Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping

Elise van Belle*, Sandra M. G. Zwakhalen, Josien Caris, Ann Van Hecke, Getty Huisman-de Waal, Maud Heinen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Aims and objectivesTo describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. BackgroundEven though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. DesignDescription of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. MethodsIntervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. ResultsKnowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. ConclusionsThe Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. Relevance to clinical practiceThis article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions.
Original languageEnglish
Pages (from-to)621-630
Number of pages10
JournalJournal of Clinical Nursing
Issue number3-4
Publication statusPublished - 1 Feb 2018


  • communication
  • fundamentals of nursing care
  • hospital
  • Intervention Mapping
  • MRC framework
  • Nursing
  • patient participation

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