Creating effective nursing partnerships: relating community development to participatory action research

The purpose of this article is to demonstrate the importance of creating effective partnerships between nurses practising community development (CD) and nurses engaged in participatory action research (PAR). To that end, an overview of the theoretical principles of CD and PAR is provided and the central tenets of each methodology explored. This is followed by a discussion of the similarities and differences inherent in CD and PAR which derive from the same theoretical and philosophical foundation; that of critical social theory. Examples of two research projects highlight the relationship between CD and PAR and demonstrate the value of creating effective practitioner/researcher partnerships. Finally, some of the lessons learned in creating these important partnerships will be presented. Although this call for practitioner/researcher alliance is not new, what is new is the central role the practising nurse could take in research. Creating partnerships between practising nurses and nurse researchers advances the opportunity to actualize responsive and effective PAR and to fulfill nursing's social contract.     

The value of participatory action research in clinical nursing practice

This paper demonstrates the value of participatory action research (PAR) and promotes its use by nurses in clinical practice. PAR has gained popularity in nursing and health-care research, offering a way of developing practice-based knowledge that can improve nursing care. PAR is described in detail: what PAR is, how to use PAR in clinical practice, and the steps in the PAR cycle as applied during an exemplar study in which nurses used PAR to address their concerns and develop, implement and evaluate a model of care in an acute medical ward. The authors advocate PAR as a collaborative means to improve the nursing care for patients in varied clinical practice settings.     

Ethical issues in participatory action research

The purpose of this article is to describe the ethical issues arising out of participatory action research (PAR), on the basis of both an empirical study and the research literature, and to discuss how to deal with these issues. The data consist of the experiences and results of three phases of PAR relating to orthopaedic patients with rheumatoid arthritis (RA) and the analysis of 20 articles on the ethics of action research. As a result, the following ethical issues and the ways to treat them were discussed: informed consent, confidentiality and anonymity, protecting an individual from harm, the role of the researcher, the location of 'power' in PAR, and the ownership of the research. The flexibility of PAR in use and its main features are also related to the decisions made and actions taken in response to ethical issues. It is particularly important in PAR to proceed according to the participants, and to involve them from the beginning of the process, in order to insure the equal balance of power between participants and researcher.     

Using participatory action research to foster nurse leadership in Australian rural hospitals

This paper outlines the processes and results of a participatory action research study undertaken to identify issues that may impact on strategies to foster nurse leadership in rural hospitals. Five Directors of Nursing from rural regions of Victoria, Australia participated. The group activities involved discussion and analysis of previous research, a review of current literature and critical reflection of the leadership performance of their organization. The analysis identified five key themes; dispel the myths, adopt big‐picture thinking, connect with colleagues, reflect on your own conduct, and create organizational buy‐in. It is essential to have an awareness of contextual challenges, an understanding of the importance of your own conduct as a visible leader, and the need for effective communication to inform the development of strategies that may be used to foster nurse leadership in rural hospitals. The platform to discuss and critically analyze leadership saw a group consensus that affirmed the need for any approach to nursing leadership to be tailored to the individual healthcare organization.     

Significant elements of community involvement in participatory action research: evidence from a community project

Significant elements of community involvement in participatory action research: evidence from a community project ¶Participatory action research (PAR) has been heralded as an important research methodology to address issues of research relevance, community involvement, democracy, emancipation and liberation. Increasingly, nurse researchers are turning to PAR as a method of choice. Although nursing interest in PAR is expanding little is known about how to successfully involve the community in research. This article attends to this dearth of information by presenting the results of a study investigating the significant elements of community involvement in PAR. Through the use of qualitative research methods, five themes emerged that describe the community participation process: (a) planning for participation, (b) the structural components of community participation, (c) living the philosophy, (d) enhancing the credibility, and (e) the type of leadership required to facilitate community participation. It is hoped that by sharing these results others may consider the knowledge gleaned from this project as they plan and proceed with the challenges and rewards inherent in PAR.     

