Inclusion and exclusion in action research on person-centered health care: A framework for cultivating the tensions in dialogue

This chapter presents a social constructionist theoretical framework for engaging in critical, reflexive analysis of the tensions integral to dialogue. The framework is based on dialogic communication theory and combines Bakhtin’s theory of dialogue and Foucault’s theory of power/knowledge and discourse. The application of the framework is illustrated in an action research project designed to further develop “Active Patient Support” (APS), a person-centred health care initiative in which nurses engage in collaborative telephone counselling with citizens with chronic illnesses. In the chapter, we describe and discuss the use of the framework to cultivate critical reflexivity of the tensions in both counselling conversations and in the action research process.