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Philosophical stance underpinning an PAR into leading the development of person-centred care

Philosophical stance underpinning an PAR into leading the development of person-centred care. Shaun Cardiff Fontys University of Applied Sciences (NL) Ulster University (UK). WHY?.

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Philosophical stance underpinning an PAR into leading the development of person-centred care

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  1. Philosophical stance underpinning an PAR into leading the development of person-centred care Shaun Cardiff Fontys University of Applied Sciences (NL) Ulster University (UK)

  2. WHY? Explicating the philosophical stance contributes to the ontological and epistemological authenticity of the study (Titchen and Higgs, 2007) and helps the reader follow and assess rigour of decisions made during the study.

  3. PCN framework (McCormack & McCance, 2006) Leadership: Transformational? (Bass & Riggio, 2006) Person-centred? (Plas & Lewin,2001) PC culture Effective workplace Culture (Manley et al, unpublished) Background How can person-centred leadership be developed on a nursing unit? How can person-centred care be developed on a nursing unit?

  4. AIMS

  5. Critical Realism Realist ontology + Relativist epistomology Intransitivity – “what we percieve is not necessarily all that there is” • Intransitive – the ‘what is’ • Transitive – the ‘what we can know’

  6. 13th:74pts Philosophy - what do you believe in?

  7. Stratification – “what we can percieve emerges from what is” ❇ Empirical layer – perceivable ⇪ Actual layer – events • Real layer – generative mechanisms

  8. Tulips from .. Generative mechanisms -> Germination -> Tulips Mechanisms can be: unexercised; exercised but not actualised or counteracted; exercised actualised but not perceived; exercised actualised and perceived by humans

  9. Social structures, conventions & practices Human activity Transformational model of society Mind independance (not people independance) Existential relationship (not causal) Reproduction/Transformation

  10. Fay (1987) Humans are: • active- • embedded- • embodied- • historical- • traditional-beings Enlightenment – know that ↓ Empowerment – know how ↓ Emancipation - transform Enabling / Limiting

  11. Application • Units A&B, high turnover of staff. • ‘B’ not perceive the reality (intransitive), nothing changes (reproduction). Apathy has a long history on the unit, is embedded and embodied • ‘A’ perceives (transitive) investigates mechanisms (enlightenment) intends & attends to change (empowered) transform & continuously readdress culture (emancipation)

  12. Knowledge • Knowing that • Knowing how • Knowing what it is like Surfacing knowledge only via (traditional) cognitive verbal communication limits the type of knowledge exposed. Using creative expression enables the surfacing of pre-conscious & embodied knowledges Rational & cognitive Rational & cognitive and/or pre-conscious & embodied

  13. Generation Creating communicative spaces where: • Personal knowledges are shared (creatively) • Reflection, critique, contestation takes place • Intersubjective agreements, mutual understandings and unforced consensus about what to do • Co-constructing new knowledge & ‘plausible’ explanations

  14. So, is this all just a fairytale ?????

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