Inquiry In Health Care Research Articles

Systematic review and narrative synthesis of the impact of Appreciative Inquiry in healthcare

BackgroundAppreciative Inquiry is a motivational, organisational change intervention, which can be used to improve the quality and safety of healthcare. It encourages organisations to focus on the positive and investigate...

A scoping review protocol to map the evidence on the use of action research methodology by healthcare professionals and in healthcare team settings.

Background: Action research (AR) starts with an existing practical situation with which there is a concern or potential for improvement. It seeks transformative change through the simultaneous process of doing research and undertaking actions, both of which are linked together by a critical reflective process. It simultaneously allows one to systematically investigate a given social situation while promoting democratic change and collaborative participation. AR approaches have been used for many years in business management and education. More recently, AR has become an increasingly popular method of inquiry in healthcare, particularly in nursing, to investigate professional practice while simultaneously; introducing innovations; planning and undertaking action; and evaluating new ideas. The overall goal is to augment collaboration whilst improving the patient experience and outcomes. Methods: The Arksey and O'Malley methodology framework will be used to guide this scoping review process: stage 1 will identify the research questions; the eligibility criteria and search strategy will be defined in stage 2; studies will then be selected in stage 3; data will be extracted and charted from these included studies in stage 4; stage 5 involves aggregating and summarising these results along with criteria relevant for health professionals and policy-makers. An optional consultation (stage 6) exercise may potentially be included. Conclusion: This scoping review will comprehensively map the evidence on the use of AR methodology by healthcare professionals and in healthcare team settings. It is predicted that the findings will inform researchers in carrying out future AR and highlight gaps in the literature. An article reporting the results of the completed scoping review will be submitted for publication to a scientific journal and presented at relevant national and international conferences.

Completeness of reporting of quality improvement studies in neonatology is inadequate: a systematic literature survey

IntroductionQuality improvement (QI) is a growing field of inquiry in healthcare, but the reporting quality of QI studies in neonatology remains unclear. We conducted a systematic survey of the literature...

Early Mobility for Critically Ill Patients: Building Staff Commitment Through Appreciative Inquiry.

Immobility contributes to many adverse effects in critically ill patients. Early progressive mobility can mitigate these negative sequelae but is not widely implemented. Appreciative inquiry is a quality improvement method/change philosophy that builds on what works well in an organization. To explore whether appreciative inquiry would reinvigorate an early progressive mobility initiative in a medical intensive care unit and improve and sustain staff commitment to providing regular mobility therapy at the bedside. Secondary goals were to add to the literature about appreciative inquiry in health care and to determine whether it can be adapted to critical care. Staff participated in appreciative inquiry workshops, which were conducted by a trained facilitator and structured with the appreciative inquiry 4-D cycle. Staff members' attitudes toward and knowledge of early progressive mobility were evaluated before and after the workshops. Performance of early progressive mobility activities was recorded before and 3 and 10 months after the workshops. Sixty-seven participants completed the program. They rated the workshops as successfully helping them to understand the importance of early progressive mobility (98%), explain their responsibility to improve patient outcomes (98%), and engender a greater commitment to patients and the organization (96%). Regarding mobility treatments, at 3 months orders had improved from 62% to 88%; documentation, from 52% to 89%; and observation, from 39% to 87%. These improvements were maintained at 10 months. Participation in the workshops improved the staff's attitude toward and performance of mobility treatments. Appreciative inquiry may provide an adjunct to problem-based quality improvement techniques.

