownIntroduction 122Engaging authentically 122Levels of engagement 123Human agency and reflexivity 124Challenging the status quo and non‐person‐centred practices 125Conclusion 126Summary 127References 127Further reading 127Chapter 14 Sharing in decisions 129Jean Daly Lynn, Assumpta Ryan, and Fiona KellyIntroduction 130Shared decision making with service users 130Shared decision making in action 131Opportunities and challenges with shared decision making 133Shared decision making and cognitive impairment 135Conclusion 136Summary 137References 137Further reading 138Chapter 15 Being sympathetically present 139Tanya McCance, Brendan McCormack, Karl Tizzard‐Kleister, and Lynn WallaceIntroduction 140Understanding sympathetic presence 141Being present in the moment 143Conclusion 145Summary 145References 146Further reading 146Chapter 16 Providing holistic care 147Neal F. Cook and Michelle L. ElliotIntroduction 148The concept of holism 149People, healthcare and holism 150Factors influencing holistic provision of care 151Providing holistic care 152Upholding the holistic gaze 153Conclusion 155Summary 155References 156Further reading 156Section 3 Person‐Centredness in Health and Social Care Systems 157Chapter 17 Sociopolitical context in person‐centred practice 159Deborah Baldie, Tanya McCance, and Brendan McCormackIntroduction 160Strategic leadership 160Health and social care policy 161Strategic frameworks 162Workforce developments 163Conclusion 166Summary 167References 167Further reading 168Chapter 18 Being person‐centred in the acute hospital setting 169Christine Boomer, Bill Lawson, and Robert BrownIntroduction 170An overview of person‐centredness in the acute hospital setting 170Person‐centred moments versus consistent person‐centred practice 171The impact of the practice environment on person‐centredness in acute settings 172How can we move beyond person‐centred moments in acute hospital settings? 174Conclusion 175Summary 176References 176Further reading 177Chapter 19 Person‐centred rehabilitation 179Jackie Gracey and Ailsa McMillanIntroduction 180What is rehabilitation? 181Who can participate in person‐centred rehabilitation? 183Person‐centred processes 184Conclusion 187Summary 187References 188Further reading 188Chapter 20 Being person‐centred in community and ambulatory services 189Caroline Dickson and Lorna Peelo‐KilroeIntroduction 190The rich learning environments in community contexts 191Knowing what matters to you being in the community 191Stepping stones to enable you to be your best self in practice 193Community contexts as flourishing workplaces 194Conclusion 196Summary 196References 197Further reading 197Chapter 21 Experiencing person‐centredness in long‐term care 199Kevin Moore and Fiona KellyIntroduction 200Residential and long‐term care: supporting quality of life 201Choosing the right long‐term care setting and holding that difficult conversation 202The transition from ‘home’ to ‘home’ 203Nursing and caring expertise in residential care settings 204Dignity and the importance of effective communication and interpersonal skills 205Conclusion 206Summary 206References 207Further reading 208Chapter 22 Being person‐centred in mental health services 209David Banks, Josianne Scerri, and Jessica DavidsonIntroduction 210How rights‐based approaches can inform person‐centred care of people experiencing mental distress 210Implementing the Person‐centred Practice Framework in the context of mental distress and trauma informed practice 213The necessity of developing a shared understanding 216Story telling as a means of therapeutic engagement 216Conclusion 217Summary 217References 218Chapter 23 Person‐centred support for people with learning disabilities 219Owen Barr, Martina Conway, and Vidar MelbyIntroduction 220Definition of a person with a learning disability 221Person‐centred principles that have underpinned services for people with learning disabilities 222The ongoing need for a person‐centred framework that is evidenced in practice 223Delivering person‐centred health and social care services for people with learning disabilities 224Conclusion 227Summary 227References 228Further reading 228Chapter 24 Being person‐centred in maternity services 229Honor MacGregor and Patricia GillenIntroduction 230Contemporary maternity care 230Being professionally competent as a midwife 231Power