Developing Caring Conversations in care homes: an appreciative inquiry

Abstract

Relationship-centred practice is key to delivering quality care in care homes. Evidence is strong about the centrality of human interaction in developing relationships that promote dignity and compassion. The Caring Conversations framework is a framework for delivering compassionate care based on human interactions that was developed in the acute healthcare setting. The key attributes are: be courageous, connect emotionally, be curious, consider other perspectives, collaborate, compromise and celebrate. This paper reports on a study to explore its relevance to the care home setting and the development of an educational intervention, based on the framework, to enhance development of human interaction. The study used the approach of appreciative inquiry to develop Caring Conversations in the care home setting. Appreciative inquiry has a unique focus on what is working well, understanding why these aspects work well and co-creating strategies to help these good practices happen more of the time. The aim of the study was to celebrate and develop excellent human interaction that promotes dignity between staff, residents and families in care homes. The study took place in 2013-2014 in one care home in Scotland, over 10 months. Participants included staff (n = 37), residents (n = 20) and relatives (n = 18). Data generation methods involving residents, relatives and staff included observation and interviews about experiences of interaction. An iterative process of data analysis involved mapping core themes to the Caring Conversations framework with findings showing how people communicated correlated well with the Caring Conversations framework. Building on knowledge of what works well, staff developed small 'tests of change' that enabled these good practices to happen more of the time. Appreciative inquiry proved a valuable approach to exploring Caring Conversations, developing practice and developing an educational intervention that could be shared across other care settings.

Improving the Quality of Care in Care Homes Using the Quality Improvement Collaborative Approach: Lessons Learnt from Six Projects Conducted in the UK and The Netherlands

“…Our other observations provide practical recommendations that are consistent with, and build upon, the wider care home literature. Previous findings show when dialogue with care homes is appreciative and focused on what is working well, this helps to develop practice in care homes [ 29 ]. Evidence also shows that working relationships in the care home sector are of particular importance, as successful innovations in care homes are established on a foundation of longstanding collaboration and trust [ 30 ].…”

A reflective qualitative appreciative inquiry approach to restoring compassionate care deficits at one United Kingdom health care site

“…(, p. 7) that case studies are good to “generate an in‐depth, multi‐faceted understanding of a complex issue in its real life context.” This approach complies with a case study approach as it was used to explain and describe events in the context in which they occurred (Yin, ). The practice developer acted “as a sole data collection instrument” seeking answers to questions “about how or why a particular phenomenon” occurred [in this case care erosion] (Dewar & MacBride, ; Miller, , p. 191).…”

“…The practice developer acted "as a sole data collection instrument" seeking answers to questions "about how or why a particular phenomenon" occurred [in this case care erosion] (Dewar & MacBride, 2017;Miller, 2010, p. 191).…”

Enhancing Sleep Quality for Nursing Home Residents with Dementia: A Pragmatic Randomized Controlled Trial of an Evidence-Based Frontline Huddling Program

“…In a prior series of studies (48,49), we incorporated the evidence-based practices of strengths-based learning (50,51), systematic observation (52), e ciency (49,53), and relationship-based teamwork (54,55) into a speci c frontline staff huddling program known as the LOCK program. The LOCK program enables staff to (1) Learn from bright spots (focus on positive evidence of strengths); (2) Observe(collect data through systematic observation); (3) Collaborate in huddles (conduct frontline staff huddles); and (4) Keep it bite-size (limit activities to 5-15 minutes for e ciency) (49,56).…”