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Lin L, Fang Y, Huang F, Zhang X, Zheng J, Xiao H. Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: The mediating role of readiness for hospital discharge and stoma self-efficacy. PLoS One 2024; 19:e0306981. [PMID: 38990912 PMCID: PMC11238961 DOI: 10.1371/journal.pone.0306981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect. BACKGROUND It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy. METHODS This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson's correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data. RESULTS Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]). CONCLUSIONS Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.
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Affiliation(s)
- Liying Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yifang Fang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiaoying Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jianwei Zheng
- Department of Oncology, The Union Hospital Affiliated with Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China
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Feldbusch H, Schmidt M, Steeb EM, Paschek N, Nemesch M, Sartory Y, Brenner R, Nöst S. Theoretical concepts and instruments for measuring hospital discharge readiness: A scoping review. Heliyon 2024; 10:e26554. [PMID: 38439820 PMCID: PMC10909674 DOI: 10.1016/j.heliyon.2024.e26554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Background The Discharge Readiness of adult patients in a hospital setting is a multidimensional concept which is becoming increasingly important internationally as part of discharge planning. To date, there has been a lack of reviews of existing measurement instruments as well as theoretical concepts of discharge readiness. Objective To provide an overview of existing measurement instruments and theoretical concepts regarding readiness for hospital discharge in adult patients. Design and methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodological manual and PRISMA ScR reporting principles. A literature search was conducted using the CINAHL and LIVIVO databases (including MEDLINE and PSYINDEX) in October 2021. After test screening, all identified articles were screened by two independent reviewers using predefined inclusion and exclusion criteria before the content was extracted and mapped. Results Of the 1823 records identified, 107 were included in this review. Of these, 30 studies were included as development or validation studies of measurement instruments assessing discharge readiness, 68 were included as empirical studies with readiness for hospital discharge as the primary outcome or key concept, and nine publications were included as theoretical papers or reviews. Five dimensions of readiness for hospital discharge were extracted:1) Physical, 2) Psychological, 3) Education and Knowledge, 4) Adequate Individual Support, and 5) Social and Organisational Determinants. Of the 47 instruments identified for measuring discharge readiness, 33 were validated. The Readiness for Hospital Discharge Scale (RHDS) was the most frequently used instrument. Conclusions The systematic measurement of readiness for hospital discharge, particularly from the patient's perspective combined with the nurse's perspective, might be useful in reducing negative outcomes such as readmissions. This review provides an overview of existing and validated instruments for the systematic assessment of discharge readiness in acute inpatient care, as well as an overview of the theoretical concepts of readiness for hospital discharge. Further research is needed on the relationship between organisational determinants and readiness for discharge.
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Affiliation(s)
- Hanna Feldbusch
- Baden-Württemberg Cooperative State University Stuttgart, School of Health Sciences and Management, Stuttgart, Germany
- Robert Bosch Hospital, Stuttgart, Germany
| | - Marita Schmidt
- Baden-Württemberg Cooperative State University Stuttgart, School of Health Sciences and Management, Stuttgart, Germany
| | | | | | | | | | | | - Stefan Nöst
- Baden-Württemberg Cooperative State University Stuttgart, School of Health Sciences and Management, Stuttgart, Germany
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Cao W, Li G, Guo Y, Liu X, Wang H, Gao H. Parental readiness for hospital discharge and the relationship with growth and development of infant in China. J Pediatr Nurs 2024; 75:e112-e118. [PMID: 38184478 DOI: 10.1016/j.pedn.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/01/2024] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
PURPOSE This study aimed to evaluate the associations between parental readiness for discharge and neonatal growth. DESIGN AND METHODS This cross-sectional study included 549 newborns whose parents filled out the Newborn-Parental Readiness for Discharge Scale (N-PRDS).Additionally, data on birth weight, length, and head circumference were collected.The total N-PRDS scores were divided into three levels in terms of readiness: low, intermediate, and high readiness. Parents and infants were followed up 42 days after the birth, and the weight, length, and head circumference of the newborns were measured at the hospital. RESULTS A total of 306 data were obtained. The generalized linear mixed model (GLMM) showed that time and parental readiness had an interaction effect on the weight, length and head circumference of infants. The difference in weight between infants under the high and low readiness conditions at 42 days increased by 0.357 kg compared to the difference at birth. The difference in length between high readiness infants and low readiness infants at 42 days increased by 2.155 cm compared to the difference at birth. The difference between the infants' head circumference under the high and low readiness conditions at 42 days was 0.873 cm higher than that at birth. CONCLUSIONS High readiness for discharge could promote an increase in infant weight, length,and head circumference at 42 days after birth. PRACTICE IMPLICATIONS Nurses should assess parental readiness prior to the discharge of newborns by using the N-PRDS and provide discharge guidance and education to newborns' parents based on the outcomes of this scale.
