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Background:
Patient 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 an...
Contexts in source publication
Context 1
... scale is divided into two parts of 17 questions each: (A) the practice of individualised care during nursing interventions and (B) the perception of individuality in care. Both parts include three domains: the clinical situation (seven items), the personal life situation (four items) and decisional control over care (six items) ( Table 2). See Appendices S1 and S2 for the abbreviated questions and item scores on the QPP and ICS. ...Context 2
... outcomes and estimation. Individualized Care ScaleThe linear mixed-effect model analysis for the cardiology patients shows a significant improvement at T1 on 6 out of 9 (sub)scales (Table 2). This effect is established at different levels; the total ICS scale (effect size 0.61, p = 0.02), both part A (ES: 0.62, p = 0.04) and part B (ES: 0.73, p = 0.004), and subscales ICS-A Personal life situation (ES: 0.89, p = 0.03), ICS-B Personal life situation (ES: 1.07, p = 0.002) and ICS-B Decisional control over care (ES: 0.57, p = 0.01). ...Citations
... High-quality fundamental care is central to nursing practice (Jackson and Kozlowska 2018), contributing to enhanced outcomes for care recipients (e.g., increased care satisfaction, participation, and functional ability, and reduced adverse events), professionals (e.g., better job satisfaction), and organisations/ systems (e.g., reduced staff turnover) (de Foubert et al. 2021;Mandal et al. 2020;van Belle et al. 2021;Wiechula et al. 2016). However, numerous studies and reports internationally have shown deficits in this care delivery across different healthcare settings (Chaboyer et al. 2021;Edfeldt et al. 2024;Francis 2013;Groves et al. 2017;Gustafsson et al. 2020;Mandal et al. 2020;Sugg et al. 2021). ...
... The Framework has strong face validity and has been integrated across research, education, practice, and policy internationally (e.g., Amaral et al. 2022;Feo, Donnelly, et al. 2018;Grønkjaer et al. 2022;Jeffs et al. 2022;Voldbjerg et al. 2018;Voldbjerg et al. 2020). It has underpinned exploratory studies (e.g., Ekermo et al. 2023;Minton et al. 2017;Pavedahl et al. 2021;Van Den Berg et al. 2023); feasibility and effectiveness studies (e.g., Richards et al. 2023;van Belle et al. 2021); and the establishment of cross-institutional partnerships (Grønkjaer et al. 2022). These efforts have generated much-needed evidence to enhance fundamental care delivery. ...
Aims
To describe the development and refinement of the Flinders Fundamentals of Care Assessment Tool for Clinical Practice through stakeholder feedback. The tool, based on the Fundamentals of Care Framework, supports healthcare leaders and clinicians in assessing fundamental care in a practical and user‐friendly manner that embraces rather than minimises the inherent complexity of this care delivery as it occurs in practice.
Design
Multi‐method study informed by participatory action principles.
Methods
Data collection involved an anonymous online survey and cognitive interviews with key stakeholders internationally to gauge perspectives on the clarity, usability, and acceptability of the tool. Data were collected between October–December 2023. Quantitative, categorical data were analysed using descriptive statistics. Qualitative data were analysed via content analysis.
Results
Participants described the Tool as Comprehensive, Practical, and Useful. Participants liked the visual representation of results in the form of bar and radar diagrams, which aided in interpreting the outcomes. The main suggestions for improvement were: (1) Simplifying items relating to the ‘Context of Care’ dimension of the Fundamentals of Care Framework; (2) Reducing similarity between some items; (3) Separating or simplifying items with multiple components; and (4) Clarifying terminology.
Conclusion
Based on stakeholder feedback, the Flinders Fundamentals of Care Assessment Tool for Clinical Practice is now digitised and includes a comprehensive instruction manual and definitions for each element of the Fundamentals of Care Framework assessed within the tool. The tool supports healthcare leaders and clinicians to assess fundamental care delivery at multiple levels—individual, team, unit/ward, organisational—identifying areas of strength and improvement to inform decision‐making, planning, and quality improvement. The tool offers a way of assessing fundamental care holistically as a multi‐dimensional construct rather than as a series of disaggregated tasks, better reflecting and capturing the complex reality of fundamental care delivery.
Implications for the Profession and/or Patient Care
The Flinders Fundamentals of Care Assessment Tool for Clinical Practice supports real‐time feedback (i.e., immediate visualisation of results), facilitating its integration in clinical practice to support enhanced fundamental care delivery.
Impact
Seeking stakeholder feedback has enhanced the relevance, acceptability, and feasibility of the Flinders Fundamentals of Care Assessment Tool for Clinical Practice, facilitating its use as a decision‐making and planning tool to support improved fundamental care delivery across clinical settings.
Reporting Method
This study is reported using the CROSS and SRQR guidelines.
Patient or Public Contribution
No Patient or Public Contribution.
