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The fundamentals of care have re-emerged as an important consideration in nursing following a period when these role elements were predominantly "delegated tasks" delivered by other (usually unregistered/unregulated) members of the health and social care team. Contemporary critiques of nursing highlight the technical focus of nursing at the expense of its caring function. Person-centred nursing theory offers a way of reinstating the value of fundamental care as a core part of providing holistic nursing to persons as well as highlighting the importance of the nursing role in coordinating healthcare services in ways that are consistent with a person's beliefs and values. This paper argues that a focus on person-centredness enables the core function of nurses as providers and coordinators of holistic person-centred fundamental care to be revalued. It highlights the importance of nurses being clear about "what matters" in caring practices and suggests that nurses adopting a person-centred approach can achieve effective care coordination through the lens of the fundamentals of care. In reading this paper, a greater understanding of person-centredness in the context of the fundamentals of care can be achieved., (Copyright © 2016 Longwoods Publishing.)

Person-centredness as a concept is becoming more prominent and increasingly central within some research literature, approaches to practice and as a guiding principle within some health and social care policy. Despite the increasing body of literature into person-centred nursing (PCN), there continues to be a 'siloed' approach to its study, with few studies integrating perspectives from across nursing specialties. The purpose of this paper is to present the results of a study undertaken to explore if the secondary analysis of findings from four different and unrelated research studies (that did not have the main aim of researching person-centredness) could inform our understanding of person-centred nursing. A qualitative meta-synthesis was undertaken of the data derived from the four unrelated research studies undertaken with different client groups with long-term health conditions. A hermeneutic and interpretative approach was used to guide the analysis of data and framed within a particular person-centred nursing framework. Findings suggest 'professional competence' (where competence is understood more broadly than technical competence) and knowing 'self' are important prerequisites for person-centred nursing. Characteristics of the care environment were also found to be critical. Despite the existence of expressed person-centred values, care processes largely remained routinised, ritualistic and affording few opportunities for the formation of meaningful relationships. Person-centred nursing needs to be understood in a broader context than the immediate nurse-patient/family relationship. The person-centred nursing framework has utility in helping to understand the dynamics of the components of person-centredness and overcoming the siloed nature of many current perspectives., (© 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.)

Aims: This paper reports findings from a large-scale quasi-experimental study that used a measure of caring as a means of evaluating person-centred nursing and aims to illustrate the synergy between the concepts of caring and person-centredness., Background: Evidence would suggest that effective person-centred nursing requires the formation of therapeutic relationships between professionals, patients and others significant to them in their lives and that these relationships are built on mutual trust, understanding and a sharing of collective knowledge. This correlates with the conceptualization of caring that is underpinned by humanistic nursing theories., Design: A pretest post-test design was used in this study to evaluate the effect of person-centred nursing on a range of outcomes, one of which was nurses' and patients' perception of caring., Methods: The Person-Centred Nursing Index was the main data collection tool. The Caring Dimension Inventory and Nursing Dimensions Inventory, were component parts of the Person-Centred Nursing Index and were used to measure nurses' and patients' perceptions of caring. The Person-Centred Nursing Index was administered at five points in time over a two-year intervention period., Results: Nurses had a clear idea of what constituted caring in nursing, identifying statements that were reflective of person-centredness, which was consistent over time. This was in contrast to patients, whose perceptions were more variable, highlighting incongruencies that have important implications for developing person-centred practice., Conclusion: The findings confirm the Caring Dimension Inventory/Nursing Dimensions Inventory as an instrument that can be used as an indicator of person-centred practice. Furthermore, the findings highlight the potential of such instruments to generate data on aspects of nursing practice that are traditionally hard to measure., Relevance to Clinical Practice: The findings would suggest that nurses need to be aware of patients' perceptions of caring and use this to influence changes in practice, where the prime goal is to promote person-centredness.

Unlabelled: This paper presents the development and content of a person-centred nursing framework., Background and Rationale: Person-centred is a widely used concept in nursing and health care generally, and a range of literature articulates key components of person-centred nursing. This evidence base highlights the links between this approach and previous work on therapeutic caring., Methods: The framework was developed through an iterative process and involved a series of systematic steps to combine two existing conceptual frameworks derived from empirical studies. The process included the mapping of original conceptual frameworks against the person-centred nursing and caring literature, critical dialogue to develop a combined framework, and focus groups with practitioners and co-researchers in a larger person-centred nursing development and research project to test its face validity., Findings: The person-centred nursing framework comprises four constructs -prerequisites, which focus on the attributes of the nurse; the care environment, which focuses on the context in which care is delivered; person-centred processes, which focus on delivering care through a range of activities; and expected outcomes, which are the results of effective person-centred nursing. The relationship between the constructs suggests that, to deliver person-centred outcomes, account must be taken of the prerequisites and the care environment that are necessary for providing effective care through the care processes., Conclusion: The framework described here has been tested in a development and research project in an acute hospital setting. Whilst there is an increasing empirical base for person-centred nursing, as yet little research has been undertaken to determine its outcomes for patients and nurses. The framework developed can be described as a mid-range theory. Further testing of the framework through empirical research is required to establish its utility for nursing practice and research.