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Affiliation(s)
- Wenpei Cao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Guirong Li
- Department of Neonatology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Yu Guo
- Department of Neonatology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Xiaoning Liu
- School of Public Health, Lanzhou University, Lanzhou, China.
| | - Hongyan Wang
- Department of Neonatology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
| | - Hongxia Gao
- Department of Neonatology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China
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Morales JF, Gomez A, Carvalho J, Ye XY, Downey K, Siddiqui N. Quality of Recovery After Unplanned and Planned Cesarean Deliveries: A Prospective Observational Study Using the Obstetric Quality of Recovery-10 Tool. Anesth Analg 2024:00000539-990000000-00755. [PMID: 38381657 DOI: 10.1213/ane.0000000000006876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND There is a paucity of literature examining the differences between patient-reported outcome measures after planned and unplanned cesarean delivery using a validated quality of recovery tool. The Obstetric Quality of Recovery-10 (ObsQoR-10) scoring tool has been validated to quantify functional recovery after cesarean delivery. We aimed to use the ObsQoR-10 to compare the postoperative recovery characteristics of patients undergoing planned and unplanned cesarean deliveries. METHODS We conducted a prospective single-center observational study. Patients undergoing planned and unplanned cesarean deliveries under neuraxial anesthesia were asked to complete the ObsQoR-10 questionnaire 24 hours, 48 hours, and 1 week postpartum. We collected information on total in-hospital postoperative opioid consumption and patients´ perception of readiness for discharge at 24 and 48 hours postpartum. Additionally, patient characteristics were collected to assess their correlation with our findings. RESULTS We included 112 patients (56 in each group). No statistical differences in ObsQoR-10 scores at 24 hours, 48 hours, and 1 week postpartum were observed between the planned and unplanned cesarean deliveries. Additionally, there was no difference between the groups in patients' perception of readiness for hospital discharge at 24 and 48 hours and opioid consumption in the first 2 days after surgery. Most patients in both groups did not think they would be ready for discharge at 24 hours postpartum. Analysis of the individual components of ObsQoR-10 at 24 hours showed a difference in the responses assessing the severity of shivering (higher in unplanned cesarean deliveries) and the ability to look after personal hygiene (lower in unplanned cesarean deliveries). CONCLUSIONS As assessed by the ObsQoR-10, no significant difference in the quality of recovery was observed between patients undergoing planned and unplanned cesarean delivery.
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Affiliation(s)
- Juan F Morales
- From the Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, Ontario Canada
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Hall M, Afzal A, White DE. Single Room Maternity Care Versus Traditional Maternity Care: A Cross-Sectional Study Examining Differences in Mothers' Perceptions of Readiness for Discharge and Satisfaction and Health Outcomes. Can J Nurs Res 2023; 55:345-353. [PMID: 36945743 PMCID: PMC10416552 DOI: 10.1177/08445621231165233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development. METHODS This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A cross-sectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers' satisfaction, newborn length of stay, and mother length of stay. Several covariates were examined. RESULTS In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables. CONCLUSIONS There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.