sharing in person‐centred maternity care 232Enabling person‐centred maternity care through shared decision making 233Conclusion 234Summary 235References 235Further reading 236Chapter 25 Being person‐centred in children’s services 237Ruth Magowan and Brian McGowanIntroduction 238Person‐centred processes 239Working with the person’s beliefs and values 240Engaging authentically 240Sharing decision making 241Being sympathetically present 242Working holistically 242Conclusion 244Summary 245References 245Further reading 246Chapter 26 Being person‐centred when working with people living with long‐term conditions 247Anne Williams, Suzanne Martin, and Vivien CoatesIntroduction 248The context and challenges of living with a long‐term condition 248Healthcare system design 249Supporting people with long‐term conditions 251Assessment in the context of providing holistic care 253Critical perspectives 254Conclusion 255Summary 255References 255Further reading 256Chapter 27 Palliative and end of life care services 257Antonia Lannie, Erna Haraldsdottir, and Juliet SpillerIntroduction 258Key strategic drivers reflecting the person‐centred macro context of palliative care 259Prerequisites: being a person‐centred practitioner in palliative care 259The context of palliative care and person‐centred practice 261Person‐centred processes in palliative care 262Challenges to person‐centred outcomes in palliative care 263Summary 264References 264Further reading and resources 265Section 4 Approaches to Learning and Development for Person‐Centred Practice 267Chapter 28 Being an active learner 269Jan Dewing and Brighide LynchIntroduction 270What is active learning? 270Our primary senses as the foundation for learning 271Multiple intelligences 271What makes active learning necessary for human flourishing? 272Active learning and the Person‐centred Practice Framework 273Active learning in class‐based learning 274Active learning in the workplace 274Conclusion 277Summary 277References 277Further reading 278Chapter 29 Knowing and becoming through reflective learning 279Donna Brown and Kristina MountainIntroduction 280Reflection for person‐centred practice 280In pursuit of knowing and becoming 281Creating communicative spaces 282Working with the challenges of knowing and becoming 284Linking knowing and becoming to experiences from practice 284Creating the conditions for knowing and becoming 285Conclusion 286Summary 286References 287Further reading 287Chapter 30 Becoming a critical thinker 289Neal F. Cook, Sonyia McFadden, and Lindsey ReganIntroduction 290What is critical thinking? 290The importance of critical thinking in practice 291Enablers and inhibitors of critical thinking 293The journey of becoming and being a critical thinker 295Understanding self in becoming and being a critical thinker 296Conclusion 296References 297Further reading 297Chapter 31 Developing and supporting practice educators 299Fiona Stuart, Lucia Ramsey, and Jacinta LynchIntroduction 300Person‐centred learning cultures 301Learning processes 302Evaluation processes 304Evaluating your role and responsibility 305Summary 306References 306Further reading 307Chapter 32 Being curious through research and knowledge exchange 309Cathy Bulley, Margaret Smith, and Alison WilliamsIntroduction 310Person‐centred values and principles in research and knowledge exchange 311Starting off: developing ideas for research and knowledge exchange through conversation 311Continuing: developing ways of addressing research questions and knowledge exchange topics 313Moving forward: ensuring that our work has positive impacts on people 315Conclusion 316Summary 316References 316Further reading 317Chapter 33 Being a lifelong learner 319Lindesay Irvine, Patricia Gillen, and Owen BarrIntroduction 321Lifelong learning and its relationship to person‐centredness 321Practice learning as adult learners 326How we learn, and its effect on practice learning 327Developing reflexivity in learning 328Conclusion 329Summary 329References 330Further reading 330Chapter 34 The future of person‐centred practice – a call to action! 331Brendan McCormack, Tanya McCance, Donna Brown, Cathy Bulley, Ailsa McMillan, and Suzanne MartinThe need for conceptual and theoretical clarity 332The KISS Principle 335Resting place 336References 336Index 339

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