Tackling perinatal loss, a participatory action research approach: research protocol

pastor-montero s.m., romero-sánchez j.m., paramio-cuevas j.c., hueso-montoro c., paloma-castro o., lillo-crespo m., castro-yuste c., toledano-losa a.c., carnicer-fuentes c., ortegón-gallego j.a. & frandsen a.j. (2012) Tackling perinatal loss, a participatory action research approach: research protocol. Journal of Advanced Nursing68(11), 2578-2585. ABSTRACT: Aim. The aim of this study was to promote changes to improve the care provided to parents who have experienced a perinatal loss through participatory action research. Background. The birth of a child is a joyful event for most families, however, unfortunately some pregnancies end in loss. Perinatal loss creates a heavy emotional impact not only on parents but also on health professionals, where in most cases there is an evident lack of skills, strategies and resources to cope with these kinds of situations. Design. Participatory action research is the methodology proposed to achieve the purpose of this study. Methods. Participatory action research consists of five stages: outreach and awareness, induction, interaction, implementation and systematization. The working group will include professionals from the Mother and Child Unit for patients at a tertiary level public hospital in Spain. The duration of the study will be 3?years since the approval of the protocol in January 2011. The qualitative techniques used will include group dynamics such as the SWOT analysis the nominal group technique, focus groups and brainstorming, among others that will be recorded and transcribed, generating reports throughout the evolution of the group sessions and about the consensus reached. Content analysis will be conducted on the field diaries kept by the participants and researchers. This project has been funded by the Andalusian Regional Ministry of Health. Discussion. Participatory action research is a methodological strategy that allows changes in clinical practice to conduct a comprehensive transformative action in the care process for perinatal loss.     

Advanced clinical roles: investigating dilemmas and changing practice through action research

Summary

• ? A new career structure for clinical nurses was implemented in 1987 in Victoria with the intention of providing clinical advancement and material rewards for nurses in clinical settings.
• ? This paper explains how participatory action research was used to explore some of the issues inherent in the role of the associate charge nurse.
• ? The clinical/management tension and the role expectations formed within the taken-for-granted rituals and routines of the ward and the hospital managerial structure are examined.

     

The implementation of intentional rounding using participatory action research

‘Intentional'/‘hourly rounding’ is defined as regular checks of individual patients carried out by health professionals at set intervals rather than a response to a summons via a call bell. Intentional rounding places patients at the heart of the ward routine including the acknowledgement of patient preferences and in anticipation of their needs. The aim of this study was to implement intentional rounding using participatory action research to increase patient care, increase staff productivity and the satisfaction of care provision from both patients and staff. Outcomes of the study revealed a drop in call bell use, no observable threats to patient safety, nursing staff and patient satisfaction with care provision. However, any future studies should consider staff skill mix issues including the needs of newly graduated nursing staff as well as the cognitive status of patients when implementing intentional rounding on acute care wards.     

Feminist-informed participatory action research: a methodology of choice for examining critical nursing issues

Identifying a methodology to guide a study that aims to enhance service delivery can be challenging. Participatory action research offers a solution to this challenge as it both informs and is informed by critical social theory. In addition, using a feminist lens helps acquiesce this approach as a suitable methodology for changing practice. This methodology embraces empowerment self-determination and the facilitation of agreed change as central tenets that guide the research process. Encouraged by the work of Foucault, Friere, Habermas, and Maguire, this paper explicates the philosophical assumptions underpinning critical social theory and outlines how feminist influences are complimentary in exploring the processes and applications of nursing research that seeks to embrace change.     

Community-based participatory nursing research: A culturally focused case study

This article provides highlights of a lecture, titled Community-based Participatory Research: A Culturally Focused Case Study , given at the Japan Academy of Nursing Science's 29th annual meeting in Chiba, Japan on 28 November 2009. Community-based participatory research (CBPR) is defined as research that includes both the researcher and the participant group in collaborative, egalitarian, and partnership processes to assess, define, problem-solve, evaluate, and disseminate an issue that is chosen by the stakeholders. A CBPR framework is highlighted and case-study examples from each stage are included. The barriers and facilitators for communities and researchers taking part in CBPR projects are described. Strategies to improve researcher competence in CBPR are listed. Community-based participatory research can be very fulfilling when incorporated into a faculty member's teaching, research, and service to the community.     

Practical suggestions for community interventions using participatory action research

Advanced practice nurses and nurse researchers with experience in clinical settings may encounter challenges in the initial development and implementation of community-based projects. Participatory action research methodology, a user-friendly framework for community-based research activities, provides a way for researchers and community members to work together to define a problem, take action, and evaluate their work. This article attempts to bridge the theory-implementation gap by describing background steps that researchers can use when conceptualizing and initiating a research project with community partners. Suggestions for initial steps and the planning and review cycles are presented, along with examples from the literature.     

