Abstract
Health service research, particularly that emanating from sociology, has long recognized the hierarchical nature of the hospital environment. Issues concerning power, empowerment, participation and different kinds of knowledge are highlighted with the voices of some groups being silenced or dominated by others. Such issues are also of central concern in action research and determinants of the quality of an inquiry process (Bradbury and Reason, 2003; Reason, 2006). Thus, how we give voice to patients or different kinds of knowledge is a primary focus in healthcare-related action research. The purpose of this chapter is to show how the idea of heteroglossia or multi-voicedness may help in understanding what underlies persistent difficulties in implementing a well-supported palliative care policy. We explore the idea of voices as world views and multiple narratives rippling through the practice environment and inquiry process. We see these as ever present in how we hear and address other points of view, values and beliefs. The idea of multiple voices in action at any given moment shifts the focus from representing the individual(s) to how we consciously or unconsciously represent voices or narratives that flow through the inquiry process.
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© 2013 Geralyn Hynes, David Coghlan and Mary McCarron
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Hynes, G., Coghlan, D., McCarron, M. (2013). Giving Voice in a Multi-Voiced Environment: The Challenges of Palliative Care Policy Implementation in Acute Care. In: Keating, M.A., McDermott, A.M., Montgomery, K. (eds) Patient-Centred Health Care. Organizational Behaviour in Health Care. Palgrave Macmillan, London. https://doi.org/10.1057/9781137308931_11
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DOI: https://doi.org/10.1057/9781137308931_11
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