Appreciative Inquiry: A Program to Enhance Positive Nurse-to-Nurse Interaction

Appreciative Inquiry (AI) is a model of organizational behavior developed by Cooperrider and colleagues in the 1980s. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar Within the last decade, the AI model has been applied within health care organizations to develop different understandings and enhance the process of care delivery. 2 Trajkovski S Schmied V Vickers M Jackson D Implementing the 4D cycle of appreciative inquiry in healthcare: a methodological review. J Adv Nurs. 2013; 69: 1224-1234 Crossref PubMed Scopus (53) Google Scholar AI consists of 4 key components: discover—to recognize the best that is; dream—to describe how to make what is good even better; design—to develop what could be; and destiny—to put the best designs into practice. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar Appreciative Inquiry is further described as a way of being and seeing. It is both a worldview and a process for facilitating positive change in human systems, e.g., organizations, groups, and communities. Its assumption is that every human system has something that works right–things that give it life when it is vital, effective, and successful. AI begins by identifying this positive core and connecting to it in ways that heighten energy, sharpen vision, and inspire action for change. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar Appreciative Inquiry (AI) is a model of organizational behavior developed by Cooperrider and colleagues in the 1980s. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar Within the last decade, the AI model has been applied within health care organizations to develop different understandings and enhance the process of care delivery. 2 Trajkovski S Schmied V Vickers M Jackson D Implementing the 4D cycle of appreciative inquiry in healthcare: a methodological review. J Adv Nurs. 2013; 69: 1224-1234 Crossref PubMed Scopus (53) Google Scholar AI consists of 4 key components: discover—to recognize the best that is; dream—to describe how to make what is good even better; design—to develop what could be; and destiny—to put the best designs into practice. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar Appreciative Inquiry is further described as a way of being and seeing. It is both a worldview and a process for facilitating positive change in human systems, e.g., organizations, groups, and communities. Its assumption is that every human system has something that works right–things that give it life when it is vital, effective, and successful. AI begins by identifying this positive core and connecting to it in ways that heighten energy, sharpen vision, and inspire action for change. 1 Cooperrider D Whitney D Stavros J Appreciative Inquiry Handbook for Leaders of Change. 2nd ed. Crown Custom Publishing, Brunswick, OH2005 Google Scholar

Optimising qualitative longitudinal analysis: Insights from a study of traumatic brain injury recovery and adaptation.

Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature. This article reviews three challenges encountered in a large longitudinal qualitative descriptive study about experiences of recovery and adaptation after traumatic brain injury in New Zealand, and the strategies and technologies used to address them. These were (i) tracking coding and analysis decisions during an extended analysis period; (ii) navigating interpretations over time and in response to new data; and (iii) exploiting data volume and complexity. Concept mapping during coding review, a considered combination of information technologies, employing both cross-sectional and narrative analysis, and an expectation that subanalyses would be required for key topics helped us manage the study in a way that facilitated useful and novel insights. These strategies could be applied in other qualitative longitudinal studies in healthcare inquiry to optimise data analysis and stimulate important insights.

Inquiry about Domestic Violence against Women in Healthcare Uganda: Do Practitioner Attitudes, Role Conflicts, Efficacy, Safety Concerns and Support Networks Play a Role?

Objectives: We scrutinized the extent of inquiry about domestic violence against women by practitioners in healthcare Uganda, and its relationship with individual, professional and organization factors. Specifically, we hypothesized that the frequency of IPV inquiry in healthcare would be associated with practitioner attitudes, professional role conflicts, self-efficacy, provider/client safety and system support. Methods: The Domestic Violence Healthcare Provider Survey Scale questionnaire was administered to a random sample of 376 health care providers (n = 250 valid responses) from Gulu, Anaka, Lacor and Iganga hospital situated in northern and eastern Uganda. The data was analyzed using chi-square tests, correlation tests and ordinal regressions analyses. Results and Conclusions: We found that over a three month period, the majority of participants (31%) had inquired about domestic violence exposure among clients between 4 - 6 times, with 18% having not inquired at all. As hypothesized, low self-efficacy, poor availability of a support network, high professional role conflicts/fears of offending patients, and concerns about victim/provider safety reduced the probability of IPV inquiry. These findings have implications for the reorganization of the health care settings, review of organization policy and further training of care personal before IPV inquiry can develop into a universal routine practice in healthcare Uganda.

Domestic Abuse, Safeguarding Children and Public Health: Towards an Analysis of Discursive Forms and Surveillant Techniques in Contemporary UK Policy and Practice

In the UK, domestic abuse has shifted from the margins to the mainstream, and is now firmly established as an important public policy issue. This paper is concerned with how domestic abuse is constructed in public policy, particularly in the realms of safeguarding children and public health. These issues are examined through a Foucaldian theoretical lens which draws attention to the discursive constructions of social problems and how they are managed under conditions of governmentality, and presents a line of analysis rarely applied to domestic abuse. The paper illustrates how health and social care professionals come to know about domestic abuse affecting women and children through techniques of surveillance; this includes routine inquiry in health care, police notifications to children's social care and risk assessment used by MARACs (Multi Agency Risk Assessment Conferences). The emphasis upon identification has increased awareness of the problem, but questions remain on whether the safety and support of women and children affected by domestic abuse has improved. Moreover, these developments have taken place amidst resource constraints which create a challenging context for delivering effective services for women and children.

