CCS Cards get positive results in healthcare communication research study

Review of study from the Journal of communication in healthcare


“The visual images enabled patients the freedom to discuss topics in a non-threatening and open environment, and seemed to assist patients to reveal their daily life struggles …”

CCS cards were the subject of a recent research project that explored the use of images as a visual communication technique for nurses and patients in the haemodialysis context. That is, in the interactions between dialysis nurses and their patients who regularly come in for dialysis.

The study, Using images to communicate the hidden struggles of life on dialysis, is published in The Journal of Communication in Healthcare (Maney Publishing) Volume 6, Number 1, March 2013 , pp. 12-21(10). Authors: Paul N Bennett, Ann Bonner, Janet Andrew, Jyotsna Nandkumar, Catherine Au. Here is a brief summary of some findings that I believe give some valuable scientific rigour to the use of CCS in communication activities.

First a little background …

When I was first contacted by A/Prof Paul Bennett from Deakin-Southern Health (Melbourne) Nursing Research Centre, he talked about the importance of communication between dialysis nurses and their patients and how poor communication may lead to low-quality nursing care and undesirable patient outcomes. Communication in this context is considered unique, given the amount of time spent together in a confined clinical room. Paul indicated that he had observed the CCS being used in this context and wanted to carry out some scientific research to find out more.

The CCS cards were used by the nurses “to engage with the patients and to open up the conversation” using topics such as:
“What 3 cards best represent how you feel about being on dialysis?” and
“What 3 cards best represent how you might celebrate success in your life?”

The nurses used some prompting phrases such as “Can you tell me more about that?” and “What do you mean by that?”


Some findings …

The study documents which cards were chosen and quotes participants describing their CCS choices. Importantly, the kinds of things patients talked about are apparently not regularly shared by patients (this is no surprise to us of course!).

The researchers concluded that,

“The cards assisted in uncovering these often covert (to nurses) aspects of dialysis patients’ lives.”

As developers of the CCS, what most excites us are the CCS affirming things the nurses reported about their card-based interviews with the patients:

“The nurses reported gaining a better understanding of the challenges faced by people on dialysis. They expressed their surprise about how open and honest the patient participants were in discussing their personal relationships and their financial struggles … This contributed to their conclusion that the cards increased their own empathy towards the patient participants.”

“They [the nurses] stated that the cards brought out goals that the patients may not have previously identified if they had just been asked what are your goals and how would you celebrate successfully meeting these goals.”

The nurses believed that the card-based interviews provided them “with an opportunity to self-reflect and walk in the patient’s shoes” and as experienced nurses they “were unable to recall conversations with patients that they had which were similar to the card-generated conversations.”

If you are a regular user of the CCS, I suspect you would have been nodding in agreement with the level of disclosure the nurses experienced from their patients in the card-based interviews. It certainly confirms all the testimonies we hear from CCS users around the world.

Want to read the whole study?

The study is published in The Journal of Communication in Healthcare (Maney Publishing) Volume 6, Number 1, March 2013 , pp. 12-21(10). Authors: Paul N Bennett, Ann Bonner, Janet Andrew, Jyotsna Nandkumar, Catherine Au.

ORTRAN Self-Management Solutions

The use of the CCS in healthcare as a tool for self-management was pretty much pioneered by Dr Sue Curtis and Owen Curtis from ORTRAN Self Management Solutions.