Key principles of systems theory

A system could be described as any unit or group structured on feedback (Bateson, 1972). Figure 4.2 highlights the different systems that might occur as part of community volunteer visiting. However, the main interests of this thesis are the systems the volunteer is part of, with the dying person and hospice staff.

A core concept in systems theory is that people exist in the context of other systems: families, communities and organisations, each with their different rules and beliefs (Winek, 2009). Understanding the context and power in those systems connects with the descriptions in Chapter 2, where regulation and commissioning systems are seen as an increasing influence on hospices and potentially on volunteers, and will be important in this research. I am therefore interested in how the contexts of societal beliefs about death, and the influence of regulation on systems and beliefs affect volunteers’ behaviours and experiences (Figure 4.3). Systems theory therefore provides a theoretical base on which to broaden the perspective, not only looking at the one system, but the contexts and power of other systems that surround and influence the volunteer’s behaviours and experiences.

The rules in systems that influence behaviour can be described as either ‘overt’,

being something expressed routinely, or ‘covert’ and not expressed out loud (Vetere and Dallos, 2003). Examples of overt and covert rules are seen in the study by Claxton-Oldfield, S et al. (2011a). An overt rule expressed in this study was that a volunteer should never accept money from a patient or family, whereas a more covert rule was that volunteers “can still get close to their patients/families, just not too close” (Claxton-Oldfield et al., 2011a, p. 430).

It is clear from the studies reviewed in Chapter 3 that the presence of rules does not mean that people will apply them, as how people decide to apply rules is influenced by their personal beliefs about those rules, the meaning they attribute to them and the feedback they receive (Dallos and Draper, 2010). The different beliefs and meaning about professionalism and volunteering were evident in Chapters 2 and 3, therefore exploring the beliefs and meaning told by the volunteers interviewed form an important part of this thesis. Chapters 2 and 3 highlight the importance of relationships with dying people and how regulation and societal opinion about death may affect those relationships. Bateson (1972) suggests that when we seek to explain behaviour we should look for differences in behaviour. Therefore, I focus on looking for differences in the stories to see how volunteers might respond differently in their relationships with the people they are visiting and with hospice staff, who will be part of a hospice system.

Systems theory proposes that how people behave in relationships may depend on the feedback they receive from others. Feedback can either help people adapt or may cause them to be stuck in a pattern of behaviour. Figure 4.4 shows the boundaries and feedback which will be present between the volunteer, the dying person and the hospice staff, acknowledging that hospice staff will be part of a process of feedback with the wider hospice system. In this thesis I am particularly curious about the stories volunteers tell about how they manage their relationships with the dying person and the hospice staff.

Campbell (1991, p.12) describes “feedback as the lifeblood” of any systems and suggests that an organisation must be able to respond to internal and external feedback. Campbell (1991) warns that organisations can find themselves needing to balance the need for stability and the need for change and often use what could be described as covert rules to manage that tension, which may also hinder change. This has particular relevance to hospices as they face a need to change because of growing demand.

From this theoretical base the focus in this thesis is on exploring: the context surrounding the volunteers’ experiences, the meaning and beliefs held by the volunteers, the boundaries of their relationships, the systems that surround them and the feedback between those systems.

4.4

Summary

In this chapter I have explained the process through which a narrative methodology was chosen to answer the research question. I have explored how a philosophical paradigm that takes a critical realist position and uses a social constructionist base to understand the knowledge created through the research process is congruent with the aims of the research. I have also demonstrated the benefit of using systems theory to understand the experiences told by the volunteers, because of its focus on understanding how people behave in relation to others and respond to the rules and to the wider systems that influence their experiences and behaviours.

5 Research methods

As described in Chapter 4 a narrative methodology has been selected to answer the research question to understand the experiences of community hospice volunteers and their attitudes to death and dying. This chapter describes how the study was designed and the methods used to generate and analyse the data.

When planning the research, I discussed my research ideas with nine community hospice volunteers at my own hospice. Most felt that one needed to be face to face to tell a story, rather than using a diary or video. The group thought that volunteers might talk about training, support, thoughts about death and dying and how they felt about the work they did. These ideas helped shape the design of the research, particularly my approach to interviews.