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Affiliation(s)
- Marc Hall
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | - Arfan Afzal
- Faculty of Nursing, University of Calgary, Calgary, Canada
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Adams YJ, Agbenyo JS. Improving the Quality of Postpartum Care in Ghana: Protocol for a Parallel Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e47519. [PMID: 37606965 PMCID: PMC10481215 DOI: 10.2196/47519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Although the postpartum period poses substantial risks and can result in significant maternal morbidity and mortality, postpartum care of the mother receives much less attention in transitional countries. OBJECTIVE We describe the protocol for a randomized controlled trial to implement and evaluate a postpartum care delivery model titled Focused-PPC (Focused Postpartum Care). METHODS Focused-PPC is an integrated group postpartum care model that meets the clinical care, education, and support needs of mothers up to 1 year after birth. The Focused-PPC intervention is a parallel randomized controlled trial with a total of 192 postpartum women at 4 health centers in Tamale, Ghana. Participants will be randomized into 1 of 2 trial arms at a 1:1 allocation ratio: (1) the control arm, which receives the standard postnatal care currently delivered in health facilities, or (2) the intervention arm, which receives the Focused-PPC model of care. Women enrolled in the intervention arm will receive postpartum clinical assessments and education for the first 6 weeks and will continue to receive education, measures of vital signs, and peer support for 12 months post partum during child welfare visits. Led by trained midwives, each postpartum group in the intervention arm will meet at 1-2 weeks, 6 weeks, and monthly thereafter for up to 1 year post partum, following the Ghana Health Service postnatal care schedule. RESULTS The Focused-PPC guide, data collection tools, and audiovisual education materials were successfully developed and translated into the local language. We have enrolled and conducted baseline surveys for 192 women (sample size met) in the Focused-PPC trial who have been randomized into intervention and control arms. We have established a total of 12 Focused-PPC groups in the intervention arm, 3 groups from each site, all of which have sessions underway. CONCLUSIONS Focused-PPC has the potential to change the postpartum care delivery model in Ghana and other countries in sub-Saharan Africa and beyond. TRIAL REGISTRATION ClinicalTrials.gov NCT05280951; https://clinicaltrials.gov/study/NCT05280951. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47519.
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Affiliation(s)
- Yenupini Joyce Adams
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States
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Wu DL, Luo CL, Du X, Li PP, Jiang M, Liu T, Sun Y. Current Status and Influencing Factors of Readiness for Discharge of Elderly Patients with Chronic Obstructive Pulmonary Disease. Patient Prefer Adherence 2023; 17:1323-1333. [PMID: 37255947 PMCID: PMC10226539 DOI: 10.2147/ppa.s410725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Readiness for hospital discharge is an important indicator of patients' transition from illness to health and can predict rehabilitation and prognosis. Identifying factors that influence readiness for discharge is crucial for developing effective nursing interventions. Therefore, this study aims to investigate the current status of discharge readiness and its influencing factors in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 311 elderly inpatients diagnosed with COPD were enrolled in this investigation at a tertiary hospital in Chengdu between December 2021 and June 2022. Questionnaires were designed to collect general information, disease-related information, and responses to the Readiness for Hospital Discharge Scale (RHDS) and the Quality of Discharge Teaching Scale (QDTS). Univariate and multivariate linear regression analyses were employed to further analyze factors related to discharge readiness and the correlation between discharge readiness and the quality of discharge guidance. Results The total score of discharge readiness of elderly COPD patients was 77.72 ± 11.86 with a mean score of 6.48 ± 0.19 for each item. The quality of discharge instructions was 110.54 ± 15.66, with a mean score of 6.12 ± 0.15 for each item. Discharge preparation was positively correlated with the quality of discharge guidance. Multivariate analysis showed that marital status, admission mode, length of stay in hospital, Classification of Severity of Airflow Limitation, mMRC classification, number of medications taken with discharge, presence of inhalers in medication orders, mode of home oxygen therapy, and quality of discharge guidance were independent factors of discharge readiness in elderly COPD patients (P < 0.05). Conclusion Both discharge readiness and the quality of discharge guidance for elderly COPD patients in China are currently suboptimal and need further improvement. The survey findings provide valuable insights that can guide future management practices and interventions aimed at improving discharge readiness.
