Action Research A Methodology for Change and Development

Action research in health, social care and community
settings
A personal narrative
DOING ACTION RESEARCH DIFFERENTLY 41
So why have I chosen to look next at health, social care and community settings?
I suppose there are two reasons: first, that I became involved in my
role as Co-ordinator of the then Classroom Action Research Network in a
movement within the UK to increase the involvement of the nursing profession
in research and then later as an editor of the journal, Educational
Action Research, was able to observe the growth in a grass-roots literature of
nurse action researchers; second, that this involvement was one of the
things that helped me to understand how responsive action research
methodology is to culture and context – action research in health care settings
was simply different from action research in education. My interest in
action research in social care and community settings came later, but again
fascinated me because social care, in the UK, is located within cultural and
regulatory frameworks that are different again from those of nursing; and
community work, in contrast, is more grass-roots based, less well-resourced
and more emancipatory.
My involvement in health started with a letter in 1989 from Dr Alison
Kitson of the UK’s National Institute for Nursing, inviting me to join the
Advisory Board for an action research project at the John Radcliffe Hospital
in Oxford. The focus of the work was on a fundamental change to nursing
practice known as patient-centred nursing, in which as I remember one of
the strategies was to be for every patient to have a named ‘primary nurse’
who would hand over care of the patient to the named ‘associate nurse’
rather than to the ward sister at the change of shift. This was to ensure that
patients had continuity of care and a new kind of relationship with named
nurses. The project was led by Alison Binnie, a ward sister at the Radcliffe
and Angie Titchen, a former physiotherapist who by that time was a fulltime
researcher at the Institute of Nursing. This would involve a fundamental
shift in nurses’ understandings of their work to ensure that there
were significant changes to practice rather than merely technical or ‘cosmetic’
changes. The action research took place primarily in the general
medical ward for which Alison had responsibility and involved the participation
of all staff. Angie was also registered for a doctor of philosophy
degree at the University of Oxford with Donald McIntyre as her research
supervisor. The three meetings a year of the Advisory Board took place at
the Institute of Nursing and served as my introduction to action research in
health and social care settings. These meetings were extremely interesting.
Angie and Alison regularly produced discussion papers that dealt sequentially
over the two years with the action research design and methodology,
methodological issues arising from work in progress and the generation and