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Holding Complex Spaces Through Relational Work: A Qualitative Descriptive Study of Co-Design Facilitation
B Heckemann1,2, E Varkey3,4, P Andréll1,5
1Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Summary
Co-design facilitation in healthcare is complex relational work requiring continuous awareness and interpretation. A new conceptual model helps facilitators navigate unpredictable dynamics and develop reflective skills for better patient engagement.
Area of Science:
- Healthcare research and innovation
- Patient and public involvement in research
- Co-design methodologies
Background:
- Patient and public involvement in healthcare research is increasingly mandatory.
- Co-design is a structured approach for collaborative problem-solving.
- Facilitation skills for co-design workshops are often learned on the job, with limited guidance on relational aspects.
Purpose of the Study:
- To explore co-design facilitation as relational work.
- To develop a conceptual model for understanding and reflecting on co-design facilitation complexity.
- To guide facilitators in managing the relational dynamics of co-design workshops.
Main Methods:
- Five co-design workshops were facilitated with individuals living with chronic pain.
- Reflective accounts were gathered through individual interviews and dyadic discussions post-workshop.
- Reflexive thematic analysis was used to analyze the recorded reflective data.
Main Results:
- Co-design facilitation involves managing unpredictability and structural considerations.
- Three themes emerged: planning/evaluation/learning space, workshop-holding space (structural, emotional, physical, activation), and tacit space.
- An overarching theme and conceptual model, 'Holding complex spaces through relational work,' was developed.
Conclusions:
- Co-design facilitation is demanding relational work requiring continuous interpretation and awareness.
- The conceptual model offers a flexible tool for understanding facilitation complexity, not a procedural guide.
- The model, developed in chronic pain contexts, may be transferable to other healthcare settings for facilitator training.
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