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Affiliation(s)
- Dao-Lin Wu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Chun-Li Luo
- School of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xu Du
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Pei-Pei Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Min Jiang
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Tao Liu
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Department of Oncology, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Key Clinical Specialty of Sichuan, Chengdu, Sichuan, People’s Republic of China
| | - Yun Sun
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
- Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
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Rattanakanlaya K, Vuttanon N, Noppakun L, Sangwattanarat W, Boonyu N, Iamruksa S. Readiness for hospital discharge post-initial invasive percutaneous transhepatic biliary drainage: A mixed-methods study. Heliyon 2023; 9:e15341. [PMID: 37144202 PMCID: PMC10151257 DOI: 10.1016/j.heliyon.2023.e15341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023] Open
Abstract
This study explores perceptions regarding hospital discharge readiness among patients with post-first invasive percutaneous transhepatic biliary drainage (PTBD), family caregivers, and healthcare providers who are involved during the discharge period. A convergent mixed-method design was applied. A purposive sample of 30 patients completed a scale measuring readiness for hospital discharge, and 30 participants, including patients, family caregivers, and healthcare providers, participated in in-depth interviews. Descriptive analyses were combined with quantitative data, thematic analyses with qualitative data, and joint displays with mixed analyses. Findings indicate that readiness for hospital discharge was high, the expected support subscale was at the highest possible level, and the personal status subscale was at the lowest level. Three main themes emerged from an analysis of the interview transcripts: improved health conditions, self-care knowledge, and homecare preparedness. Self care knowledge had three sub-themes: taking care of biliary drainage, consuming a suitable diet, and observation of abnormal symptoms. Being ready for hospital discharge contributes to a safer transition from hospital to home. Healthcare providers need to reconsider the criteria for discharge and clarify patients' individual needs. Patients, family caregivers, and healthcare providers need to be prepared for hospital discharge.
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Affiliation(s)
- Kanittha Rattanakanlaya
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110/406 Intrawarorot Rd, Suthep, Muanf, Chiang Mai, 50200, Thailand
- Corresponding author.
| | - Nuttamon Vuttanon
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110/406 Intrawarorot Rd, Suthep, Muanf, Chiang Mai, 50200, Thailand
| | - Lalida Noppakun
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110/406 Intrawarorot Rd, Suthep, Muanf, Chiang Mai, 50200, Thailand
| | - Wantanee Sangwattanarat
- Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Rd, Sriphum, Muang, Chiang Mai 50200, Thailand
| | - Nongnuch Boonyu
- Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Rd, Sriphum, Muang, Chiang Mai 50200, Thailand
| | - Srisuda Iamruksa
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110/406 Intrawarorot Rd, Suthep, Muanf, Chiang Mai, 50200, Thailand
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Liu Y, Peng LL, Zhang YY, Tang MY, Tang MQ, Xu YY, Ma ZY, Tang Y, Gao L. The post-discharge coping difficulty of puerperal women in a middle and low-income tourist city during the COVID-19 pandemic. BMC Pregnancy Childbirth 2023; 23:251. [PMID: 37055725 PMCID: PMC10099011 DOI: 10.1186/s12884-023-05554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/29/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Since the coronavirus disease 2019 (COVID-19) pandemic outbreak, the incidence of mental health problems in perinatal women has been high, and particularly prominent in China which was the first country affected by COVID-19. This paper aims to investigate the current situation and the related factors of maternal coping difficulties after discharge during COVID-19. METHODS General information questionnaires (the Perinatal Maternal Health Literacy Scale, Postpartum Social Support Scale and Post-Discharge Coping Difficulty Scale-New Mother Form) were used to investigate 226 puerperal women in the third week of puerperium. The influencing factors were analyzed by single factor analysis, correlation and multiple linear regression. RESULTS The total score of coping difficulties after discharge was 48.92 ± 12.05. At the third week after delivery, the scores of health literacy and social support were 21.34 ± 5.18 and 47.96 ± 12.71. There were negative correlations among health literacy, social support and coping difficulties after discharge (r = -0.34, r = -0.38, P < 0.001). Primipara, family income, health literacy and social support were the main factors influencing maternal coping difficulties after discharge. CONCLUSION During the COVID-19 pandemic, puerperal women in a low- and middle-income city had moderate coping difficulties after discharge and were affected by many factors. To meet the different needs of parturients and improve their psychological coping ability, medical staff should perform adequate assessment of social resources relevant to parturients and their families when they are discharged, so they can smoothly adapt to the role of mothers.
