Participatory action research to enhance the collective involvement of residents in elderly care: About power, dialogue and understanding

Abstract

The collective involvement of patients and clients in health care organizations is valued in our Western society. In practice, giving form to this involvement seems to be a complex process. In this paper we present our learning experiences with a process of enhancing the involvement of older people in a residential care home in the Netherlands, by using a participatory action research approach, called PARTNER. This approach is inspired by responsive evaluation and developed for the context of long-term care. We use concepts of Habermas’ theory to understand what happens when trying to create communicative spaces through dialogue. Our learning history shows that the involvement of residents is not an easy task, because power issues are at stake. System values seem to dominate the lifeworld and expert knowledge seems to be more valued than expressed emotions and narratives of residents. Researchers who use participatory action research must be aware of these issues of power, often hidden in language and discourse. Dialogue can be a vehicle to enhance mutual understanding, when attention is paid to underlying values, assumptions and meanings of all people. Then, the gap between system and lifeworld can be bridged and communicative spaces can be opened up.

Sowing Seeds to Harvest Healthier Adults: The Working Principles and Impact of Participatory Health Research with Children in a Primary School Context

“…Participatory action research has been practiced with various, often marginalized groups, such as older people [9,10] and people who have psychiatric vulnerabilities [11]. Moreover, children have been engaged in participatory research to gain a better insight into their lifeworld and develop health promotion action plans that better meet their needs [12][13][14].…”

Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation

“…A recurring mantra among the participants was, 'good and safe care, to do good for the patient'. The actual impact that eldercare professionals have on the design process was questioned [45,46]. As one of the interviewees explained:…”

Health and healthcare as the context for participatory action research

“…' (Lee et al, 2019). Woelders and Abma (2019) offer an example where dialogue and communication are inhibited. This action research project involved residents in elderly care and underscores how professionals deliberately did not prioritise meetings with residents.…”

“…A good example to learn from is, for example Kira and Lifvergren (2013) where they raise awareness on how to work upstream with healthcare problems and always consider the social, economic and ecological consequences of all change initiatives. Action researchers need to be made aware that dialogue and communication enhance the transformative change experienced by the participants as highlighted in the articles by Plazas et al (2019); Woelders and Abma (2019). Integrating sustainability issues in healthcare is not only important for human health and welfare but for the planet as a whole.…”

“…What advice do they give? Some articles in this issue include dialogues and reflections together with participants (Donnelly & Morton, 2019; Gustavsson & Andersson, 2019; Mann & Hung, 2019; Woelders & Abma, 2019).…”