参与式教学法在护理本科生科研训练中应用效果评价

目的：评价参与式教学法在护理本科生科研训练中的应用效果。方法：选择2011届和2012届在北京市某医科大学附属临床医学院参加科研训练的护理本科生作为研究对象。201l届为对照组,采用目前“双导师”科研训练模式;2012届为干预组,在“双导师”科研训练模式中采用参与式教学法。采用问卷调查和半结构式访谈法评价干预效果。结果：①干预组研究对象科研知识、态度得分均在干预后呈现出明显的升高趋势,与对照组比较差异具有统计学意义（P〈0．05）。②对10名干预组研究对象进行半结构式访谈,得到三个主题：参与式教学法在一定程度上调动了本科生参与科研训练的主动性,参与式教学法可提升本科生在科研训练过程中的团队协作精神;护理本科生应尽早开始护理科研培训。结论：参与式教学法可在一定程度上弥补传统“双导师”制科研教学的不足,可作为护理本科生科研教学的方法。     

Understanding partnerships in developing disabled entrepreneurs through participatory action research

Purpose.?The paper reports on a community disability entrepreneurship project in Khayelitsha and Nyanga, Cape Town, South Africa. Disabled people, Disabled People South Africa ( a national organization made up by disabled people's organizations), a non-governmental organisation and occupational therapists from the University of Cape Town collaborated with the focus to achieve economic empowerment of disabled people though the establishment of micro-enterprises.

Method.?Participatory Action Research strategies, which informed and monitored the effective development of the community disability entrepreneurship project, were carefully integrated with the existing principles of community development.

Results.?The participatory action research process provided an opportunity for shared learning and development. This article reports on the challenges and strategies faced by disabled people in the quest to establish themselves as entrepreneurs. The challenges that were identified through analysis from the experiences of participants were starting with nothing, lack of capacity and complexity of establishing working relationships. The strategies used were building group identity and developing capacity together. Indicators of positive outcome that emerged from an inductive content analysis are presented and discussed.     

Understanding partnerships in developing disabled entrepreneurs through participatory action research

Purpose. The paper reports on a community disability entrepreneurship project in Khayelitsha and Nyanga, Cape Town, South Africa. Disabled people, Disabled People South Africa ( a national organization made up by disabled people's organizations), a non-governmental organisation and occupational therapists from the University of Cape Town collaborated with the focus to achieve economic empowerment of disabled people though the establishment of micro-enterprises.

Method. Participatory Action Research strategies, which informed and monitored the effective development of the community disability entrepreneurship project, were carefully integrated with the existing principles of community development.

Results. The participatory action research process provided an opportunity for shared learning and development. This article reports on the challenges and strategies faced by disabled people in the quest to establish themselves as entrepreneurs. The challenges that were identified through analysis from the experiences of participants were starting with nothing, lack of capacity and complexity of establishing working relationships. The strategies used were building group identity and developing capacity together. Indicators of positive outcome that emerged from an inductive content analysis are presented and discussed.     

Participatory action research and photovoice in a psychiatric nursing/clubhouse collaboration exploring recovery narrative

ACCESSIBLE SUMMARY: ? Personal stories about recovery in mental health are important sources of knowledge. ? Research methods are needed for exploring personal stories of recovery which honour and empower the authors of recovery stories. ? The Clubhouse of Winnipeg and an assistant professor in psychiatric nursing piloted a research project using photography in order to explore, document and share Clubhouse Member stories of recovery. ABSTRACT: The Clubhouse of Winnipeg (a community psychosocial rehabilitation centre) collaborated with a psychiatric nursing assistant professor on a participatory action research (PAR) project exploring the concept of recovery using a using a research method called photovoice. The collaborative project -Our Photos Our Voices- demonstrates how PAR and photovoice are well suited for collaborative research in mental health which honours principles underlying consumer empowerment and recovery. The foundation of empowerment is the power to act on one's behalf; PAR and photovoice support the full participation of concerned individuals in all aspects of research with the ultimate goal of action to solve problems or to meet goals identified by those individuals. Empowerment is also the ability to lay claim to one's own truth. At the core of the recovery model is the principle that recovery is defined by the individual and based on individual determinations of meaningful goals and a meaningful life. The Our Photos Our Voices project uses PAR and photovoice to effectively access, explore, document and share personal, local knowledge about recovery grounded in the personal experience of the Clubhouse researchers.     

Enhancing lives through the development of a community-based participatory action research programme

A community-based participatory action research (PAR) programme that has spanned 5 years is discussed in this article. A primary healthcare philosophy requires research in this practice setting and supports the way healthcare is ideally organized within an integrated team and supported by a community network that includes not only the healthcare workers and service providers but also the community as partners. The principles driving three PAR inquiries are described: the development of a model for prevention of workplace violence; working with clinicians towards improving wound management practice; and management of continence for community-dwelling women living with multiple sclerosis. Participatory action research is a potentially democratic process that is equitable and liberating as participants construct meaning in the process of group discussions. We conclude that the cyclical processes inherent in PAR promote reflection and reconstruction of experiences that can lead to the enhancement of people's lives, either at an individual or community level, or both.