Appreciative Inquiry in Youthful Offender Psychiatric Nursing Research

PROBLEM: Combined with demonstrated impulsive behaviors and culturally bound expectations, youth who are detained in the juvenile justice system are challenged to find opportunities to articulate their stories and life experiences that contribute to a future life. METHODS: Appreciative inquiry (AI) as a research method is used to analyze interviews of youth residing in a juvenile detention center. FINDINGS: The narrative, or life pattern, that youth in detention express is explicated through the four processes of the 4‐D Cycle in AI. The processes are discovery, dreaming, designing, and delivery. CONCLUSIONS: AI as a research method is useful to conduct interviews with detained youth, to provide a data analysis method for qualitative interviews, and generate nursing interventions. Through articulation of their own stories, youth discover voice and envision empowerment.     

Exercise,self‐efficacy,and mobility performance in overweight and obese older adults with knee osteoarthritis

Objective

To examine changes in mobility‐related self efficacy following exercise and dietary weight loss interventions in overweight and obese older adults with knee osteoarthritis (OA), and to determine if self efficacy and pain mediate the effects of the interventions on mobility task performance.

Methods

The Arthritis, Diet, and Activity Promotion Trial was an 18‐month, single‐blind, randomized, controlled trial comparing the effects of exercise alone, dietary weight loss alone, a combination of exercise plus dietary weight loss, and a healthy lifestyle control intervention in the treatment of 316 overweight or obese older adults with symptomatic knee OA. Participants completed measures of stair‐climb time and 6‐minute walk distance, self efficacy for completing each mobility task, and self‐reported pain at baseline, 6 months, and 18 months during the trial.

Results

Mixed model analyses of covariance of baseline adjusted change in the outcomes demonstrated that the exercise + dietary weight loss intervention produced greater improvements in mobility‐related self efficacy (P = 0.0035), stair climb (P = 0.0249) and 6‐minute walk performance (P = 0.00031), and pain (P = 0.09) when compared with the healthy lifestyle control intervention. Mediation analyses revealed that self efficacy and pain served as partial mediators of the beneficial effect of exercise + dietary weight loss on stair‐climb time.

Conclusion

Exercise + dietary weight loss results in improved mobility‐related self efficacy; changes in these task‐specific control beliefs and self‐reported pain serve as independent partial mediators of the beneficial effect of exercise + dietary weight loss on stair‐climb performance.