Faculty of Life and Health Sciences, Institute of Nursing and Health Research, Ulster University, Jordanstown, UK.
Faculty of Life and Health Sciences, Ulster University, Jordanstown, UK.
J Clin Nurs. 2018 Jan;27(1-2):427-440. doi: 10.1111/jocn.13949. Epub 2017 Aug 31.
To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes.
Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical basis of the action research study described in this article.
This was a complex action research study using the following multiple methods: nonparticipatory observation using the Workplace Culture Critical Analysis Tool (n = 30); critical and reflective dialogues with participants (n = 39) at time 1 (beginning of study), time 2 (end of study) and time 3 (6 months after study had ended); narratives from residents at time 1 and time 2 (n = 8); focus groups with staff at time 2 (n = 12) and reflective field notes. Different approaches to analyse the data were adopted for the different data sources, and the overall results of the thematic analysis were brought together using cognitive mapping.
The Person-Centred Situational Leadership Framework captures seven core attributes of the leader that facilitate person-centredness in others: relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust.
This study led to a theoretical contribution in relation to the Person-Centred Practice Framework. It makes an important key contribution internationally to the gap in knowledge about leadership in residential care facilities for older people.
The findings can be seen to have significant applicability internationally, across other care settings and contexts.
实施并评估使用以人为中心的情境领导框架在养老院中发展以人为中心的护理的效果。
近年来,国际上已经开发出许多护理领导模式,但不符合新兴的养老院护理复杂哲学。本研究开发了以人为中心的情境领导框架,支持这种哲学。它构成了本文所述行动研究的理论基础。
这是一项复杂的行动研究,使用了以下多种方法:使用工作场所文化关键分析工具(n=30)进行非参与式观察;在第一时间(研究开始时)、第二时间(研究结束时)和第三时间(研究结束后 6 个月)与参与者(n=39)进行批判性和反思性对话;在第一时间和第二时间(n=8)从居民那里获取叙事;在第二时间(n=12)与工作人员进行焦点小组讨论,并记录反思性实地笔记。对于不同的数据源,采用了不同的方法来分析数据,并且使用认知映射将主题分析的总体结果结合在一起。
以人为中心的情境领导框架捕捉到了领导者的七个核心属性,这些属性有助于在他人中实现以人为中心:与存在的本质相关;使行动与愿景协调一致;平衡对合规性的关注与对以人为中心的关注;在当下与他人建立联系;有意激发他人行动;用心倾听他人;通过协作、欣赏和信任实现统一。
本研究在以人为中心的实践框架方面做出了理论贡献。它在国际上对老年人居住护理设施领导力知识差距做出了重要的关键贡献。
这些发现可以被视为在国际上具有重要的适用性,适用于其他护理环境和背景。