This paper sets out to explore the meaning of practice development. The data from which this exploration is derived is largely drawn from an empirical research project that set out to explore practice development through concept analysis. The paper argues for a model of practice development that is focused on achieving increased effectiveness in patient-centred care. It argues that one-off changes in practice are not the same as a sustained systematic development of practice that focuses on achieving cultural changes in practice settings, ie the context of practice. It will be argued that facilitation is a key concept underpinning practice development work, but that in itself, facilitation is a misunderstood and abused concept. Finally, the consequences of practice development activity will be outlined and the need for further research in this area highlighted.

An action research project sought to create a learning culture in a hospital. Adult learning principles and facilitation of learning at and from work were emphasized. Although the hospital's top-down management eventually ended the project, active staff participation in learning was begun. (SK)

Flourishing is the highest good of all persons, but hard to achieve in complex societal systems. This challenge is borne out through the lens of the global nursing shortages with its focus on the supply of nurses to meet health system demands. However, nurses and midwives spend a significant part of their lives at work and so the need to pay attention to the conditions that facilitate flourishing at work is important. Drawing on ancient and contemporary philosophies, as well as critical, creative and embodied ways of knowing, enabling a flourishing practice ecosystem will be explored in this paper. [ABSTRACT FROM AUTHOR]

Purpose: In order to provide guidance and prepare ward managers for future crisis situations similar to the COVID-19 pandemic, the aim of this study was to reflect and learn how person-centred nursing leadership may be strengthened in such situations. Background: The pandemic has forced nurse leaders to face new challenges. Knowledge about their experiences may contribute to advancing leadership practices in times of future crises. Methods: A qualitative directed content analysis was chosen. The theoretical perspective was person-centred leadership. Thirteen ward managers from a Danish university hospital were included and interviewed using telephone interviews three months after the first national COVID-19 case was confirmed. Findings: The main findings of the study revealed that the ward managers often experienced a lack of timely, relevant information, involvement in decision-making and acknowledgement from the head nurse of department and the executive management. This was caused by the existing organizational cultures and the traditional hierarchy of communication. This meant that the ward managers' sense of own competences and leadership values and beliefs came under high pressure when they had to balance different stakeholders' needs. Conclusion: When the experience of ward managers results in them being unable to lead authentically and competently in a crisis like the COVID-19 pandemic, lack of engagement can occur, with serious consequences for patients, staff and the ward managers themselves. Traditional organizational cultures that are hierarchical and controlling needs to be challenged and reoriented towards collaborative, inclusive and participative practices of engagement and involvement. Leadership development must be an established and integrated component of organizations, so that ward managers are able to sustain person-centred ways of being and doing in times of crisis. [ABSTRACT FROM AUTHOR]

Background: Collaboration with care partners is a political aim in recent white papers in Norway and internationally. Home care services regularly work closely with care partners, but there are many indications that the collaboration does not work satisfactorily. Aim: To explore home care staff and leaders' experiences of collaborating with care partners of older people with mental health problems through a personhood perspective. Methods: The study had a qualitative design and comprised eight health professionals in two focus groups and in‐depth interviews with three leaders in one home care district. The data were analysed using a thematic framework analysis building on previous research on personhood. criteria for reporting qualitative reporting guidelines were used to ensure comprehensive reporting. Results: Four themes were identified in the analysis: 'non‐negotiated relationships', 'contradictory agendas', 'weak paternalism' and 'moral compromise'. Conclusion: There seems to be a lack of facilitation of collaborative relationships through all levels of the home care organisation. The interactions between care partners and home care staff sometimes appear to produce low or negative levels of emotional energy, and situations where the personhood of neither of them is respected occurs. Paying attention to the four modes of being as a framework for understanding personhood creates the foundation for a person‐centred approach that enhances the potential of creating stronger partnership in care relationships. [ABSTRACT FROM AUTHOR]

Background: Palliative care is aimed at improving the quality of life of an individual with chronic noncommunicable disease and their care partners. Limitations in the provision of palliative care are mainly lack of knowledge and experience by nurses, fear of treating palliative persons, loss of control over treatment and fear of providing poor‐quality palliative care to persons and care partners. Aim: The aim of this study was to investigate the perception, knowledge and attitudes of palliative care by nurses who use palliative care approaches in practice, as well as the difference in perception, knowledge and attitudes of palliative care between nurses in Slovenia and Finland. Methods: We conducted a cross‐sectional descriptive study. The survey included 440 nurses in clinical environments in Slovenia and Finland with a completed bachelor, master or doctoral level of education. Results: We found statistically significant differences between both countries in the perception of palliative care. Differences between the two countries in the knowledge of palliative care were not confirmed. We confirmed statistically significant differences between both countries in the attitudes of palliative nursing care. Conclusion: Early person‐centred palliative care is an important part of the holistic and integrative treatment of a person who has a disease with disturbing symptoms. For such an approach, it is important to educate nurses about knowledge, expectations, values and beliefs in developing a concept of person‐centred palliative care to improve quality of life. The better perception, knowledge and attitudes of palliative care by nurses may help persons to improve and raise their quality of life, as well as diminish stress in their care partners and improve quality of life. [ABSTRACT FROM AUTHOR]