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Affiliation(s)
- Yan Liu
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lan-Lan Peng
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Yi-Yuan Zhang
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Mei-Yin Tang
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Mei-Qiong Tang
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Yun-Yun Xu
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Zong-Ying Ma
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China
| | - Yi Tang
- Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, Guangxi, China.
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China.
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Lau E, Adams YJ, Ghiaseddin R, Sobiech K, Ehla EE. Discharge Readiness and Associated Factors Among Postpartum Women in Tamale, Ghana. West J Nurs Res 2023; 45:539-546. [PMID: 36782383 DOI: 10.1177/01939459231152122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Ghana experiences a relatively high maternal mortality ratio, with the majority of maternal deaths occurring in the postpartum period. Discharge readiness is a reliable indicator of maternal health outcomes and involves a postpartum woman's perception of preparedness to leave the hospital following delivery. We measured the discharge readiness of postpartum women in Ghana through an institutional-based cross-sectional study involving 151 participants. Participants completed an interviewer-administered survey, and data analyses included linear regression models. The study sample demonstrated relatively high discharge readiness, with a mean score of 177.57 on a scale from 0.00 to 220.00. Higher gravidity was positively associated with discharge readiness score, while longer length of hospital stay and receiving educational handouts were negatively associated with discharge readiness score. Clinical interventions addressing the factors found to be associated with discharge readiness have significant potential to improve postpartum care and maternal outcomes in Ghana.
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Affiliation(s)
- Elizabeth Lau
- College of Science, University of Notre Dame, Notre Dame, IN, USA
| | | | - Roya Ghiaseddin
- Department of Applied and Computational Mathematics & Statistics, University of Notre Dame, Notre Dame, IN, USA
| | - Kathleen Sobiech
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
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Chen Y, Chen Z, Jin H, Chen Y, Bai J, Fu G. Associations of financial toxicity with symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home: a prospective observational study. BMC Cancer 2023; 23:140. [PMID: 36765325 PMCID: PMC9912596 DOI: 10.1186/s12885-023-10580-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Cancer patients with financial toxicity experience psychological distress and often miss medical appointments and quit treatments early, which could be a barrier to the effective management of oral chemotherapy drugs at home. This study explores whether financial toxicity predicts symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home, which will contribute to the safe management of oral chemotherapy. METHODS Data in this study was from a prospective observational study, which was conducted between October 2018 and December 2019. 151 patients completed the Comprehensive Score for Financial Toxicity at discharge and completed the MD Anderson Symptom Inventory and unplanned healthcare utilization questionnaires after finishing one cycle of oral chemotherapy at home. Regression analyses were conducted to explore the associations of financial toxicity with symptoms and unplanned healthcare utilization. RESULTS Among 151participants, 88.08% reported severe or moderate financial toxicity, 43.05% reported symptom interference, and 31.79% reported unplanned healthcare utilization while taking oral chemotherapy at home. Patients between the age of 45-60y (p = 0.042) have higher financial toxicity, while those living in urban areas (p = 0.016) have lower financial toxicity. Patients with worse financial toxicity suffered increased symptoms of fatigue, emotional distress, disturbed sleep, and lack of appetite. Consequently, their mood and personal relation with other significant suffered. However, no statistical differences in unplanned healthcare utilization were found among patients with different levels of financial toxicity. CONCLUSION Middle-aged adults and those living in suburban or rural areas experienced worse financial toxicity than other groups. Patients with worse financial toxicity experienced more severe psychological symptoms (e.g., fatigue, distress, disturbed sleep, and lack of appetite) and affective interference (e.g., mood and relations with others). Identifying at-risk patients is necessary to offer tailored support for psychological symptom management.
