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Background: Person-centred healthcare focuses on placing the beliefs and values of service users at the centre of decision-making and creating the context for practitioners to do this effectively. Measuring the outcomes arising from person-centred practices is complex and challenging and often adopts multiple perspectives and approaches. Few measurement frameworks are grounded in an explicit person-centred theoretical framework. Aims: In the study reported in this paper, the aim was to develop a valid and reliable instrument to measure the experience of person-centred care by service users (patients)–The Person-centred Practice Inventory-Care (PCPI-C). Methods: Based on the 'person-centred processes' construct of an established Person-centred Practice Framework (PCPF), a service user instrument was developed to complement existing instruments informed by the same theoretical framework–the PCPF. An exploratory sequential mixed methods design was used to construct and test the instrument, working with international partners and service users in Scotland, Northern Ireland, Australia and Austria. A three-phase approach was adopted to the development and testing of the PCPI-C: Phase 1 –Item Selection: following an iterative process a list of 20 items were agreed upon by the research team for use in phase 2 of the project; Phase 2 –Instrument Development and Refinement: Development of the PCPI-C was undertaken through two stages. Stage 1 involved three sequential rounds of data collection using focus groups in Scotland, Australia and Northern Ireland; Stage 2 involved distributing the instrument to members of a global community of practice for person-centred practice for review and feedback, as well as refinement and translation through one: one interviews in Austria. Phase 3: Testing Structural Validity of the PCPI-C: A sample of 452 participants participated in this phase of the study. Service users participating in existing cancer research in the UK, Malta, Poland and Portugal, as well as care homes research in Austria completed the draft PCPI-C. Data were collected over a 14month period (January 2021-March 2022). Descriptive and measures of dispersion statistics were generated for all items to help inform subsequent analysis. Confirmatory factor analysis was conducted using maximum likelihood robust extraction testing of the 5-factor model of the PCPI-C. Results: The testing of the PCPI-C resulted in a final 18 item instrument. The results demonstrate that the PCPI-C is a psychometrically sound instrument, supporting a five-factor model that examines the service user's perspective of what constitutes person-centred care. Conclusion and implications: This new instrument is generic in nature and so can be used to evaluate how person-centredness is perceived by service users in different healthcare contexts and at different levels of an organisation. Thus, it brings a service user perspective to an organisation-wide evaluation framework. [ABSTRACT FROM AUTHOR]

Background: Person-centred practice is inherently integrated in palliative care. However, it cannot be assumed that its underpinning values are lived out in day-to-day practice in a hospice. At St Columba's Hospice, Edinburgh, the five-year strategy demonstrated commitment to person-centredness and this prompted an 18-month project focusing on the evaluation and development of a person-centred culture, taking a practice development approach. Aim: To implement a person-centred practice development research project to assess, evaluate and enhance person-centred culture within St Columba's Hospice. Methods: The theoretical underpinnings of the programme were based on the Person-centred Practice Framework. A transformative practice development approach was employed to bring about change in individuals and teams. Twelve multidisciplinary team members from different departments across the hospice formed a core research project group, which was allocated 10 protected learning and development days over the 18-month period. To assess the existing culture, data were collected at the beginning of the practice development programme, including observation in practice and real-time interviews with patients and staff. The data were analysed using a participatory approach, with group members mapping the data collected against the Person-centred Practice Framework and undertaking creative hermeneutic analysis. Discussion: The project created and sustained a space to explore and expose person-centredness within the hospice and raised awareness of what person-centred culture means in day-to-day practice. Fourth-generation evaluation highlighted further areas for action, with teams developing their own action plans aimed at enhancing person-centred culture. Conclusion and implications for practice: The context of day-to-day practice in a hospice setting is complex, and developing person-centred culture is an ongoing process. Hospices can help their staff to flourish by providing the necessary space to reflect and for critical awareness of own practices to be heightened. This could encourage staff to embrace the contradictions inherent in the work they undertake and to learn from it in order to improve their own wellbeing. [ABSTRACT FROM AUTHOR]

