APPRECIATIVE INQUIRY (AI)1 is a strength-based approach to facilitate organizational change that is becoming increasingly popular. During the AI process, ...
KNOWLEDGE TRANSLATION IN DEMENTIA CARE: A REVIEW OF THE EVIDENCE FOR “APPRECIATIVE INQUIRY” AS A METHOD TO FACILITATE ORGANIZATIONAL CHANGE Belinda Goodenougha,b, Michael Youngc, Ruby Tsangb aDementia
Training Study Centre (NSW/ACT), University of Wollongong b Dementia Collaborative Research Centre - Assessment and Better Care, University of New South Wales c School of Psychology, University of New South Wales
APPRECIATIVE INQUIRY (AI)1
AI IN AGED CARE
is a strength-based approach to facilitate organizational change that is becoming increasingly popular. During the AI process, a team explores the best of what is and further develops that to generate an image of a better future. This process can be described as a continuous 4-D cycle of discovery, dreaming, designing and destiny:
In 2010, Reed2 conducted a literature search using appreciative + inquiry and older + people as search terms, and found: editorials
3
Discovery
9
discussion papers
8
research papers
1
book review
“A reading of these studies showed that none reached the fourth stage of delivery and reports did not explicitly discuss the reasons for this.”
“the best of what is”
Destiny
Dreaming
“what will be”
“what might be”
It concluded that, despite the number of papers recommending the use of AI, more research is required.
Designing “what should be”
UPDATE LITERATURE SEARCH We conducted an update search (2010+) in the PsycINFO and MEDLINE databases as well as Google Scholar using a combination of keywords including “appreciative inquiry”, “care”, “dementia”, and “aged”, and identified an additional: 1 7
literature review A word cloud created with words from the text of the 4 identified studies that used AI in dementia care settings.
independent research studies
Only 4 studies used AI in the context of dementia care: AI used to explore consumer involvement in care Did not report on decisions and increase social inclusion3 practice change AI used to develop end-of-life care tools for Qualitative and residential care facilities based on the capacity quantitative analyses of care staff and visiting health professionals4 showed positive changes in working relationships and resident outcomes
WHERE TO FROM HERE? While waiting for relevant research, we suggest that AI might be a useful strategy when leading change with teams that lack cohesion. Applying the DTSC Knowledge Translation Framework (see below), AI might assist consensus and decision-making about innovation adoption for teams yet to reach the ‘agreement’ stage, such as:
AI integrated with participatory action research Did not report on to improve dementia care practices5 practice change
AI used to explore components of and factors that enhance quality of dementia care6
Did not report on practice change
innovations that touch on values (e.g., palliative/end-of-life care, sexuality assessment etc.) previous change experience has been negative and a ‘circuit breaker’ is needed interdisciplinary conversation (including consumers) needing a new/ common language to describe the vision for a ‘good outcome’
The majority of these studies were qualitative process reports of visionsetting conversations with staff and/or consumers. There is a dearth of evidence for sustainable practice change or consumer outcomes. Pre-KT
Knowledge Translation Framework
We currently do not have enough evidence
AWARENESS
AGREEMENT
to support or reject the value of the AI approach for facilitating change in dementia care.
REFERENCES 1Cooperrider & Whitney 1999, Appreciative Inquiry, San Francisco: Berret-Kochler.
4Amador
2Reed
5Fortune
2010, Int J Older People Nurs 5:292-298.
3Seebohm
et al. 2010, Ment Health & Soc Inclusion 14:13-21.
6Scerri
et al. 2014, Int J Geriatr Psychiatry 29:758-766.
et al. 2015, J Aging Stud 34:38-47.
et al. 2015, J Clin Nurs 24:1916-1925.
ACKNOWLEDGEMENT The Dementia Training Study Centres and the Dementia Collaborative Research Centres are funded by the Australian Government.
ADOPTION
ADHERENCE
