Action Research In Health Care Research Articles

Integrating System Dynamics and Action Research: Towards a Consideration of Normative Complexity Comment on "Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research".

Holmström and co-authors argue for the value of integrating system dynamics into action research to deal with increasing complexity in healthcare. We argue that despite merits, the authors overlook the key aspect of normative complexity, which refers to the existence of multiple, often conflicting values that actors in healthcare systems have to pragmatically develop responses to in their daily practices. We argue that a better theoretical and empirical understanding of the multiplicity of values and how actors deal with value conflicts in daily practices can enrich discussions about complexity in healthcare. We introduce the alternative methodology of 'value exnovation' for action researchers to broaden the scope of system-based thinking and action research in healthcare.

The Asset-based Collaborative Working model: pragmatic action research in healthcare

Embedding researchers in clinical practice may not be an obvious consideration in asset-constrained healthcare settings. However, with increasing calls for best practice and value-for-money, understanding what works, for whom and why, is of paramount importance. This article illustrates how a researcher embedded in a healthcare professional group not only facilitated a service development within existing resources, but also enabled the group to identify relevant theories, and their interrelationships, underpinning the group's actions during the developmental process. This resulted in the construction of a new theoretical model, the Asset-based Collaborative Working model. This research suggests that embedding research in service development is feasible and can result in substantive learning and an understanding of group working which is required in contemporary healthcare provision. While developed in the clinical field of lymphoedema, the Asset-based Collaborative-Working model may be applicable in other care settings.

Action research in the healthcare field: a scoping review

This scoping review aimed to explore international literature related to the application of action research in studies in the healthcare context. Action research is an approach that involves collaboration to develop a process through knowledge building and social change. Several viewpoints of action research have been introduced as the different traditions of developed action research. To develop a coherent process, researchers have to posit their worldviews and theoretical framework and align these with the research aims and procedures, and local transformation needs. This diversity leads to a variety of action research practices in healthcare. Particularly, in this review, we raised the need for examining participants' experiences and changes related to the action research process. This scoping review considered studies that included any professional healthcare provider, patient or recipient of healthcare products or services involved in action research. Studies that used the action research methodology in the healthcare context were included. All quantitative and qualitative studies were considered. The quantitative component considered experimental and epidemiological studies, whereas the qualitative component considered studies that focused on qualitative data. A three-step search strategy was used in this review. MEDLINE, CINAHL, Web of Science, Social Sciences, ERIC, PsycINFO, Health Source, ScienceDirect, Wiley and SciELO databases were searched with no publication date limitation. Studies published in English, Portuguese and Spanish were included. The data were extracted using a charting table, which was developed to record key information from sources relevant to the review question. The findings were descriptively presented, with tables and figures to support the data when appropriate. We included 124 studies with different aims and procedures. The levels of participation ranged from no real input into or influence on the research process to democratic knowledge sharing and collective understanding. The action research processes occurred in diverse settings in the healthcare context, and participants with different objectives and demands took part in the research.From study objectives, knowledge building, and social change data, we developed three domains and categorized the studies. In general, Europe and Australia published more studies in the organizational domain and mainly had healthcare stakeholders as participants. North America published more studies in the individual domain, and Latin America, the continent with a higher percentage of publications, published studies that were more frequently related to the collective domain. Asia and Africa did not have a consistent number of publications. There was a major repercussion on the health promotion perspective in North America and Latin America. There are several ways of conducting action research in healthcare that consider the researcher's aims and theoretical assumptions. Further qualitative systematic review questions may arise from the results and conclusions of this scoping review.

Action research healthcare: Focus on patients, improve quality, drive down costs.

We discuss action research healthcare as a transformative approach that continuously innovates in healthcare, attending to the "quadruple" aim. This article is shaped around a decade of evidence in Sweden. At the heart of healthcare action research is the endeavour to "learn by doing" with the participation of key stakeholders, including the patient. Experience suggests that an action research approach is particularly relevant when treating patients with chronic diseases and complex care needs. This inclusion is itself a social learning process and is key to realizing the improved outcomes. Insights from objective quantitative studies are balanced with personal and inter-subjective dialogue that aligns different parts of a system in a movement towards improvement. Close-up non-defensive self-inquiry in the company of colleagues, with trust dynamics building over time, may be a key point of leverage for such systemic improvement activities.