Background: Developing person-centred cultures is a key focus of practice development. To do so requires engagement with learning approaches that are creative and critical. In preparing students for a future as person-centred practitioners, educators need to engage with creative approaches to the facilitation of learning. National standards in nursing (for example) as well as the international literature on adult learning endorse the need for creativity in learning. Yet, educators continue to be challenged to engage in creativity and to use creative learning strategies in their practice. This paper provides a reflective overview of the experiences of a group of educators in one school of nursing who participated in a programme of creative engagements that focused on exploring 'self' as a key concept in person-centredness. Objectives: 1. Explore through different media, contrasting aspects of 'self' as an educator 2. Engage in playful activity in a safe space to explore own creativity and ways in which this creativity could be surfaced and integrated into everyday practice 3. Through engaging with different media explore the potential of creativity in person-centred approaches to teaching, learning and research 4. Experience 'risk taking' in a facilitated environment in order to develop potential for meaningful connections with others - students and colleagues Conclusions: Through a systematic process of creative engagement, this critical reflection highlights the challenges associated with integrating creative engagement strategies in teaching and learning. The paper highlights in particular the challenges associated with 'letting go' in learning situations and the importance of exploring 'self' in the context of person-centred learning processes. Implications for practice: Practice development depends on effective facilitation undertaken by facilitators who are critical and creative. Whilst there is an increasing literature on facilitation models and processes, there is less attention paid to 'understanding self' as a facilitator of person-centred cultures. Practice development methodologies need to make such exploration an explicit part of their work in order to engage in authentic facilitation of learning and development. [ABSTRACT FROM AUTHOR]

The article presents an overview of the methodology and methods utilized in a literature review which examined the evidence around practice development (PD) in Scotland. It cites the use of PD in describing various approaches to supporting changes in health care. It explains the use of the review methods of realist synthesis in reviewing published PD literature. It also outlines the steps for utilizing the realist synthesis approach.

Objectives: To develop We Walk, a theoretically informed, 12-week person-centred dyadic behaviour change intervention to increase physical activity (PA) in community-dwelling people with stroke (PWS) through outdoor walking., Design: Three-phase intervention development study. Phase 1: we reviewed literature on barriers and facilitators to PA after stroke and mapped them to the Behaviour Change Wheel and Theoretical Domains Framework to define intervention components. The Health Action Process Approach determined intervention structure underpinned by person-centred principles. Phase 2: stakeholder focus groups involving PWS, their companions and health professionals reviewed the draft intervention, and experts in behaviour change were consulted. Phase 3: informed by phases 1 and 2, the intervention and form of delivery were refined, with final review through patient and public involvement., Setting: Three Scottish community rehabilitation stroke services., Participants: Twenty-three ambulatory community-dwelling PWS and their companions, thirty-seven health and exercise professionals, seven behaviour change experts., Results: Phase 1 determined key intervention components: information about benefits of walking; developing motivation and confidence to walk; facilitating dyadic goal setting and making plans together; monitoring walking, overcoming challenges; and maintaining walking behaviour. Phase 2 review by stakeholder focus groups and behaviour change experts endorsed intervention components and structure, emphasising dyadic relational aspects as central to potential success. In phase 3, intervention content and handbooks for PWS and buddies were finalised. Healthcare professionals proposed third-sector delivery as most appropriate for intervention delivery. A detailed delivery manual was developed. Participants preferred facilitated face-to-face and telephone delivery., Conclusions: Our multilens intervention development approach ensured this novel intervention was evidence-informed, person-centred, theoretically coherent provided appropriate social support, and addressed issues of concern to PWS. This study established intervention components and structure and identified operational issues critical to future success. Future research will pilot and refine We Walk and evaluate acceptability, feasibility, effectiveness and cost-effectiveness., Trial Registration Number: ISRCTN34488928., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)