Background: Registered nurses are increasingly expected to provide person-centred end-of-life care. However, there is a gap between patients' needs and the capacity of nurses to meet the existing recommendations on provision of this care. Identifying the relevant barriers and facilitators can inform the development of strategies to support person-centred nursing. Aim: To identify registered nurses' perceived barriers and facilitators in terms of providing personcentred end-of-life care. Method: A scoping review was conducted according to the 2005 guidelines proposed by Arksey and O'Malley. The databases Medline, CINAHL, PsycINFO, Cochrane, Web of Science and Embase were searched using the period 2000 to 2018. Empirical studies, literature reviews and studies focusing on the experiences of generalist nurses providing end-of-life care were included. The selected articles were independently reviewed by two researchers. Results: A total of 2,126 publications were identified, with 26 retained after applying the eligibility criteria. Four barriers to providing person-centred care were identified: knowledge of end-of-life care; communication skills; coping strategies; and teamwork. Three main facilitators were identified: knowing the person in a holistic way; nurses' self-knowledge; and the development of a good nurse-person relationship. Organisational and managerial support also emerged to be important. These findings are reflected in the construct of McCormack and McCance's (2017) Person-centred Practice Framework. Conclusions and implications for practice: This review provides an overview and an understanding of the key elements that influence the provision of person-centred end-of-life care by registered nurses. These barriers and facilitators point to professional competencies that could improve nurses' ability to provide this care. This scoping review highlights registered nurses' need for more specific education, and the elements identified could be a starting point to design an innovative educational programme for registered nurses focused on person-centred end-of-life care to improve person-centred carerelated outcomes. [ABSTRACT FROM AUTHOR]

Aim Background Design Methods Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital.Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability.A narrative inquiry.Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data.The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation.Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians.Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly.The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting.The consumer researcher was involved in design, data analysis and publication preparation. [ABSTRACT FROM AUTHOR]

Background: In this article we reflect on the experience of the first author (Berit Margrethe Sandvik) of conducting seven qualitative research interviews with public health nurses trained in parenting guidance by the International Child Development Programme at the University of South-Eastern Norway. The interviews focused on how the nurses use a particular set of competencies in their daily work at the health centre. A person-centred practice framework was used to reflect on whether personcentred prerequisites and processes could be recognised in the completed interview processes, and how a greater focus on a person-centred approach could improve the quality of data collection. The results of this reflection are presented in this paper. Aim: To understand how a researcher can use person-centred principles to facilitate qualitative interviews. Findings: Being reflexive is essential to a person-centred approach in qualitative research interviews. It relates to the researcher's ability to facilitate an engagement that promotes authenticity, selfdetermination and reciprocity. Knowing oneself without letting conscious or unconscious values and perceptions overshadow the opportunities that arise in gaining an understanding of the participant's values and perceptions is essential. Through being vigilant in all senses, an holistic, mutually respectful dialogue can be created, through which new knowledge and understandings can be generated. Conclusion: It is important to consider person-centredness in the planning and undertaking of research methods. While there is an increasing evidence base about person-centredness in health and social care practice, there continues to be a dearth of publications that focus on its role in research methods. Implications for practice: •Developing the ability to facilitate mutually respectful dialogue in research interviews is important in researcher development programmes •Facilitating flow and creativity through engaging all senses in the dialogical situation has the potential to create a more person-centred approach to interview practices •Being open to and aware of the lifeworlds of others, and having the ability to adjust one's own pre-understanding, facilitates an engagement that promotes authenticity, self-determination and reciprocity •There is a need for more studies to use person-centred principles and practices explicitly in the conduct of research. This article provides a reflexive framework for doing that and suggests principles that can be applied in future research studies. [ABSTRACT FROM AUTHOR]

Background: Person-centred practice is advocated internationally across multiple healthcare contexts and professions. Originating in nursing and medicine, its enactment in physiotherapy requires careful consideration. Aim: To explore perceptions of person-centred practice within nursing and physiotherapy in online social media communities to gain insight into differences and similarities in how it can be enacted professionally. Methods: A large, online focus group was undertaken through an international tweetchat within the existing social media communities WeNurses and Physiotalk. Participants were fully informed before participation. Tweets from the tweetchat, which lasted for the planned hour plus an extra 15 minutes, were downloaded via the healthcare social media analytics platform Symplur. Analysis was conducted using an interpretative phenomenological approach, with consideration of group development of insight and meaning. Tweets were analysed if they were from nurses and physiotherapists, related to the research aim and interpretable. Results: A selected 233 of 504 tweets from 38 nurses and 23 physiotherapists were analysed. Four themes are discussed here: relationship between professionals and patients,perceptions of who holds the power,treating the condition not the person,and impact of organisational demands. Nurses and physiotherapists were seen to share many perceptions of person-centred practice, with the latter demonstrating a focus on informed decision making and education to empower. Discussion also showed that a biomedical approach was often taken by physiotherapists. Patient privacy was highlighted by nurses. Explanatory theory was produced to incorporate the views of physiotherapists alongside established perceptions of person-centred practice from the nursing literature, expanding insights into profession-specific applications. Conclusions: Perceptions of person-centred practice described by participants were generally supportive of existing frameworks. Insights suggested some physiotherapists might perceive their professional role in a way that is not completely consistent with person-centred practice,this would benefit from further exploration. The importance of education to empower patients within collaborative relationships was emphasised in relation to physiotherapy. Implications for practice: •Discussion supported many similarities in the perceptions of person-centred practice between nursing and physiotherapy online communities that resonate with existing frameworks, including prioritisation of what matters to the person and empowerment through relationship, and the barriers to this resulting from structures and cultures within workplaces •Participants from both professions emphasised the importance of focusing on the beliefs, values and priorities of the person in development of a collaborative relationship, with shared decision making •Physiotherapists involved in the tweetchat placed additional emphasis on the need to empower patients through education to enable greater participation in informed and shared decision making •Tweets suggested there are professional barriers to the enactment of person-centred practice among physiotherapists. Some may focus on the condition rather than the person, and view the professional as expert with greater power in the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the effects of the implementation of a methodological framework for a narrative‐based approach to practice development and person‐centred care in residential aged care settings. Background: Care in long‐term residential settings for older people is moving away from the biomedical approach and adopting a more person‐centred one. Narrative can help shape the way care is planned and organised. The provision of person‐centred care that is holistic and that takes account of resident's beliefs and values can be enhanced by incorporating narrative approaches to care within a practice development framework. Design: The chosen methodology was participatory action research. Methods: Between 2010–2014, a methodological framework of narrative practice was implemented in two residential care settings, comprising 37 residents and 38 staff, using an action research approach. Three action cycles: (i) narrative practice and culture identification, (ii) developing narrative practice and (iii) working in a storied way emerged during the implementation. Results: Key outcomes emerged in relation to the findings. These were based on narrative being, knowing and doing and centred around the key outcomes of (i) how people responded to change (narrative being), (ii) the development of shared understandings (narrative knowing) and (iii) intentional action (narrative doing). Conclusion: The implementation of a framework of narrative practice demonstrated that how people respond to change, the development of shared understandings and intentional action were interrelated and interlinked. It illustrated the importance of ensuring that practice context is taken account of in the implementation of action research and the importance of ensuring that narrative being, knowing and doing are clear and understandable for change to occur. Relevance to clinical practice: Implementation of a narrative approach to care can develop new ways of working that value biography and promote the development of a co‐constructed plan of care. [ABSTRACT FROM AUTHOR]

