Background: Narratives have the potential to promote person-centred practice, yet few studies have been undertaken on the impact of a narrative approach on learning for care professionals or students. With this in mind, we co-designed an educational programme on the use of older persons’ narratives for professionals in research, education and nursing. Aims: To investigate the impact of attending a narrative educational programme on the learning of nursing and healthcare assistant students, and on their person-centred practice. We also examined what factors characterised and influenced this learning. Methods: This was a mixed-methods evaluation study. We evaluated the impact of a narrative educational programme on third-year healthcare assistant students and second-year nursing students. Students were invited to complete a survey before and after the educational programme. After the programme, we performed interviews with all the educators and some of the students. Results: Students’ learning from the narratives was varied, and there were differences in the extent to which the programme raised awareness. Some students demonstrated new understandings, actions and behaviours. Students self-reported that they had experienced learning related to 12 learning outcomes and to their person-centred practice. According to educators and students, this learning was experiential and reflective, and was influenced by the students’ level of participation, personal characteristics and openness to other perspectives, as well as the educators’ guidance and the workplace conditions. Conclusion: This study shows that the educational programme ‘Tell Me! Learning From Narratives’ can contribute to the learning of healthcare assistant and nursing students in terms of their understanding of the field of narrative inquiry as well as the development of their person-centred practice. Providing support for educators is a prerequisite for the programme to work. Implications for practice: The programme has the potential to contribute to a person-centred care curriculum Self-evaluation, for example via the self-scan person-centred care survey in this study, prompts awareness in students Educators should be supported in their use of a narrative approach, person-centred care values and didactic skills Educators should reflect the values of person-centred care in their practice and in their relationships with students as role models
Background: Intimacy and sexuality are essential aspects of quality of life for older adults in long-term care. Numerous tools and interventions are available to support healthcare professionals in their conversations about intimacy and sexuality but they are often unfamiliar with these, or do not know when or how to use them. Aim: To develop a tool to help healthcare professionals choose from existing interventions to facilitate conversations with older adults on the subject of intimacy and sexuality. Methods: A design study, comprising five substudies and 16 workshops, was carried out in inpatient and outpatient settings for older adults. Participants were healthcare and design professionals, older adults and their relatives, undergraduate students and researchers. Data collection and analysis took place in several iterations, with insights from one phase guiding the design of the next. Findings: A paper brochure and a digital knowledge programme (IntiME) was developed to inform the selection of interventions and tools to initiate conversations about intimacy and sexuality with older adults. Initial experiences with IntiME suggest it can support healthcare professionals in this area. Conclusions: The IntiME tool has the potential to improve person-centred care around intimacy and sexuality by matching the personal characteristics of healthcare professionals and older adults with available interventions and tools. Further research into experiences with the use of IntiME is warranted. Implications for practice: IntiME has the potential to improve person-centred care by matching the personal characteristics of staff and older adults with available interventions and tools Co-creation with older adults and staff plays an important part in designing tools for person-centred care Using IntiME may help staff become more aware of their own needs and thereby enhance competence in conversations about intimacy and sexuality
Background: This article shares the reflection journey of a newly formed workplace wellness team, whose members documented their experience throughout an eight-week project using reflective journaling. Reflection was seen as a valuable tool for developing greater self-awareness and insight into team dynamics. Sharing reflections among the team also served to strengthen bonds and provided a chance to discuss challenges that were faced. Aim: To demonstrate the importance of promoting and prioritising the practice of reflection amid the high workload intensity of a busy healthcare environment. Conclusion: A diverse group of healthcare workers was able to identify the value of dedicated worktime for reflection while meeting the demands of project targets and tight time frames. Implications for practice: Personal and team reflective practice offers teambuilding opportunities for newly formed teams along with time for confidence building, self-improvement and connecting with others Timely documentation of these reflections can give immediate insight into challenges individuals or the entire team may be experiencing, thus allowing prompt response and adjustments, in addition to creating a record for personal and team learnings over time To ensure engagement in, and sustainability of, wellness-oriented reflective practice, both bottom-up and top-down commitment is required
This paper is derived from research I undertook as a part of my honours degree in nursing. My research produced a thesis that examined person-centred care in Australian residential aged-care settings. The idea for this came from my 15 years’ experience as an aged-care nurse and questions arising from my lived experience of person-centred care not being a reality for residents, families and staff despite being widely espoused in the aged-care sector. The sector in Australia is undergoing a system redesign, with proposals for a new Aged Care Act put forward this year by the Royal Commission into Aged Care Quality and Safety (RCACQS, 2021) after a review of the aged-care system between 2018 and 2021. The review looked into the prevalence of elder abuse and estimated that almost 40% of residents may have experienced emotional, physical or neglectful abuse (RCACQS, 2020a). Person-centred care could be an important concept to establish in Australian residential aged care in order to tackle the experience of abuse and embed high-quality, safe services.
When thinking about the subject for this editorial, we found it hard to look beyond the current context of health and care and the continuous challenges faced by those striving to develop person-centred cultures, to enable the best outcomes and experiences for all. Through our work with clinically based practitioners, we have both noticed a concerning downward turn, with increasing reports of staff fatigue and ill health, workforce shortages and frequent changes in management, all at a time of growing levels of patient need. A perfect storm! As I (Kate) prepared a presentation recently, I found myself thinking about the story of Hans, a small boy who found a leak in a dike and used his finger to plug the hole and save his town from a potential deluge of water. This reminded me of a recent supervision session, when I used the metaphor of a dam to help someone to explore the pressure they were experiencing. What was contributing to the force of water? What, if any, were the sources of water that were in their control to divert before they reached the dam? What was the nature of the bricks the dam was built from? How could the bricks be supported and strengthened? Where could more bricks be found? But holding back the water is not in the gift of one individual. We need to share the load and work collaboratively to understand what is important and what matters to people (patients and staff), to prioritise where we put our efforts and energy. We also need to be innovative and creative, to explore what is possible, to enable people to be the best that they can be, and to offer hope and joy at a time when it is in short supply. And so, what is encouraging, as we share this issue of the International Practice Development Journal with you, are the many ways in which the authors are doing just that.
