Person-Centred Practice in Nursing and Health Care: Theory and Practice by

Language: eng
Format: azw3
ISBN: 9781118990582
Publisher: Wiley
Published: 2016-07-19T16:00:00+00:00

Conclusion

I argue that AAR is an appropriate methodology for exploring and developing person-centred cultures. It offers a significantly different approach to the necessary transformation of health and social care that goes through the ‘front door of enthusiasm’ (Ludema et al. 2001, p. 191).

Evidence from practice suggests these tools have been helpful, particularly in relation to enhancing relationships and achieving positive person-centred outcomes for those involved. The caring conversations framework and the practice tools developed go some way in helping to support others in the craftful application of the principles of AAR into practice, and may aid the implementation of the Person-centred Nursing framework (McCormack & McCance 2010).

Appreciative caring conversations promote appreciation and affirmation, which, in turn, provoke generative inquiry into existing ways of thinking and acting. By noticing the best of what already exists and bringing that to more collective awareness they enable innovation that feels ‘doable’ and hopeful. They don't impose solutions from elsewhere but help to share responsibility for development and change, strengthening collaboration amongst staff and between staff, patients or residents and their relatives. They provide feedback and actionable new knowledge about what matters to people, whether they are managers, staff, patients or relatives. The practice tools can only be enacted in relationship: their effectiveness rests on the qualities of genuine inquiry, empathy and authenticity that cannot be mandated or ‘rolled-out’ but that must be nurtured at all levels in health and social care.

Appreciative action research must include methods that are appreciative and provocative: build on what is working well; support people to have the courage to challenge dominant ideologies; and be confident and curious to really explore what matters to those who give and receive care. The glue that enables the above to happen is caring conversations. We suggest that it is through using a framework for caring conversations more deliberately, that innovation can be realised.

We need to use the framework of caring conversations in appreciative action research to enable us to foreground the practices of affirmation, provocation, inquiry and collaboration as core elements that enhance a more hopeful and improvisational approach to innovation in health and social care. This is the ‘how’ of the necessary cultural transformation of public service reform.

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