Aim To explore the inter-play between external facilitation and nursing home contexts relative to intervention outcomes. Background The Promoting Action on Research Implementation in Health Services framework is frequently used to theoretically inform implementation and research in nursing and recent reviews indicate high face validity for health services. However, the inter-play and relationship between framework sub-elements of evidence, context and facilitation and the prospective utility in non-English speaking contexts warrant further illumination. Design In an overarching single-blind cluster-randomized controlled trial, we applied participatory action research and ethnography from August 2011-June 2015 to evaluate a standardized education intervention to reduce restraint and agitation in nursing home residents living with dementia. The trial results are published elsewhere. Methods Prospectively informed by the PARIHS framework, a research team and eight facilitators participating in dual roles as action researchers designed, implemented, and evaluated the intervention. How contextual factors influenced the facilitation processes were explored in focus group interviews (1), reflection notes (84) written by the facilitators' after each education session, ethnographic field studies (6 homes), and co-analysis workshops (5). Directed content analysis was used to analyse data. Results Clinical leaders taking roles of internal facilitator influenced the success of implementation, while complex and fluctuating context elements determined whether restraint use was reduced- or not. The PARIHS framework was found to be relevant in a non-English nursing home setting, albeit some elements merit further conceptualization. Conclusions Our findings confirm the prospective utility of the PARIHS framework for implementation in a non-English context, particularly the notion of implementation processes as dynamic and multifaceted. [ABSTRACT FROM AUTHOR]

Context: Professional doctorates have been a part of the academic landscape for many years. Over this time, their focus, structure and mode of delivery have changed significantly as the terrain of professional practice has developed. In this paper we articulate this development over time through discussion of the evolution of first- and second-generation professional doctorates, and argue that there is a need for a third-generation doctorate with greater clarity regarding focus, structure and mode of delivery, in the context of advanced professional practice. Aims: A scoping review was undertaken of the development of professional doctorates in the discipline of nursing to inform thinking with regard to future design work for a post-masters (nurse practitioner endorsement) professional doctorate. Conclusion: In the context of the absence of any identified published outcome-based evidence of the value of first- or second-generation professional doctorates in general, and specifically in nursing, a third-generation evolution is proposed. This is based on the conclusion that the lack of identified outcomes is based not only on the axiomatic absence of research, but also that this may be symptomatic of a prevailing lack of clarity in programme design. A third-generation professional doctorate for nursing offers an opportunity to focus on congruence and internal consistency between the aims of the programme, learning outcomes, learning content and design, and the assessment. Implications for practice development: • The third-generation professional doctorate would no longer need to be distinguished from other degrees via an expression of what it is not, but rather would set out what it is • The educational product, with clear processes and content that are congruent with the course aims, could be clearly described as a self-contained entity more capable of producing measurable outcomes • Practice development is an integral part of the learning product through being a prescribed method in the research component of the course [ABSTRACT FROM AUTHOR]

Aims To explore the expertise of Registered Nurses in residential care for older people. Background As older people in residential care have many complex dependencies, nursing expertise is an essential component of care excellence. However, the work of these nurses can be invisible and, therefore, unrecognized. Thus, additional attention is required to illuminate such nursing expertise. Design A mixed method design was used in this study. Methods The research took place in 2012 in the Republic of Ireland. Twenty-three case study nurses were recruited from nursing homes. Each case study nurse involved five data collection methods: shadowing, interview with a colleague, interview with a resident, a demographic profile and a director of nursing survey. The study was also informed by a modified focus group. Qualitative data were analysed using directed content analysis using a conceptual framework generated from the literature on nursing expertise. Quantitative data were analysed using SPSS and presented in descriptive statistics. Findings The findings from the case studies and the modified focus group are presented in seven themes, which represent nursing expertise in residential care of older people: transitions, context of the nursing home, saliency, holistic practice knowledge, knowing the resident, moral agency and skilled know how. Conclusion Nursing expertise in residential care of older people is a complex phenomenon which encompasses many aspects of care delivery in a person-centred framework. By rendering this expertise visible, the need for appropriate and adequate skill mix for a growing residential care population is presented. [ABSTRACT FROM AUTHOR]