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Affiliation(s)
- Yongfeng Chen
- grid.410652.40000 0004 6003 7358Nursing Department, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhenxiang Chen
- grid.410652.40000 0004 6003 7358The Department of Chemotherapy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Haiyun Jin
- grid.410652.40000 0004 6003 7358The Department of Chemotherapy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanrong Chen
- grid.410652.40000 0004 6003 7358The Department of Chemotherapy, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, 30322, Atlanta, GA, USA.
| | - Guifen Fu
- Nursing Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China. .,Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, 530021, Nanning, China.
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12
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George S, Showalter D, Graham K. Implementing the Role of Neonatal Assessment Nurse to Improve Skin-to-Skin Care and Breastfeeding Exclusivity. Nurs Womens Health 2023; 27:79-89. [PMID: 36773627 DOI: 10.1016/j.nwh.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/01/2022] [Accepted: 01/18/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To improve rates of exclusive breastfeeding during the postpartum hospital stay by implementing a new role of dedicated neonatal assessment nurse (NAN), whose primary function was neonatal care beginning immediately after birth. DESIGN Quality improvement project with plan-do-study-act using evidence-based guidelines for implementing the NAN role. SETTING/LOCAL PROBLEM Labor and delivery department of a tertiary care teaching hospital in the southeastern United States; breastfeeding exclusivity rates at this hospital were in the range of 50%. PARTICIPANTS Registered nurses employed in the labor-delivery-recovery unit, mother-baby unit, and NICU. INTERVENTION/MEASUREMENTS The NAN role was implemented to promote immediate skin-to-skin care (SSC) for stable newborns after vaginal and cesarean birth. Each NAN's competency was evaluated at the beginning and end of the education session through a pretest/posttest, and a skills validation was used to affirm their readiness for the new role. The outcome measure was breastfeeding exclusivity at the time of discharge from the hospital. SSC initiation and duration immediately after birth were the process measures. RESULTS Twenty-five bedside registered nurses participated in this quality improvement project. There was a statistically significant difference between the pretest and posttest scores (p < .001), indicating a knowledge increase. All nurses met the skills validation criteria. The rate of SSC immediately after vaginal birth increased from 49% to 82% and after cesarean birth from 33% to 63%. Breastfeeding exclusivity rate at the time of discharge from the hospital increased from 50% to 86%. CONCLUSION The NAN role provided transitional care at the bedside without the separation of mothers and newborns. This was an innovative role, without the need to hire new staff, that provided evidence-based care, resulting in improved SSC and exclusivity of breastfeeding before discharge.
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13
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Xia ML, Lin WX, Gao LL, Zhang ML, Li ZY, Zeng LL. Readiness for Hospital Discharge After a Cesarean Section and Associated Factors Among Chinese Mothers: A Single Centre Cross-Sectional Study. Patient Prefer Adherence 2023; 17:1005-1015. [PMID: 37077667 PMCID: PMC10106991 DOI: 10.2147/ppa.s404137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose Knowledge of the readiness for hospital discharge can help health care professionals accurately determine the patients' discharge time. However, few studies were on the readiness for discharge and its related factors among mothers with cesarean sections. Thus, this study aims to examine the readiness for hospital discharge and its associated factors among Chinese mothers with cesarean sections. Patients and Methods A single-centre cross-sectional study was conducted from September 2020 to March 2021 in Guangzhou, China. Three hundred thirty-nine mothers with cesarean sections completed the questionnaires on demographic and obstetric characteristics, readiness for hospital discharge, quality for discharge teaching, parenting sense of competence, family function, and social support. Multiple linear regression analysis was used to identify independent factors influencing readiness for hospital discharge among mothers with cesarean sections. Results The total score of readiness for hospital discharge was 136.47 ± 25.29. The quality of discharge teaching, parenting sense of competence, number of cesareans, family function, and attending antenatal classes were independent factors influencing the readiness for hospital discharge (P < 0.05) among mothers with cesarean sections. Conclusion The readiness for hospital discharge of mothers with cesarean sections need to be improved. Improving the quality of discharge teaching, parenting sense of competence, and family function may help improve the readiness for hospital discharge of mothers with cesarean sections.
