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Fundamentals of Person-Centred Healthcare Practice


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       Donna Brown1 and Savina Tropea2

       1 Ulster University, Northern Ireland, UK

       2 Queen Margaret University, Edinburgh, Scotland, UK

      Contents

        Introduction

        Understanding and defining self: different perspectives

        Different aspects of self

        The journey through ‘knowing self’: tools and approaches

        The importance of self‐knowledge for developing healthful cultures

        Using reflection to know self

        Creating the conditions to know self and others

        Conclusion

        Summary

        References

       Gain some understanding of the different perspectives of self.

       Determine how the choices we make impact upon our professional and personal self and vice versa.

       Refine our personal self‐awareness

Schematic illustration of the definition of knowing self.

      This chapter will primarily focus on the prerequisite of knowing self. It will also consider the importance of knowing self in relation to the care environment and to the person‐centred processes. We will explore the value of knowing self, as a person, and consider ways in which we can become more aware of self, of how this awareness impacts on working relationships between colleagues and the person using health services.

      In the Person‐centred Practice Framework, knowing self is defined as the way a person makes sense of their knowing, being and becoming through reflection, self‐awareness and engagement with others. This definition will guide our thinking as we work through this chapter. Within this perspective, self is not viewed as something fixed. As persons, we are on a constant journey of learning to ‘find and re‐fine oneself’ (Dworkin 1991, p. 32). With the goal of self‐development, we engage with lifelong learning and professional growth, through developing self‐awareness and engaging in self‐reflection.

      Experiential perspectives focus on self as an independent and private entity, and on subjective experience. We experience the world and life from a certain point of view, through the lens of our own self. To be a person means to be aware of these experiences (of our thoughts and feelings, for example) and to be aware of being aware. It also means to be able to reflect on our thoughts and actions, to consider different alternatives and the possibility of change. On the other hand, social constructionist perspectives originating from sociology and social sciences view reality and self as socially constructed, as created through the interaction of individuals and groups in the social context. As we grow, social relationships and interactions with others (as well as language and culture) continue to shape who we are and contribute to our ways of thinking and feeling. Furthermore, there are narrative accounts of self, highlighting that selves are agents. Actions take place in time and we can make sense of them when placed within a coherent narrative or life story (temporal and social dimension of self) (Stevens 2002; Zahavi 2014).

      There are also realist perspectives of self. These are embraced by various empirical scientists from the areas of psychology, psychiatry and neuroscience, who utilise an experimental approach to the investigation of self, trying to identify measurable variables, to find out the rules that could explain psychological phenomena and the way we behave. As to the biological perspectives of self, these