... Across the 18 interventions (published in 33 studies), 12 type 1 interventions (patient-reported information about own health/needs/ concerns or other relevant outcomes) and 6 type 2 interventions (patient feedback about clinical practice) were included in this review (see Table 4). For type 1 interventions, different teams of researchers tested Tell-us cards, a paper-based communication tool provided by nurses for patients to report goals, needs, questions and concerns, which nurses acted upon (Jangland et al., 2012;Jangland & Gunningberg, 2017;Theys et al., 2020;van Belle et al., 2021). ...
Aims
To describe the characteristics of hospital‐based, patient‐mediated interventions and their impact on patient, clinician and organization outcomes.
Design
Systematic review.
Data Sources
Health literature databases (MEDLINE, CINAHL and EMBASE) were searched in August 2021. Backward and forward citation searching was conducted.
Review Methods
Studies investigating patient‐mediated interventions, targeted at adult hospitalized patients were eligible. Data were extracted related to study and intervention characteristics. Narrative synthesis was used to understand intervention impact on patient, clinician and organization outcomes (as per a framework). Methodological quality was assessed using the Mixed Methods Assessment Tool.
Results
Thirty‐three studies, reporting 18 interventions, were included. Twelve interventions prompted patients to report health information about their own health/needs/concerns and six interventions encouraged patients to provide feedback about clinical practice. Across all interventions, there was evidence that patients used patient‐mediated interventions and that they may improve patient communication. Healthcare professional outcomes were mixed for actual/intended use, acceptability and usefulness of interventions; yet there was some evidence of healthcare professional behaviour change. Interventions that encouraged patients to report health information about their own health/needs/concerns appeared more successful than other types of interventions.
Conclusions
There is some evidence that hospital‐based patient‐mediated interventions may influence patient communication and healthcare professional behaviour. Patient‐mediated interventions that encourage patients to report patient data before a clinical encounter may be more impactful than interventions that encourage patient feedback during or post‐encounter.
Impact
To date, most patient‐mediated intervention research has been conducted in primary care settings; we uncovered the types of patient‐mediated interventions that have been trialled in hospitals. We found that patient communication and healthcare professional behaviour may be influenced by these patient‐mediated interventions. Future researchers could explore the suitability and effectiveness of a wider range of hospital‐based patient‐mediated interventions.
No patient or public contribution
There was no funding to remunerate a patient/member of the public for this review.
... 24 For example, a tool that was developed for hospitalized patients showed a positive effect on patient participation. 25,26 A review focusing on shared decision-making, which is an aspect of person-centred care, concluded that patients who use decision aids feel clearer about their values. 27 An existing theoretical framework defines several themes that are important to infertile patients, 12 but this framework does not provide an intervention that can be used in clinical practice and does not use a person-centred viewpoint. ...
Background
An important—and often missing—element of person‐centred care is the inclusion of individual patients' values and preferences. This is challenging but especially important for high‐burden fertility treatments. We describe the development of a clinical tool that aims to facilitate the delivery of person‐centred fertility care by giving insight into the patients' values and preferences.
Methods
We developed the Tell me tool following the three principles of user‐centred design: (1) early and continual focus on users; (2) iterative design; (3) measurement of user behaviour. Accordingly, our methods consisted of three phases: (1) conducting semi‐structured interviews with 18 couples undergoing fertility treatment, followed by a consensus meeting with relevant stakeholders; (2) performing seven iterative improvement rounds; (3) testing the feasibility of the tool in 10 couples.
Results
The Tell me tool consists of a ranking assignment of 13 themes and two open‐ended questions. These themes relate to the couples' wellbeing and experience of the treatment, such as mental health and shared decision making. The open‐ended questions ask them to write down what matters most to them. The field test showed variation between the individual patients' answers. The tool proved to highlight what is important to the individual patient and gives insight into patients' personal contexts.
Conclusions
We developed a tool that gives insight into the values and preferences of the individual patient. The tool seems feasible for facilitating person‐centred fertility care.
Patient or Public Contribution
The tool was developed with a user‐centred design that strongly involved patients.
Background:
Effective communication between residents (older adults), families, and the healthcare team supports person-centred care. However, communication breakdowns can occur that can impact care and outcomes. The aim of this paper is to describe a feedback approach to developing a communication tool for residents and families to guide information sharing during care discussions with the healthcare team in long-term care.
Methods:
Development of the communication tool included consultation with key stakeholders for their feedback and input. Following initial development of the tool template by our research team, we invited feedback from our study collaborators. Next, individual interviews and a focus group were conducted with family members, followed by individual interviews with selected residents from two long-term care homes in Ontario, Canada. Participants were asked to provide input and feedback on the tool's content and usability and to share ideas for improving the tool. Content analysis was used to analyse the interview data.
Results:
Feedback from residents and family included suggestions to enhance the tool's content and use of plain language, and suggestions for potential application of the tool.
Conclusion:
Feedback highlighted the value of engaging residents and family members in the development of a communication tool. The communication tool offers a structured format to support participation of residents and families in information sharing for care discussions with the healthcare team.