Rationale Besides a growing demand for safe high-quality care for older people, long-term care ( LTC) often struggles to recruit appropriately qualified nursing staff. Understanding what LTC staff value in their work may contribute to a more comprehensive understanding of what can attract staff and support person-centred care. Aim To explore staff experience of the advantages of working in LTC settings for older people. Methods Narrative descriptions of 85 LTC staff in Ireland, the Netherlands and Sweden on what they value in their work were analysed with qualitative content analysis. Ethics Ethical approval was obtained according to the requirements of each country, and participants provided informed consent prior to the individual interviews. Findings Working in LTC signifies bonding with the older people residing there, their next of kin and the team members. It means autonomy in one's daily tasks amalgamated with being a part of an affirmative team. Participants reported a sense of accomplishment and fulfilment; caring meant consideration and recognition of the older people and the relationships formed, which provided for professional and personal growth. The sharing of compassion between staff and residents indicated reciprocity of the relationship with residents. Study limitations The findings may be transferable to LTC in general although they address only the positive aspects of caring for older people and only the experiences of those staff who had consented to take part in the study. Conclusions The findings add to what underpins the quality of care in nursing homes: compassion in the nurse-resident relationship and person-centred care in LTC. They indicate reciprocity in the relations formed that may contribute to the empowerment of older people, but further studies are needed to explore this in more detail. [ABSTRACT FROM AUTHOR]

Background: The emancipatory practice development and evidence-based practice movements play significant roles in driving today's nursing and midwifery practice and knowledge development agendas. Often, however, they are characterised as philosophically opposed to one another. Aims and objectives: To provide an overview of the philosophical and epistemological background to these two movements and locate them in relation to today's overall nursing knowledge and practice development environment. Methods: Literature review, case study and model advance. Findings: The paper argues that a mutualised evidence-based emancipatory practice development (EBEPD) is today both practical and achievable, and proposes a convergent model. The EBEPD model is discussed with particular reference to contemporary philosophical debate in nursing, some of which positions positivism (a primary underpin to evidence-based practice) and critical realism (a primary underpin to emancipatory practice development) as epistemologically irreconcilable. Conclusion and implications for practice: Significant knowledge and practice development opportunities are likely to emerge from working to bring together these two fundamentally important and arguably symbiotic movements in healthcare. [ABSTRACT FROM AUTHOR]

Aims and objectives To report on the development of a framework of narrative practice, in residential care settings for older people. Background Residential care settings for older people provide care for people who are no longer able to live in their own home. To date, the impact and structure of nursing practice on care provision in these settings has proved difficult to conceptualise within a specific nursing theory framework. Design A hermeneutic approach incorporating narrative methods was used. Methods Forty-six narrative interviews with older people in residential care were secondary-analysed for key themes through a three-stage process: by the first author, four focus groups of 12 clinical nurse managers and two independent experts. Themes were also derived from a focus group of eight residents who explored person-centredness and narrative. Finally, the combined findings were used to derive a single set of themes. Results The secondary data analysis process led to the development of a framework of narrative practice for the care of older people in residential settings. The framework is influenced by narrative enquiry, person-centred practice and practice development. It has four pillars, prerequisites, care processes, care environment and narrative aspects of care. To operationalise the framework of narrative practice, three narrative elements, narrative knowing, narrative being and narrative doing, need to be considered. Working with the foundational pillars and the narrative elements would enable staff to 'work in a storied way' and provide person-centred outcomes and a narrative informed philosophy of care for older adults in residential care. Conclusion This framework provides nurses with a template that confirms the identity of the older person taking account of their biography. Relevance to clinical practice The framework outlines an approach that provides staff with a template on how to provide person-centred care in a narrative way. [ABSTRACT FROM AUTHOR]

Hope is a central concept in nursing and other fields of health care. However, there is no consensus about the concept of hope. We argue that seeking consensus is futile given the multifaceted and multidimensional nature of the concept, but instead we encourage in-depth studies of the assumptions behind talk about hope in specific contexts. Our approach to the 'science of hope' is inspired by philosophical pragmatism. We argue that hope is a concept that opens different rooms for action in different contexts and that accordingly, all hope interventions are contextually sensitive. Careful attention to how the relative positions and power of nurses and patients influence what can be inferred from their different ways of talking about hope may make hopeful conversations more meaningful in health care relationships. [ABSTRACT FROM AUTHOR]

The author contemplates on the value of nursing in a time of crisis like the COVID-19 pandemic. He cites that due to the pandemic student nurses became a subsidiary workforce to replace the chronic shortage of nurses that existed prior to the pandemic. He also states the significance and importance of nursing knowledge according to the American Academy of Nurses (AAN).