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Affiliation(s)
- Mei-Ling Xia
- Reproductive Centre, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Wen-Xuan Lin
- Nursing Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Correspondence: Ling-Ling Gao, School of Nursing, Sun Yat-sen University, Guangzhou, People’s Republic of China, Tel +86-20-87335013, Fax +86-20-87333043, Email
| | - Mao-Ling Zhang
- Reproductive Centre, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Zhi-Yun Li
- Obstetric Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Li-Ling Zeng
- Obstetric Department, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
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14
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Ran M, Songwathana P, Damkliang J. Discharge readiness and its associated factors among first-time mothers undergoing cesarean section in China. BELITUNG NURSING JOURNAL 2022; 8:497-504. [PMID: 37554237 PMCID: PMC10405666 DOI: 10.33546/bnj.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/02/2022] [Accepted: 11/28/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Helping first-time mothers who have just undergone cesarean section and transitioning from hospital to home with their infant is a complex process. Therefore, understanding what contributes to discharge readiness is necessary. OBJECTIVE This study aimed to determine discharge readiness level and its associated factors among first-time mothers who have undergone cesarean section. METHODS A descriptive cross-sectional study was conducted among 233 first-time mothers who had undergone cesarean sections selected using quota sampling from the two largest referral centers in China. Data were collected from March to June 2021 using a demographic characteristics form, Readiness for Hospital Discharge Scale-New Mother Form (RHDS-NMF), and Quality Discharge Teaching Scale-New Mother Form (QDTS-NMF). Descriptive and inferential statistics were used for data analysis. RESULTS The discharge readiness of the respondents was at a moderate level. Age (r = -0.129, p = 0.049) and complications after cesarean section (r = -0.136, p = 0.038) had a negative correlation with discharge readiness. In contrast, the subscales of QDTS-NMF, particularly the content (r = 0.519, p = 0.000) and delivery (r = 0.643, p = 0.000), had a positive correlation with discharge readiness. CONCLUSION The findings enable nurses, midwives, and other healthcare professionals to understand discharge readiness and its related factors among first-time mothers undergoing cesarean section. It is also suggested that the quality of discharge teaching with a comprehensive assessment of first-time mothers preparing for discharge from the hospital and following the guideline to prevent post-cesarean section complications should be reinforced.
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Affiliation(s)
- Mingfei Ran
- Faculty of Nursing, Prince of Songkla University, Thailand
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15
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Qiu C, Feng X, Zeng J, Jiang Y. Relationships between Cataract Surgery Patient-Perceived Discharge Teaching Quality, Discharge Readiness, and Post-Discharge Outcomes: A Cross-Sectional Study Based on Regression Modeling Analysis. Ophthalmic Res 2022; 66:328-338. [PMID: 36353771 DOI: 10.1159/000527958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2023]
Abstract
INTRODUCTION A short hospital stay makes discharge planning services especially critical for patients undergoing cataract surgery. Studies on discharge teaching quality, discharge readiness, and post-discharge outcomes for patients with cataracts are lacking. Our study aimed to explore the relationships between the perceived discharge teaching quality, discharge readiness, and post-discharge outcomes of cataract surgery patients and to conduct a differential analysis between inpatient and day ward patients. METHODS We recruited 387 patients from the ophthalmology ward of a top-tier hospital in western China through convenience sampling. Data were collected on the day of discharge and at 2 weeks post-discharge. Statistical methods included multiple linear regression analysis, χ2 test, and the Mann-Whitney U test. RESULTS Regression models indicated that discharge teaching quality was the key factor of discharge readiness, while post-discharge outcomes were influenced by discharge readiness and discharge teaching quality. Further, inpatients' discharge teaching quality, discharge readiness, and post-discharge subjective feelings were better than those of day ward patients. CONCLUSIONS The effect of discharge planning services on patients undergoing cataract surgery was generally satisfactory. High-quality discharge teaching can enhance patients' discharge readiness, further improving their post-discharge outcomes. When conducting discharge teaching, day ward medical staff should pay more attention to patients' demands and explore a more effective teaching delivery method.
