Over the last 15 years at Bournemouth University, Professors Kathleen Galvin and Les Todres have been developing a coherent programme that integrates health-related philosophy with qualitative research. This programme is summarised in their book: Caring and Well-Being: A lifeworld approach (Routledge, 2013), Click here for a brief overview of this book and some reviews. This focus has been taken up by other researchers, educators and practitioners both within Bournemouth University as well as nationally and internationally.
Why is humanising health and social care so important?
The research is particularly topical and relevant following the Francis report which considered appalling standards of care at the Mid Staffordshire NHS Foundation Trust. The Francis report heralds an overdue ‘wake-up’ call to the realisation that ‘something important is missing’ in current health and social care practices and systems. There are debates about what this ‘something missing’ is, and Galvin and Todres characterise this as ‘humanly sensitive care.’
The Francis report is not an isolated expression of concern and one may refer, for example, to a published Patients Association Report entitled ‘Patients….not numbers, People not Statistics.’ (The Patient’s Association, 2009) and also to the Commission on Dignity in Care (2012), amongst other allied public documents.
It is generally acknowledged that we should not only pay attention to extreme situations such as at Mid-Staffordshire. Patients and service-users are telling us in different ways that they too often feel ‘not met as human beings’ within health and social care service contexts. Within the debate about how to restore humanly sensitive care, different priorities have been considered. The view that we take is that the restoration of humanly sensitive care is not just about ‘more time’ or ‘better leadership’, but more centrally about how the ‘humanising focus’ is clearly articulated and ‘kept alive’ as a primary focus next to other relevant targets.
Such a humanising focus needs two foundational ‘assets’ on which to hang all the usual strategies such as leadership; resources; organisation; training etc:
1) A distinctive and simple ‘vocabulary’ that keeps the focus on ‘humanisation’ issues as a central concern.
2) Ways of ensuring that such a focus is coherently championed at all levels: political, organisational, practical and educational.
It is within this context and concern that we believe the ‘Humanising’ Research Programme at Bournemouth University has something distinctive to offer: a coherent ‘humanising’ framework that can be easily translated into everyday vocabularies and practices.
Beginning in health-related philosophy, and supported by a ‘fusion’ of qualitative research, curriculum development, and practice development projects with NHS partners, we have engaged in the kind of translational research that has both theoretical depth and practically transferrable potential. We have begun to test the framework within Somerset NHS hospitals, Hull and Bournemouth Hosptials and within our own educational curricula at undergradaute and postgraduate levels.
The Distinctiveness of the Programme and its Aims
- The first aim of the programme is to derive insights in response to the question: What makes people feel ‘more human’ or ‘less human’ when engaging in health and social care systems and interactions? While acknowledging that such an ‘experience-near’ question is complex and unusually formulated in relation to traditional academic discourse and jargon, we have found that everyday people intuitively understand what we mean when asking them this question. Also, the question does in fact have a rich philosophical heritage.
- The second aim of the programme is to apply these insights in healthcare practice and education. This second aim has potential to generate multiple applications.
The outcomes of the theoretical and philosophical phases of the research have resulted in the articulation of eight bipolar dimensions (Todres, Galvin & Holloway, 2009) that describe what constitutes health and social care processes and interactions that are ‘humanising’ or ‘dehumanising’ as summarised in the following diagram:
Conceptual Framework of the Dimensions of Humanisation
|Forms of Humanisation||Forms of Dehumanisation|
Sense – making
Sense of Place
Loss of meaning
Loss of personal journey
In alignment with Bournemouth University’s Fusion Strategy in which Research, Practice and Education mutually support one another the menu on the left indicates the multiple ways that the Humanising agenda is being pursued by School of Health and Social Sciences staff and students.