Generating insights into what matters to emergency nurses and family members when caring for older people with dementia: how to use generativity as a principle of appreciative inquiry.

Background: Participatory research approaches aim to hear the voices of those who give and receive services to co-create insights into future improvements in care experiences. Appreciative Inquiry (AI) is one such participatory approach. The purpose of AI is generativity which is defined as helping people to see old things in new ways. Generativity shows much potential but there is little research describing the ‘how to’ of doing this in practice. This paper describes the how to of generativity in the Dream Phase of an AI study. Aims: The aim was to share and co-analyse with emergency nurses, family member experiences of being in an emergency department with an older person with dementia. Methods: Three critical methods were used to generate data - storytelling, appreciative framing and dialogue, and collaborative sensemaking. The principles of AI provided a framework for data analysis. Findings: In using AI methodology, emergency nurses were able to envision a preferred future based on what people value and what matters in approaches to care. Generativity enabled them to visualise what it would take to bring this new way of nursing to reality. Conclusions: Creative methods, when maximised, may be powerful tools in reframing narratives and helping practitioners to transcend the rut that perpetuates the status quo and obscures hope for the future. Generation of new insights and perspectives is critical to identifying and developing strategies for practice enhancement.