Caring about caring: Developing a model to implement compassionate relationship centred care in an older people care setting

Appreciative Inquiry as an intervention to change nursing practice in in-patient settings: An integrative review

“…Yet, many of the studies seemed to pay only limited attention to the objectives of the 4D Cycle which was generally rolled out in a series of workshops of short duration. This is in contrast to Dewar and Nolan (2013) who undertook a year -long clinically based project and became immersed in the context and activities of the setting. In the other studies in this review, the 4D Cycle appeared to be superficially applied so that it was difficult for the reader to get a feel for the imagery or the unique dialogue or the fateful questioning that would ultimately bring about radical change.…”

“…Only one study, Dewar and Nolan (2013) 4.2 Appreciative Inquiry as an inclusive and democratic process In all of the included studies Appreciative Inquiry was acknowledged by participants as a democratic and inclusive process. The participants who were nurses, nurse leaders, patients, family members, ward clerks and allied health care professionals, welcomed the opportunity to get involved in a positive and interactive form of communication (Lazic et al 2011).…”

“…However, only one of the studies achieved transformation (Dewar and Nolan 2013). In this Appreciative Inquiry intervention there was creation of a safe place where members of staff dispensed with defensiveness.…”

“…The attention to strengths was considered uplifting as was the opportunity to openly celebrate what was working well (Dewar and Nolan 2013). Only Sidebotham et al (2015) expressed disappointment at the outcome of Appreciative Inquiry because it did not produce 'positive solution focused dialogue' (p. 8).…”

“…Lack of expert facilitation in deployment of a complex, unknown methodology, might explain in part the apparent going through the motions of the 4D Cycle or the deficit of novel responses that was evident in the majority of studies in this review. Significantly, the only study to engender transformation was Dewar and Nolan (2013) and in this case the appreciative inquirer was an experienced facilitator and action researcher. A moot point is that if expert facilitation becomes a necessary precursor to the Appreciative Inquiry intervention this has implications for its use in nursing, especially in relation to the scarcity and cost of hiring a methodological expert.…”