1. Philosophical stance underpinning an PAR into leading the development of person- centred care Shaun Cardiff Fontys University of Applied Sciences (NL) Ulster University (UK)

2. WHY? Explicating the philosophical stance contributes to the ontological and epistemological authenticity of the study (Titchen and Higgs, 2007) and helps the reader follow and assess rigour of decisions made during the study.

3. Background PC culture Effective workplace Culture (Manley et al, unpublished) PCN framework (McCormack & McCance, 2006) Leadership: Transformational? (Bass & Riggio, 2006) Person-centred? (Plas & Lewin,2001) How can person-centred leadership be developed on a nursing unit? How can person-centred care be developed on a nursing unit?

4. AIMS Critical Social ScienceCritical Realist  help participants free themselves from any shackles inhibiting their flourishing i.e. obstacles to person-centred relationships.  enable participants to transform any undesirable aspects of social reality by journeying through Enlightenment and Empowerment towards Emancipation.  generate plausible explanations on how (transforming) social structures, practices and conventions give rise to a perceived reality of person- centred relationships.

5. Critical Realism Realist ontology + Relativist epistomology Intransitivity – “what we percieve is not necessarily all that there is” –Intransitive – the ‘what is’ –Transitive – the ‘what we can know’

6. 13 th :74 pts Philosophy - what do you believe in?

7. Stratification – “what we can percieve emerges from what is” ❇ Empirical layer – perceivable ⇪ Actual layer – events Real layer – generative mechanisms

8. Tulips from.. Generative mechanisms -> Germination -> Tulips Mechanisms can be: unexercised; exercised but not actualised or counteracted; exercised actualised but not perceived; exercised actualised and perceived by humans

9. Transformational model of society Social structures, conventions & practices Human activity Existential relationship (not causal) Mind independance (not people independance) Reproduction/Transformation

10. Fay (1987) Humans are: active- embedded- embodied- historical- traditional-beings Enabling / Limiting Enlightenment – know that ↓ Empowerment – know how ↓ Emancipation - transform

11. Application Units A&B, high turnover of staff. ‘B’ not perceive the reality (intransitive), nothing changes (reproduction). Apathy has a long history on the unit, is embedded and embodied ‘A’ perceives (transitive) investigates mechanisms (enlightenment) intends & attends to change (empowered) transform & continuously readdress culture (emancipation)

12. Knowledge Knowing that Knowing how Knowing what it is like Surfacing knowledge only via (traditional) cognitive verbal communication limits the type of knowledge exposed. Using creative expression enables the surfacing of pre-conscious & embodied knowledges Rational & cognitive Rational & cognitive and/or pre-conscious & embodied

13. Generation Creating communicative spaces where: Personal knowledges are shared (creatively) Reflection, critique, contestation takes place Intersubjective agreements, mutual understandings and unforced consensus about what to do Co-constructing new knowledge & ‘plausible’ explanations

14. So, is this all just a fairytale ?????