lynch b.m., McCormack b. & McCance t. (2011) Journal of Nursing Management 19, 1058-1069 Development of a model of situational leadership in residential care for older people Aim The aim of the present study was to present the process used to develop a composite model of situational leadership enacted within a person-centred nursing framework in residential care. Background Transforming the culture of the residential unit from a restrictive institution to a vibrant community of older adults requires transformational leadership. Situational leadership is one form of transformational leadership, which claims that there is not one leadership style that works in all situations. Method A model of situational leadership in residential care was developed through a series of systematic steps that identified direct linkages between situational leadership and the main constructs of the Person-Centred Nursing Framework. The process included reviewing the evidence, undertaking a comparative analysis, identifying key concepts, connecting the concepts and developing a model. Conclusion A conceptual model is presented which integrates person-centredness with leadership thinking in order to effectively impact on the follower's performance in managing the care environment and delivering person-centred care. Implications for Nursing Management Currently the model is being utilized in an action research study to evaluate the role of leaders in the practice setting of long-term care. While some of the connecting concepts have been identified in the present study, more work needs to be done to unravel these connections in further study of leaders in practice. [ABSTRACT FROM AUTHOR]

Background: This paper, which draws upon an Emancipatory Action Research (EAR) approach, unearths how the complexities of context influence the realities of nursing practice. While the intention of the project was to identify and change factors in the practice context that inhibit effective person-centred pain management practices with older people (65 years or older), reflective critical engagement with the findings identified that enhancing pain management practices with older people was dependent on cultural change in the unit as a whole. Methods: An EAR approach was utilised. The project was undertaken in a surgical unit that conducted complex abdominal surgery. Eighty-five percent (n = 48) of nursing staff participated in the two-year project (05/NIR02/107). Data were obtained through the use of facilitated critical reflection with nursing staff. Results: Three key themes (psychological safety, leadership, oppression) and four subthemes (power, horizontal violence, distorted perceptions, autonomy) were found to influence the way in which effective nursing practice was realised. Within the theme of 'context,' effective leadership and the creation of a psychologically safe environment were key elements in the enhancement of all aspects of nursing practice. Conclusions: Whilst other research has identified the importance of 'practice context' and models and frameworks are emerging to address this issue, the theme of 'psychological safety' has been given little attention in the knowledge translation/implementation literature. Within the principles of EAR, facilitated reflective sessions were found to create 'psychologically safe spaces' that supported practitioners to develop effective person-centred nursing practices in complex clinical environments. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that older people hold lower expectations of healthcare, which restricts their involvement. Narrative research provides an option to explore personal experiences beyond the boundaries of a questionnaire, providing insights into decisions involving treatment, screening, and various health practices that can help guide the development and provision of effective healthcare services. Purpose: The purposes of this article were to develop and to implement a narrative research approach in a rehabilitation unit for older people to inform service development. Methods: This study applied a narrative research approach. Participants in this study were at least 65 years of age and were patients in the target rehabilitation center. They were cognitively and physically able to communicate and give informed consent to participate. Patients were interviewed toward the end of their stay at the rehabilitation center. A total of 28 patients were invited for the interview. Narrative interviewing skills were developed and used in data collection. Literature review and comparative method were used to analyze data. Results: Findings revealed researcher characteristics, including respect, understanding, and acceptance, as key attributes of success in conducting narrative work with the older people. Narrative interview skills were essential to sustain such characteristics when collecting participant stories. It was found that participants who had been already assigned a discharge date were more likely to participate in the narrative interview. Conclusions/Implications for Practice: Narrative approaches aim to provide an environment in which service users can experience the development of services through their service utilization experience. The narrative research approach and the narrative interview skills may help practitioners facilitate and cultivate person-centered nursing practice. [ABSTRACT FROM AUTHOR]

Action Learning is now a well established strategy for reflective inquiry in healthcare. Whilst a great deal is know about action learning there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This article reports on the findings of 15-month action learning program based in a special care nursery. A realistic evaluation of the program uncovered individual and group journeys and provide evidence that action learning is an effective strategy in practice development. [ABSTRACT FROM AUTHOR]

Rationale: The nurse shortage is increasing in the developed world. Organisational context is important in determining issues associated with nurse shortages, such as retention, recruitment, and job satisfaction. Recent research has utilised the Nursing Work Index-Revised (NWI-R) as a measure of organisational context traits. Within the NWI-R a four-factor model has been reported as being important in determining good organisational context, yet researchers have recently questioned the stability of the four-factor structure. Aim: No known study has attempted to replicate the four-factor structure reported in the NWI-R. The aim of this research is to examine the factor structure of the 15 items that comprise the four factors of the NWI-R. Methods: The NWI-R is an instrument that is focused on capturing organisational attributes that characterise professional nursing environments. A random sample of 172 (50%) acute care hospital nurses completed the NWI-R as part of a larger research project. The sample was diverse concerning nursing grade and specialty. Data were analysed using SPSS.11.0 to extract factors' structures (principal component and maximum likelihood), measures of homogeneity and descriptive statistics were generated from the findings. Results: The four-factor structure of the NWI-R was not replicated in the data analysis. Instead a modified three-factor structure was identified accounting for 57% of the variance. Measures of internal consistency were acceptable. Discussion: Previous research utilised the four factors of the NWI-R as a method to identify supportive organisational context and practice. The three-factor model raises questions regarding the stability of the findings using the NWI-R. This research shows the synthesis of the two models in light of previous findings. Conclusions/Implications: The findings might have far reaching implications for research that has utilised the NWI-R as a measure of organisational context. Further research is required to examine this study's findings and literature. [ABSTRACT FROM AUTHOR]

