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'Person-centredness' is a term that is becoming increasingly familiar within health and social care at a global level; it is being used to describe a standard of care that ensures the patient/client is at the centre of care delivery. In this article we explore the relevance of person-centredness in the context of nursing, taking account of the ongoing critical debate and dialogue regarding developments in this field. Person-centredness is recognised as a multidimensional concept. The complexity of the concept contributes to the challenge of articulating its shared meaning and describing how it can be applied in practice. The aim of this paper is to explore some of the issues pertaining to language and conceptual clarity, with a view to making connections and increasing our shared understanding of person-centred care in a way that can impact nursing practice. We begin by describing the development of the concept of person-centredness, after which we discuss the synergies with patient-centredness and other related terms, and consider how nurses can operationalise person-centredness in their practice.

Developing person-centred care is not a one-time event; rather it requires a sustained commitment from organisations to the ongoing facilitation of developments, a commitment both in clinical teams and across organizations. Contextual factors pose the greatest challenge to person-centredness and the development of cultures that can sustain person-centred care. We will begin with a general comment on 'context' and its meaning before exploring three particular factors that influence the practice context, namely, workplace culture, learning culture, and the physical environment. Next we explore a particular approach to developing person-centred care through emancipatory practice development. We highlight the importance of facilitation through emancipatory practice development programmes and describe how person-centred care can be developed through the presentation of a case study that illustrates the principles and processes of emancipatory practice development as well as the outcomes achieved. We conclude with an application to clinical practice. A key consideration for all organisations in the development of person-centred care is to move from what we suggest are 'person-centred moments' (individual, ad hoc experiences of person-centredness) to 'person-centred care' as an underpinning culture of teams and organisations.

From MDPI via Jisc Publications Router ; Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory. ; 19 ; pub ; pub ; 4

Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory.

The focus of this special issue is some of the main tacit policies and practices in the Norwegian welfare state. By looking at what is tacit, mute, unarticulated and neglected we will contribute to raising and presenting knowledge about the social and ethical question of dignity in welfare. This introductory article will first give a short overview of the historical background of the Norwegian welfare state and some of its current features. This will be followed by our positioning of the Norwegian welfare state as situated within complex practices, political discourses and dimensions that might be characterised as tacit, implicit or unarticulated. The article aims to discuss the concept of dignity in welfare services, at the individual and structural level, by asking 'what kind of practices and structural conditions preserve dignity and where might dignity be violated, ignored or left out?' The various articles in this special issue of the International Practice Development Journal illuminate what can be said and what is mute and tacit in different ways, and consider a range of practice-based responses. By revealing tacit dimensions in the Norwegian welfare this issue offers important insight into practices and discourses where dignity is at stake. It is a requirement of us all that we revisit dignity and its location and representation in our health systems to ensure it is not left behind as the state and other systems within it evolve. ; publishedVersion

The focus of this special issue is some of the main tacit policies and practices in the Norwegian welfare state. By looking at what is tacit, mute, unarticulated and neglected we will contribute to raising and presenting knowledge about the social and ethical question of dignity in welfare. This introductory article will first give a short overview of the historical background of the Norwegian welfare state and some of its current features. This will be followed by our positioning of the Norwegian welfare state as situated within complex practices, political discourses and dimensions that might be characterised as tacit, implicit or unarticulated. The article aims to discuss the concept of dignity in welfare services, at the individual and structural level, by asking 'what kind of practices and structural conditions preserve dignity and where might dignity be violated, ignored or left out?'The various articles in this special issue of the International Practice Development Journal illuminate what can be said and what is mute and tacit in different ways, and consider a range of practice-based responses. By revealing tacit dimensions in the Norwegian welfare this issue offers important insight into practices and discourses where dignity is at stake. It is a requirement of us all that we revisit dignity and its location and representation in our health systems to ensure it is not left behind as the state and other systems within it evolve. ; publishedVersion