Abstract
BackgroundPatient participation is fundamental to nursing care and has beneficial effects on patient outcomes. However, it is not well embedded yet and little is known on how nurses could effectively stimulate patient participation in hospital care. The Tell‐us Card is a communication tool for inviting patients to talk about their preferences and needs, and to increase patient participation in daily care.ObjectivesTo assess feasibility and early effectiveness of the Tell‐us Card communication tool for enhanced patient participation during hospitalisation.Design and methodA pilot cluster randomised controlled study design was used including four nursing wards. Effectiveness was measured with the Individualized Care Scale (ICS) and the Quality from the Patients’ Perspective (QPP) questionnaire. Linear mixed model analysis was used for analysis. Feasibility was assessed with an evaluative questionnaire for patients and nurses and by reviewing the content of Tell‐us Cards using the Fundamentals of Care Framework (FOCF) for analysis. Ethical approval was attained.ResultsData of 265 patients showed a significant increase at one intervention ward on the ICS (effect size 0.61, p = 0.02) and most ICS subscales. No effect was visible on the QPP. The majority of patients regarded the intervention as beneficial; nurses however experienced barriers with incorporating the Tell‐us Card into daily care. Analysis of the Tell‐us Card content showed many elements of the FOCF being mentioned, with most patients indicating psychosocial needs like being involved and informed.ConclusionsThis pilot study showed a positive early effect of the Tell‐us Card communication tool on patient participation, although integration in daily nursing care appeared to be complex and an optimal fit has not yet been reached. Patients were positive about the intervention and wrote meaningful issues on the Tell‐us Cards. More research is needed on how to incorporate patient participation effectively in complex hospital care.
Highlights
Hospitalised patients’ participation in care is challenging but has various beneficial effects in patient safety [1], adherence to therapy or lifestyle advices [2], and both patient [3] and healthcare professionals work satisfaction [4]
There is not one clear definition of patient participation, and the concept is interchangeably used with terms like patient-centredness, shared decision-making, personcentred care, and patient empowerment or engagement
The Tell-us Card was handed out 158 times to 107 individual patients; 123 times to 72 patients at the surgical ward, and 41 times to 35 patients on the cardiology ward
Summary
Hospitalised patients’ participation in care is challenging but has various beneficial effects in patient safety [1], adherence to therapy or lifestyle advices [2], and both patient [3] and healthcare professionals work satisfaction [4]. Patient participation in nursing practice is defined by Sahlsten et al as an established relationship between nurse and patient, a surrendering of power or control by the nurse, shared information and knowledge, and active engagement together in intellectual or physical activities [5]. This established relationship forms the core of effective patient participation and person-centred care [6]. Conclusions: This pilot study showed a positive early effect of the Tell-us Card communication tool on patient participation, integration in daily nursing care appeared to be complex and an optimal fit has not yet been reached. More research is needed on how to incorporate patient participation effectively in complex hospital care
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