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Fundamentals of Person-Centred Healthcare Practice


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rel="nofollow" href="#u78e34f61-3710-5041-8b5a-c111acb431c7">Chapter 8), interpersonal skills (see Chapter 10), and awareness of the strong emotions that might arise. To manage these situations and respond effectively, it can be helpful to be aware of those topics and behaviours that might trigger in us strong or negative emotional responses (Masterson 2007, p. 30).

      When we feel that our personal self has been attacked (our ‘buttons’ have been pushed), processes are triggered through the amygdala to protect ourselves by rushing into action (fight‐or‐flight response) (Goleman 1996; Bruno 2011). To maintain professionalism in these situations, it is important to ‘cool down’. Emotional intelligence (see Chapter 10) helps us in this process. By acknowledging and listening to what our feelings are telling us and managing them more effectively to aid our logical thinking, we can regain perspective (through activation of the orbitofrontal cortex) (Goleman 1996; Bruno 2011).

       Look for alternative ways of explaining a situation (i.e. reframing a discussion).

       Exchange negative thoughts for positive ones (i.e. use of thoughts and phrases that can help to shift the focus to something positive or pleasant).

       Observe thoughts and feelings from a distance (i.e. practice of mindfulness).

      Developing self‐awareness allows us to know ourselves better, to help make self‐regulation possible (to modify our behaviour, choose how to respond to a situation rather than following possible temptations) and to experience greater consistency between the way we behave and our attitudes. To become self‐aware, we need to reflect on what we experience when we focus, for example, on our sensations, perceptions, emotions, thoughts, attitudes, preferences and intentions (Morin 2011). Reflection is therefore a central skill in the development of self‐awareness.

      Reflection and self‐awareness are key to knowing self in order to further develop who we are as persons and as professionals. By reflecting on our actions and critically relating to them, we become aware of why we act in certain ways and introduce the potential for learning and change (see Chapter 29). Through reflection, for example, we can work on reconciling the ideal professional self and the actual professional self, the desired practice and the actual practice (Freshwater 2002).

      Activity

      Reflect on and write down an example of a time in your practice when the care you were providing was not consistent with those desired by the other person. For example, the person did not want to drink the nutrition supplement, try a particular exercise, take medication or vaccinate their baby. What did you do?

      This activity may be deeply challenging but has the potential to help you ask yourself difficult questions in order to consider your future behaviours. To develop deep questioning skills, explore the following.

       Did I live out person‐centred values?

       Which element(s) of the Person‐centred Practice Framework does this map to?

       What organisational pressures obstructed my perception?

       How could my actions have been perceived by others?

       What (if anything) do I need to change to become more person‐centred in my practice?

       What is the research evidence on the topic?

      Critical reflective practice, whether on an individual level or within groups, is essential to enabling persons who provide healthcare to gain insight into self, the care environment and how these entwine with their practice and the care they deliver (person‐centred processes). Reflection encompasses asking challenging questions and being able to live through the discomfort or anxiety of changing deeply held ways of being (Bolton 2014). As heightened anxiety can be counterproductive to learning, it is imperative that we remain mindful of the need to actively contribute to creating spaces in which it is safe to share thoughts and learn from our experiences (see work of Brown and McCormack 2016).

       What feedback do I want and am I ready to hear it?

       Who do I trust and value to assist me?

       Are they the right person?

       Who can support me as a person?

       Is that different from who supports me in a team?

       What do I need to achieve a positive outcome for all?

      Activity

      Either individually or in a group, reflect on what factors you think are necessary to create the conditions in which to explore knowing self and get to the heart of your practice.

      You are encouraged to contemplate things such as time to reflect, quietness, being open, honest, self‐confidence, ability to think laterally and non‐judgementally about your self and practice. It is easy to be overly critical of our own practice and disappointed in ourselves. It is always good to articulate and work with positive things we have done in practice to affirm values and beliefs and be motivated to acknowledge these to improve our knowledge of self. Perhaps you were thinking of working with others and considered they needed to actively listen, be supportive, generous of self, time and knowledge, approachable, reliable and trustworthy (Heron 1999).

      Throughout this chapter we have explored different perspectives of self and possible interrelations between them. As persons, we are constantly involved in a process of being and becoming. Accepting that we are persons, with our strengths and, most importantly, our vulnerabilities, is essential so that any exploration of self is undertaken in a safe environment, through engaging in reflection and gaining feedback. In this way we can become more self‐aware and find the motivation to consider the choices we make, as these contribute to making us who we are and who we become (see Chapter 29).

       Self is not something static.

       To develop self, we need to critically reflect on our practice to gain insight into the deeply enmeshed relationship between self (prerequisites), the care environment and the person‐centred processes, and how they connect with one another.

       Using different approaches to knowing self is important in helping us to understand ourselves better and engage in person‐centred practice.

      1 Bolton,