Acceptability of the Tell-us card in somatic nursing home wards: a qualitative feasibility study

Introduction: Effective communication between nursing staff and clients is inevitable. The Tell-us card is developed to improve this communication in hospitals. However, it has not been tested on older clients in nursing homes. Research questions: What is the acceptability of the Tell-us card from the perspectives of somatic nursing home clients and nursing staff? Which content will be reported on the Tell-us card by somatic nursing home clients? Methods: A qualitative feasibility study was conducted between December 2015 and July 2016. All nursing staff and somatic clients of a selected somatic ward of a nursing home in the Netherlands who had the willingness to participate in this study were invited. Data was collected from 2 focus groups with nursing staff (n=11) and think-aloud interviews with somatic clients (n=11) and analysed using a thematic analysis. Results: The Tell-us card had several barriers like financial strains and time restrictions for nursing staff. Writing and reading disabilities were the main barriers for clients to use the Tell-us card. However, the Tell-us card could support clients and nursing staff to start a conversation about her/his needs and wishes. All nursing staff and approximately one third of the clients have the intention to use the Tell-us card in practise. One third of the clients do not want to participate in the decision making process of nursing care and will report no wishes on the Tell-us card. Other reported wishes were related to fundamental care, or do activities. Conclusion: The acceptability of the Tell-us card is limited in daily nursing home practise. Implications: Nursing staff have to implement client participation on a level that is desired by the clients. Further research is recommended to investigate the role of clients and nursing staff to enhance client participation