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.

中文翻译：

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参与行动研究，以增强居民在老年人护理中的集体参与：关于权力，对话和理解

西方社会非常重视患者和客户在医疗保健组织中的集体参与。在实践中，采取这种形式的参与似乎是一个复杂的过程。在本文中，我们通过参与式行动研究方法（称为PARTNER），介绍了我们的学习经验，以及通过增加老年人在荷兰的养老院中的参与度的过程。这种方法的灵感来自响应式评估，并针对长期护理而开发。我们使用哈贝马斯理论的概念来理解尝试通过对话创造交流空间时会发生什么。我们的学习历史表明，居民的参与不是一件容易的事，因为权力问题受到威胁。系统价值似乎主导着生活世界，专家知识似乎比居民表达的情感和叙述更有价值。使用参与式行动研究的研究人员必须意识到这些权力问题，这些问题通常隐藏在语言和话语中。当关注所有人的基本价值观，假设和含义时，对话可以成为增进相互了解的工具。然后，可以弥合系统与生活世界之间的鸿沟，并开放交流空间。