This article presents the findings of a project that focused on developing a culture of learning where practitioners were able to engage in supported work-based learning in a Special Care Nursery (SCN). The project was part of a larger study focusing on the implementation and evaluation of an emancipatory practice development programme in an SCN. The aim of this phase of the study was to gain an in-depth understanding of how the implementation of practice-development strategies could enable the creation of a culture of supportive learning in practice. The methodological and philosophical structure of the study was based on emancipatory practice development (ePD). The ePD strategies used are aimed at promoting the empowerment of nursing staff, utilizing staff knowledge and expertise to identify the need for change, encouraging reflection on and in practice, incorporating the views of service users in the change process, and supporting staff to challenge themselves and each other. Questions are framed to evaluate systematically the processes and outcomes of the study with a view to identifying changes in the learning culture that may have occurred as a result of PD strategies. Pre-intervention findings highlighted that tensions existed between what people espoused about learning and what actually occurred in practice. Through the use of PD processes, participants in the study began to focus on the learning environment. Key themes identified in the data included ‘learning about learning’, ‘movement from subservience to partnership’, movement from rituals to reflective questions’ and ‘movement from self-immersed to working with one another’. Taking self-responsibility for learning and ‘regenerating the self’ in learning emerged as key issues underpinning these themes and are subthemes of ‘values and beliefs about learning’. It is argued that developing ‘responsible self’ is key to the creation of a culture of learning where practitioners are able to develop mutually supportive relationships in order to learn in and from their practice. In conclusion, learning culture has a significant impact on how nurses go about their everyday practice. The implementation of PD processes enabled a cultural shift to occur. As a result of this, a supportive learning culture embedded within the workplace emerged. Learning about learning was seen as an important part of the context that enabled the development of the responsible self. [ABSTRACT FROM AUTHOR]

Aims. This paper reports a study to determine an appropriate framework for assessing older people's needs for nursing within the policy of ‘free nursing’, and to attempt to identify valid, reliable and usable assessment tool for determining this eligibility. Background. In 2001, the United Kingdom government introduced ‘free nursing care’ legislation, eligibility for which was subject to a nursing needs assessment. This paper outlines the search for and subsequent development of an appropriate tool for assessing older people's eligibility for free nursing care in Northern Ireland. Methods. Following a systematic search of the literature, existing tools used in ascertaining older people's nursing needs were identified. Each tool was systematically assessed in accordance with criteria of validity, reliability, usability, comprehensiveness of assessment and ability to quantify nursing care needs. From the findings, an assessment instrument, Nursing Needs Assessment Tool was subsequently developed and tested. Paired assessments of older people were undertaken independently by assessor dyads and evaluated statistically. Assessors’ opinions on the usability of the instrument were sought through a focus group. Results. One hundred and ten paired assessments were returned (63%). Overall there was 65% agreement between assessors. Kappa scores indicated good levels of inter-rater reliability. Correlation co-efficient measures reinforced these results. Findings from the focus group confirmed the validity, usability and comprehensiveness of the tool. Conclusions. The Nursing Needs Assessment Tool is a reliable, valid and usable instrument. This has major implications for the standardization of assessment for older people. [ABSTRACT FROM AUTHOR]

mccormack B. (2004) International Journal of Older People Nursing in association with Journal of Clinical Nursing 13, 3a, 31–38 Person-centredness in gerontological nursing: an overview of the literature Person-centred practice is a recurring theme in gerontological nursing literature. While there are many descriptive accounts of attempts at developing person-centred practice, in reality, there are few studies that identify the benefits of this way of working. Thus far, systematic research into person-centred nursing practice is poorly developed. This paper aims to explore the concept of person-centredness and person-centred practice in order to add clarity to discussions about the term in the context of gerontological nursing. This literature-based exploration discusses the meaning of the word ‘person’ and the way this word is translated into person-centred practice. It is argued that there are four concepts underpinning person-centred nursing: (i) being in relation; (ii) being in a social world; (iii) being in place and (iv) being with self. The articulation of these concepts through existing models of person-centred practice in nursing raises the recurring themes of knowing the person, the centrality of values, biography, relationships, seeing beyond the immediate needs and authenticity. There is a need for further research and development work in gerontological nursing to distinguish between person-centred practice and good quality care for older people. [ABSTRACT FROM AUTHOR]

Person-centredness is common speak in nursing and health care literature. Increasingly there is an expectation that practitioners adopt person-centred principles in their practice and organizations are expected to respect the values of the service user. However, in the research methodology literature, there is little explicit attention paid to the concept of person-centredness in research practice. Instead, there continues to be a reliance on traditional `ethical principles' to guide effectiveness in research work. This paper argues that the principles of person-centredness that are espoused in nursing practice should also underpin nursing and health care research. A framework for person-centred research is proposed and issues concerning its implementation in practice are discussed. [ABSTRACT FROM AUTHOR]

This paper presents a conceptual framework for person-centred practice with older people. The research from which the framework was developed was guided by hermeneutic philosophy and integrated processes of conversation analysis and reflective conversation in data collection and analysis. The research findings suggested that nurses need to be able to particularize the person that the patient is, the relationship that exists between them and the patient, and the understandings and expectations implicit in the relationship. From these findings a conceptual framework for person-centred practice was developed. In the framework, person-centredness is premised on the concept of authentic consciousness and is operationalized through five imperfect duties. The factors that enable person-centredness to operate in practice are identified as the patient's values, the nurse's values and the context of the care environment. Considerations for implementing the model in practice are highlighted. [ABSTRACT FROM AUTHOR]

The article discusses the improvements in patient safety and quality improvement in the last 10 years or more. It highlights the consequences of the use of tabards with Do not disturb front and back to improve safety during medication rounds. It refers to the exclusion of relatives from hospital wards during protected mealtimes.