Opinions of occupational therapists on the positioning of vocational rehabilitation services in Gauteng Public Healthcare

INTRODUCTION: A collaborative effort to transform occupational therapist's vocational rehabilitation services in Gauteng's public healthcare was hampered by the fact that role players were unclear as to what the scope of the service should be within the various sectors and staffing levels of public healthcare. This article reports on the opinions of occupational therapists on the positioning of vocational rehabilitation services in the Gauteng Province. METHOD: A collaborative action research team launched a non-experimental descriptive inquiry within the planning phase of a larger transformative project. Data were generated through an opinion survey to capture the perspectives of occupational therapists on the potential positioning of vocational rehabilitation services in the province. The opinions of three groups of occupational therapists were collected, i.e. clinicians working in Gauteng public healthcare, experienced vocational rehabilitation practitioners from all fields of service delivery who acted as critical friends and occupational therapy academia. RESULTS: The purposive sample was composed of 307 potential respondents. A low response rate of 31% was achieved. There was a lack of consensus as to which vocational rehabilitation services occupational therapists should render in public health care. The results reflected the need to address the scope and position of vocational rehabilitation services in public health care. CONCLUSION: Positioning of vocational rehabilitation services in public health care remains a point of contention. However, the process of asking occupational therapists their opinion created awareness and directed continuous efforts to address the issues within the field of practice. Key words: occupational therapy, vocational rehabilitation services, public healthcare action research, opinion survey

Using poetry in a critically reflexive action research co-inquiry with nurses

There are few reports of healthcare action research using collaborative or co-operative inquiry (co-inquiry) while research featuring poetry is also rare. This paper presents a cycle from a critically reflexive action research co-inquiry that explored the tensions and possibilities of nurses’ reflecting during care-giving where poems emerged as data. These poems were inspired by reflections, observations, co-inquirers’ stories and interviews. They formed part of a first-, second- and third-person co-inquiry. Applying Bourdieu’s concepts of doxa, habitus and field to the poems revealed cultural aspects of nursing practice. The poems resonated with nurses’ experiences producing deeper conversations and powerful reflexive co-inquiries about practice. The poems evoked suppressed emotions and empathy. I argue poems derived from practice are embodied knowledge and thus have a legitimate place in healthcare action research. Practice-based poems could be valuable for other practice-orientated professions in producing practice learning and change.

Action Research in Nursing and HealthcareAction Research in Nursing and Healthcare

Action Research in Nursing and HealthcareAction Research in Nursing and Healthcare

Action Research—a Necessary Complement to Traditional Health Science?

There is continuing interest in action research in health care. This is despite action researchers facing major problems getting support for their projects from mainstream sources of R&D funds partly because its validity is disputed and partly because it is difficult to predict or evaluate and is therefore seen as risky. In contrast traditional health science dominates and relies on compliance with strictly defined scientific method and rules of accountability. Critics of scientific health care have highlighted many problems including a perpetual quality gap between what is publicly expected and what is deliverable in the face of rising costs and the cultural variability of scientific medicine. Political demand to close the quality gap led to what can be seen as an elitist reform of policy on UK health research by concentrating more resources on better fewer centres and this may also have reduced support for action research. However, incompetent, unethical or criminal clinical practice in the UK has shifted policy towards greater patient and public involvement in health care and research. This highlights complementarity between health science and action research because action research can, as UK health policy requires, involve patients and public in priority setting, defining research outcomes, selecting research methodology, patient recruitment, and interpretation of findings and dissemination of results. However action research will remain marginalised unless either scientific research is transformed generally into a more reflective cycle or there is increased representation of action research enthusiasts within the establishment of health R&D or current peer review and public accountability arrangements are modified. None of these seem likely at this time. The case for complementarity is illustrated with two case studies.

Participatory Action Research in Health Care

Participatory Action Research in Health Care

The development of palliative care knowledge in care homes for older people: the place of action research

Action research in health care is a relatively new research approach, which is adopted when one aim of the research is to bring about change in practice and to research the process of that change. This paper describes the way action research, as a research methodology, can be used to develop palliative care knowledge in generalist care settings. An overview of action research is presented and its relationship to more conventional research paradigms. Two action research projects, undertaken to develop knowledge about end-of-life care for older people in care homes, are used to illustrate the key principles of action research, methods of data collection and data analysis. Finally, the challenges of such, utilising an action research approach and its strengths, are discussed.

