English title dissertation TAKING ACTION FOR ACTION: A study of the interplay between contextual and facilitator characteristics in developing an effective workplace culture in a Dutch hospital setting, through action research.
Name PhD (surname first) Lieshout, Famke van
Doctor is (has been) nurse
Date of promotion 28/06/2013
University University of Ulster
Promotores Prof. B. McCormack & prof. T. McCance
Linkedin-account linkedin.com
Researchgate-url researchgate.net
Abstract (English)

Implementing change and transforming nursing practice is not a linear but a complex process.
The evidence within practice development (PD) and participatory action research (PAR) suggests
that not enough is known about the interplay between the researcher’s characteristics
and the contextual factors, in the facilitation of PAR. This study aims to understand this interplay
in the development of evidence-based and person-centred practice through PAR, in collaboration
with nurses and management at a centre for oncology in a Dutch hospital.

The study is guided by a praxis methodology in which different philosophical perspectives are
used to connect theory with the practice of PAR. Emancipatory praxis guides the transformation
of practice through PAR and hermeneutic praxis guides the understanding of the reality
of facilitating PAR within a specific context. The research approach integrates a mix of creative,
cognitive and reflective methods. A variety of data about initiating action research in a clinical
setting were collected and put into the form of a story in order to engage in a reflexive analysis,
inspired by Van Manen’s principles of human science.

Findings emphasise the importance of the orientation phase within PAR and suggest that it is
essential for facilitators, in particular those new to the methodology, to create a system of support
to help them to understand the characteristics of the context. This is necessary in order to
create balance in their facilitation that is acceptable both to oneself and the context and which
can then achieve synchronous working with practitioners. This study adds greater clarity to the
existing body of knowledge about how facilitators of PAR can be helped to engage with the
complexity of cultures in different contexts. It demonstrates that there are essential conditions
necessary for facilitating PAR, these are captured within a ‘compass’-model. Principles for action
for researchers of PAR are explained that are assumed to contribute to the development of
researchers’ expertise engaged in the facilitation of PAR.

Download dissertation (English) Thesis-Famke-van-Lieshout.pdf