Objectives: To explore the lived experiences and support needs of the care partners of older people with mental health problems living at home with assistance from home care services. Care partners face significant challenges in their care role and they often feel unsupported. An understanding of their experiences may help improve home care to support their needs. Method: An exploratory qualitative approach was used. The study is based on the SRQR and COREQ reporting guidelines. In‐depth interviews were conducted with six Norwegian care partners from two municipalities. Data were collected during 2012–2013 and 2016. The data were analysed using Gadamer's hermeneutics. Results: Three themes were identified: "invisible cornerstones," "dimensions of collaboration" and "unwanted roles." Conclusion: Few or no routines for collaboration exist between care partners and home care, and the care partners seem to have little knowledge of legal rights. They request more information, spare time and the opportunity to remain in their original family role. However, their main focus is for the patient to receive the necessary help from home care. Home care have restricted resources for meeting these needs and share a sense of powerlessness and lack of influence over their own everyday life with the care partners. There is a need for a systematic, person‐centred approach to collaboration. A correlation is necessary between what is communicated at the system level and the means of realising this in practice for home care to meet care partners' needs. [ABSTRACT FROM AUTHOR]

The article presents the crisis in critical care nursing in South Africa. It discusses the collaboration between the University of Pretoria and Queen Margaret University of Edinburgh in England to address the low quality of person-centered nursing care and shortage of nurses with the implementation of practice development programme using cooperative inquiry methods and multi-method of pre-post intervention design.

Presents several articles and resource materials that reveals effective ways of nursing older people. Focus of the book "Zen Flesh, Zen bone: A Collection of Zen and Pre-Zen Writings," by Zen and Senzaki; Importance of person-centered caring in nursing older people; Effects of looking for external direction in nursing on person-centered effectiveness.

Announces the publication of the first issue of the stand alone "International Journal of Older People's Nursing" in 2006. Idea behind the publication of the journal; Exploration of key themes of in gerontological nursing by the journal; Plans for the Practice Development section of the journal.

Comments on the articles on the importance of place in older people nursing, published in the September 2, 2005 issue of the "International Journal of Older People Nursing." Contextual information provided by geographical gerontology; Potential of geographical gerontology to provide critical and direct evidence for practice; Role of place in the concepts of gerontological nursing practice.

Comments on the implication of the involvement of service users in care, services and policy on nursing development; Enhancement of the contribution of older people to nursing; Value base of person-centered care; Keypoints about person-centered nursing care.

Introduces articles in the second issue 2004 of the periodical "International Journal of Older People Nursing,". Theme of empowerment in papers in the section one of the publication; Papers analyzing barriers to medical care.

Developing person-centred care is not a one-time event; rather it requires a sustained commitment from organisations to the ongoing facilitation of developments, a commitment both in clinical teams and across organizations. Contextual factors pose the greatest challenge to person-centredness and the development of cultures that can sustain person-centred care. We will begin with a general comment on 'context' and its meaning before exploring three particular factors that influence the practice context, namely, workplace culture, learning culture, and the physical environment. Next we explore a particular approach to developing person-centred care through emancipatory practice development. We highlight the importance of facilitation through emancipatory practice development programmes and describe how person-centred care can be developed through the presentation of a case study that illustrates the principles and processes of emancipatory practice development as well as the outcomes achieved. We conclude with an application to clinical practice. A key consideration for all organisations in the development of person-centred care is to move from what we suggest are 'person-centred moments' (individual, ad hoc experiences of person-centredness) to 'person-centred care' as an underpinning culture of teams and organisations. [ABSTRACT FROM AUTHOR]

"Person-centredness" is a term that is becoming increasingly familiar within health and social care at a global level; it is being used to describe a standard of care that ensures the patient/client is at the centre of care delivery. In this article we explore the relevance of person-centredness in the context of nursing, taking account of the ongoing critical debate and dialogue regarding developments in this field. Person-centredness is recognised as a multidimensional concept. The complexity of the concept contributes to the challenge of articulating its shared meaning and describing how it can be applied in practice. The aim of this paper is to explore some of the issues pertaining to language and conceptual clarity, with a view to making connections and increasing our shared understanding of person-centred care in a way that can impact nursing practice. We begin by describing the development of the concept of person-centredness, after which we discuss the synergies with patient-centredness and other related terms, and consider how nurses can operationalise person-centredness in their practice. [ABSTRACT FROM AUTHOR]

The author discusses geriatric nursing and the importance of treating older patients with dignity. He talks of programs to educate nurses about engaging with older people. He considers how nurses should remember that simple issues such as feeling the sun on one's skin have been taken away from their patients and discusses the importance of developing a meaningful engagement with older patients.

The article reflects on older people nursing. There are negative connotations that are associated with what nurses do for older people. It states the need for a clear goal of care that is understood by the patient, family and significant others. It describes the environment of the care setting. It discusses the need for nurses to understand a person's self-worth. It enumerates the requirements if nursing older people is to be directed towards a humanistic philosophy.