Reflections on using an appreciative inquiry approach to enhance dignity within a care home setting

Background: Appreciative inquiry is a methodological approach which focusses on existing organisational strengths as opposed to weaknesses in order to enhance practice (Watkins and Mohr, 2001). Appreciative inquiry was first described by Cooper-rider and Srivastva in 1980 (cited by Watkins and Mohr, 2001) and is now used increasingly within health and social care research (e.g. Dewar and McKay, 2010).

Aims of paper: This paper aims to critically reflect on the experience of using appreciative inquiry as a methodological approach.

Methodological discussion: The project utilising appreciative inquiry aimed to enhance dignity through the use of relational caring conversations which are at the heart of compassionate and dignified care (Dewar and Nolan, 2013). The authors actively worked with care home staff, residents and relatives to identify positive interpersonal practices that enhance dignity; illuminate these; and develop educational resources to enhance practice.

Many successes and challenges were encountered when using an appreciative inquiry approach.

Successes include:
• Active involvement of staff, residents and relatives allowing a collective approach to transforming practice.
• Real time feedback of positive interpersonal practices helped staff be less defensive. This was particularly important in a culture surrounded by
hierarchy, inspection and poor representation in the media.
• Real time feedback to care home staff helped to raise the tacit nature of interpersonal skills and knowledge to their consciousness.

Challenges include:
• Spending time building trusting relationships with staff, residents and relatives.
• Finding the time in a busy care environment to provide real time feedback.
• Developing the skills of being an appreciative inquirer.

Conclusion: This paper contributes to the expanding use of appreciative inquiry within health and social care research, and identifies key elements that contribute to the success of this approach.