This study involves listening to illness narratives embedded in in-depth life review processes. The method of multiple interview and multi-modal analysis and reflective responding utilised in the study aims to add to the existing field of research by expanding the understanding of what it is like to be heard or not heard, for people who are either patients, or family members. The study also aims to demonstrate how self-aware ,compassionate and reflective listening, particularly in healthcare relationships, can allow meaning to emerge from within the illness experience, thus enriching the wellbeing of patients, family members and their various healthcare professionals. / Stories of disruption arising within healthcare settings often confronted me during more than forty years of nursing experience and also resonated within my personal experiences. These stories express a gulf between patients, family members, or residents in healthcare institutions, and the healthcare organization and its staff. A recurring theme was that these people felt that they had not been listened to by those they trusted to give them care, with a lasting sense of disruption to their wellbeing. In focusing on the dimensions of reflective listening and intersubjective responding, the implications of being heard on the well being of both narrator and listener can be elucidated. An objective of the research became to articulate the attributes and values of compassionate, reflective listening and elucidate the complex nature of the narrating and listening relationship. (For complete abstract open document)

This study involves listening to illness narratives embedded in in-depth life review processes. The method of multiple interview and multi-modal analysis and reflective responding utilised in the study aims to add to the existing field of research by expanding the understanding of what it is like to be heard or not heard, for people who are either patients, or family members. The study also aims to demonstrate how self-aware ,compassionate and reflective listening, particularly in healthcare relationships, can allow meaning to emerge from within the illness experience, thus enriching the wellbeing of patients, family members and their various healthcare professionals. / Stories of disruption arising within healthcare settings often confronted me during more than forty years of nursing experience and also resonated within my personal experiences. These stories express a gulf between patients, family members, or residents in healthcare institutions, and the healthcare organization and its staff. A recurring theme was that these people felt that they had not been listened to by those they trusted to give them care, with a lasting sense of disruption to their wellbeing. In focusing on the dimensions of reflective listening and intersubjective responding, the implications of being heard on the well being of both narrator and listener can be elucidated. An objective of the research became to articulate the attributes and values of compassionate, reflective listening and elucidate the complex nature of the narrating and listening relationship. (For complete abstract open document)

Collaborative care is a philosophy which guides the work of interdisciplinary teams and patients and their families internationally. It has been demonstrated to improve quality of care, safety, and patient and staff satisfaction, yet applying this philosophy still requires much investigation. This thesis describes processes of change directed towards a vision to enhance collaborative care relationships with patients and families within one hospital site of a non-acute academic health science centre in Ontario, Canada. By building focused conversations around existing patient and family centred education and using an initial conceptual framework of customer service, healthcare providers, mid- and senior level leaders shared their perspectives, negotiated meanings and created innovations to enhance collaborative relationships within the organization. Based within the critical paradigm, a critical collaborative ethnography was constructed with the use of sequential and mixed research methodologies. The ethnography evolved over three phases in a step-wise and additive design during the three year period of study. Phase 1 examined the perspectives of healthcare providers in an exploratory case study which contributed to mid-level leaders’ discussions in Phase 2. Cumulative findings from Phases 1 and 2 were brought to discussions with senior leaders in Phase 3. Members of a participative action research team assisted with research design and study processes. Shared meanings and innovative change ideas were developed and captured through the use of semi-structured focus groups and interviews, survey, participant observation and inductive analysis. A conceptual framework of ‘partners-in-care’ emerged and was used to assist participants to make sense of the values and factors important in their work with respect to collaborative relationships. The research processes facilitated the development of many innovations to enhance collaborative practice within the hospital. The organization was described by the research as undergoing directed change to enhance collaborative care as evidenced through participant self-reports, observed initiatives and the ethnographic descriptions. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-06-25 15:06:24.687