Action Research in Health Care by Alison Morton‐Cooper. Blackwell Science, Oxford, 2000, 114 pages, £14·99, ISBN 0 632 04091 2.

Journal of Advanced NursingVolume 38, Issue 1 p. 105-105 Action Research in Health Care by Alison Morton-Cooper. Blackwell Science, Oxford, 2000, 114 pages, £14·99, ISBN 0 632 04091 2. Mary Kemple, Mary Kemple University College Dublin, IrelandSearch for more papers by this author Mary Kemple, Mary Kemple University College Dublin, IrelandSearch for more papers by this author First published: 13 March 2002 https://doi.org/10.1046/j.1365-2648.2002.2184a.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume38, Issue1April 2002Pages 105-105 RelatedInformation

Book Review: Action Research in Health Care

Book Review: Action Research in Health Care

Evaluating action research.

cipants throughout the study for validation and to inform What is it? decisions about the next stage of the study. In healthcare Action research is not easily defined, as it is an approach settings, this often involves a careful process of negotiation to research, rather than a specific method. The term is across traditional boundaries (for example, between health used widely and loosely throughout the scientific and and social care professionals or between hospital and professional literature. However, the following definition community care settings). This requires both excellent broadly captures its meaning. interpersonal skills as well as research ability. ‘‘Action research is simply a form of self-reflective enquiry undertaken by participants in social situations Simultaneous contribution to social in order to improve the rationality and justice of their own practices, their understanding of those practices, science and social change and the situations in which the practices are carried If the purpose of research is to better understand and out’’ [1]. ultimately improve practice, then action research does this at the same time as generating findings for wider disseminaAction research can be seen as a rejection of more tion. With a focus on reflexive methods, the approach not traditional positivist and interpretative views of science (or only allows participants to learn for themselves but also a third way) in dealing with theory development within a empowers them to improve the social contexts in which practice discipline [2]. It is concerned with doing research they work. It is argued that action research findings are with and for people, rather than doing research on them more meaningful to practitioners because they more closely [3]. It focuses on working with people to identify problems reflect reality by responding to events as they naturally in practice, implement solutions and to monitor the process occur in the field. Action research is often written up as a and outcomes of change. Most definitions incorporate case study and it is important to note that generalisation is three important elements: its participatory character; its therefore different to more traditional forms of research democratic impulse; and its simultaneous contribution to [5]. Case studies are a means by which theoretical explanasocial science and social change [4]. tions of phenomena can be generated using analytic induction. Often action research accounts are written up in their rich contextual detail and readers are invited to judge the Participatory character relevance of the findings to their own practice situation. Participation is fundamental to action research. It is an The truths contained in a successful report are thus assumed approach which demands that participants perceive the by shock of recognition. need to change and are willing to play an active part in the research and the change process. All research requires willing subjects, but the level of commitment required in Relevance to health service research any action research study goes beyond simply agreeing to answer questions or be observed. It is important that Action research has been in existence for over 55 years volunteers participating in an action research should feel and has long been used in a variety of disciplines [2]. It is able to negotiate continually their involvement in a study, designed specifically to bridge the gap between theory, and that the researcher agrees with participants an ethical practice and research. At a time when there is increasing code of practice within which to conduct the research [2]. concern that research evidence is not sufficiently influencing practice development [6], action research is gaining credibility in healthcare settings [7]. Action research acknowledges Democratic impulse the value of professional judgement in applying scientific evidence in practice. Working closely with practitioners Action research requires participants to be seen as equals, not only with the researcher, but also with each other. The and using reflexive data collection methods, action researchers are better placed to explain the nature of professional action researcher formatively feeds back findings to parti-

Action research in health care: the collaborative action research network health care group

This article promotes the idea of using action research for health care exploration and change. It also introduces the work of the Action Research Health Care Network, what the group aims to achieve, and how practitioners can make contact and be involved with the development. The article also describes the outcome of a research study that underpin the philosophy, process and potential benefits of the network, as a means to promote practice development and change in client care.