Implementing the 4D cycle of appreciative inquiry in health care: a methodological review

To examine and critique how the phases of the 4D cycle (Discovery, Dream, Design, and Destiny) of appreciative inquiry are implemented in a healthcare context. Appreciative inquiry is a theoretical research perspective, an emerging research methodology and a world view that builds on action research, organizational learning, and organizational change. Increasing numbers of articles published provide insights and learning into its theoretical and philosophical underpinnings. Many articles describe appreciative inquiry and the outcomes of their studies; however, there is a gap in the literature examining the approaches commonly used to implement the 4D cycle in a healthcare context. A methodological review following systematic principles. A methodological review was conducted including articles from the inception of appreciative inquiry in 1986 to the time of writing this review in November, 2011. Key database searches included CINAHL, Emerald, MEDLINE, PubMed, PsycINFO, and Scopus. A methodological review following systematic principles was undertaken. Studies were included if they described in detail the methods used to implement the 4D cycle of appreciative inquiry in a healthcare context. Nine qualitative studies met the inclusion criteria. Results highlighted that appreciative inquiry application is unique and varied between studies. The 4D phases were not rigid steps and were adapted to the setting and participants. Overall, participant enthusiasm and commitment were highlighted suggesting appreciative inquiry was mostly positively perceived by participants. Appreciative inquiry provides a positive way forward shifting from problems to solutions offering a new way of practicing in health care and health research.

Appreciative inquiry in health care

Organisational change in health care is a complex, non-linear process that must evolve in response to shifts in social, economic and political environments. Given this constant flux, current organisational models fail to address the needs of the patients and healthcare workers, who are becoming increasingly dissatisfied. The radical changes required must influence work design and workforce management, while focusing on the interactions between actors within the systems. This article presents an approach to organisational change: appreciative inquiry. By building on positive ideas and images emerging from individuals or groups, this approach fosters learning andpromotes the emergence of innovative ideas. A review of the literature from 1990 to 2009 was undertaken to describe the application of appreciative inquiry in health care. After a brief description of the theoretical foundations and the process of appreciative inquiry, the studies and projects uncovered in the review are presented. The limits and advantages of using appreciative inquiry to promote organisational change in health care are discussed.

China's barefoot doctor: past, present, and future

China's long struggle with rural coverage for health care goes back to the early part of the 20th century. However, these early efforts were seen at that time as unsuccessful. 1 Li TA Report on Chinese Rural Healthcare Inquiry. Chin Med J. 1934; 20: 1113-1201 Google Scholar Although the Government tried to draft private practitioners into the rural medical service corps, 2 Chen HF History of Chinese healthcare. Shanghai Science and Technology Press, Shanghai1993: 267 Google Scholar delivery of health care was still scarce after 1949. Health-care expenditure for 8·3 million urban citizens covered by the state was more than that for 500 million peasants in 1964. 3 Huang SZ Lin SX Health in modern China. Chinese Social Science Press, Beijing1986: 13 Google Scholar After Mao Zedong criticised the urban bias of medical services and pointed out the stress placed on rural areas in 1965, 4 Mao ZD Long live Mao Zedong thought. Internal Sources. 1970; : 135 Google Scholar mobile teams of doctors from urban hospitals were sent to deliver health care and train indigenous paramedics.

Developing healthcare practice through action learning: individual and group journeys

Action Learning is now a well established strategy for reflective inquiry in healthcare. Whilst a great deal is know about action learning there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This article reports on the findings of 15-month action learning program based in a special care nursery. A realistic evaluation of the program uncovered individual and group journeys and provide evidence that action learning is an effective strategy in practice development.

Transition as a Salient Area of Inquiry in Healthcare: Asian Nurses Working in Western Countries

Transition as a Salient Area of Inquiry in Healthcare: Asian Nurses Working in Western Countries

Hennessy heads primary health care inquiry

Hennessy heads primary health care inquiry