title: How action researchers use anxiety to facilitate change in health care.
abstract: OBJECTIVE
  The aim of this paper is to report on the role of an action researcher in a study investigating the change process in a health service context where a new assessment clinic was developed to manage the excessive waiting list for that service.
  
  
  BACKGROUND
  For effective organisational change in health, there is a suggestion that change agents need to be emotionally intelligent; recognising the emotional state of individuals, reconciling that with the organisational drivers and making an assessment of readiness for organisational change. Anxiety features throughout this literature and there is a suggestion that being aware of anxiety and managing anxiety is within the emotionally intelligent change agent's repertoire, but there is a gap in the literature that explains this relationship in detail.
  
  
  METHODS
  Data were generated to investigate the discrete nature of the role of the action researcher during this organisational change that spanned two years, through three methods: participant observations in the field captured in field notes (n = 72); observations of team meetings that had been recorded and transcribed (n = 13); interviews with key informants pre- and postintervention (n = 14); a reflexive diary one document of 8920 words (n = 1).
  
  
  RESULTS
  The data illuminating the interaction between the action researcher and participants were synthesised into two broad themes: how the action researcher introduced anxiety into the system; how the action researcher facilitated the participants to tolerate change anxiety.
  The findings from this study can be applied in clinical practice where change in practice is planned. Part of the requirement of a change agent in the NHS might be to be sufficiently emotionally literate to understand anxiety in the participant system and manage it to effect change.
authors.affiliation: School of Healthcare Sciences, College of Biomedical and life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Evans
authors.affiliation: School of Healthcare Sciences, College of Biomedical and life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Hopkinson
mesh_terms: D001007:Anxiety; D006302:Health Services Research; D006801:Humans; D009936:Organizational Innovation; D012108:Research Personnel; D013222:State Medicine
keywords: action research; change agent; change anxiety; children and young people; mental health; multi-disciplinary teams; organisational change; qualitative methods