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Affiliation(s)
- Chujin Qiu
- West China School of Nursing, Sichuan University, Chengdu, China,
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China,
| | - Xianqiong Feng
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Jihong Zeng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
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16
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Lebel V, Argiropoulos N, Robins S, Charbonneau L, Feeley N. Family-centred care and breastfeeding self-efficacy determined how ready mothers were for their infants to be discharged from a neonatal intensive care unit. Acta Paediatr 2022; 111:2299-2306. [PMID: 36057447 DOI: 10.1111/apa.16538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
AIM We examined if a range of factors were associated with how ready mothers were for their infants to be discharged from a neonatal intensive care unit (NICU). METHODS This was a secondary analysis of a study on the well-being of mothers whose infants were hospitalised in the level 3 NICU at the Jewish General Hospital in Canada. We studied 132 mother-infant dyads: 70 from an open ward NICU and 62 from the purpose-built NICU with pods or single family rooms that replaced it in 2016. The mothers completed a questionnaire on NICU stress and their perceptions of family-centred care on enrolment and another on breastfeeding self-efficacy and readiness to go home a week before discharge. The infants' characteristics were retrieved from the medical files. RESULTS The infants were born at a mean age of 29.8 ±3.1 weeks. Greater family-centred care during early hospitalisation (p=0.01) and greater breastfeeding self-efficacy in the period before discharge (p=0.04) were significantly associated with higher readiness for discharge. The unit design was not a significantly associated with readiness for discharge. CONCLUSION The quality of early family-centred care and breastfeeding self-efficacy were significantly associated with how ready mothers were for their preterm infant to be discharged from the NICU.
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Affiliation(s)
- Valérie Lebel
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Nikolas Argiropoulos
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada
| | - Stephanie Robins
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Lyne Charbonneau
- Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Nancy Feeley
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada.,Ingram School of Nursing, McGill University, Montreal, Québec, Canada
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17
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Adams YJ, Lau E, Young J, Ehla EE. Cross-Cultural Adaptation and Validation of the Dagbani Readiness for Hospital Discharge Scale-New Mother. J Obstet Gynecol Neonatal Nurs 2022; 51:620-630. [PMID: 35988695 DOI: 10.1016/j.jogn.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
The Readiness for Hospital Discharge Scale-New Mother (RHDS-NM), originally developed for use in English-speaking populations, is an instrument designed to measure women's perceptions of readiness for hospital discharge after birth. We translated and cross-culturally adapted the RHDS-NM into Dagbani and conducted reliability and validity assessments of the new Dagbani RHDS-NM in the Tamale Metropolitan Area, Ghana. The average scale-level content validity index was excellent at 1.00. The Dagbani RHDS-NM had a Cronbach's α reliability coefficient of .94. Exploratory factor analysis indicated four factors with Cronbach's α reliability coefficients of .958, .915, .899, and .667 that represented the Personal Status, Knowledge, Expected Support, and Coping Ability subscales, respectively. Our findings provide initial evidence to support the reliability and validity of the Dagbani RHDS-NM.
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18
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Meng L, Lingling Z, Haihong Z, Xiaobai Z, Dandan H, Shaoyan W. Readiness for Hospital Discharge and Its Correlation with the Quality of Discharge Teaching among the Parents of Premature Infants in NICU. Appl Bionics Biomech 2022; 2022:4924021. [PMID: 35874642 PMCID: PMC9300354 DOI: 10.1155/2022/4924021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives To assess the extent of the readiness for hospital discharge and the correlation with discharge teaching quality among parents of premature infants' in the NICU. Background Low readiness for discharge from the hospital can lead to negative outcomes in healthcare for infants born prematurely and their parents. Discharge guidelines are a basic approach to ensure the readiness of the parents for discharge from the hospital. No investigation has ever been conducted into the sufficiency of hospital discharge guidelines for premature infants and their impact on parental readiness for hospital discharge. Design Data was collected from four hospitals in China using a correlational descriptive study. Methods Two hundred and eight parents of premature NICU-hospitalized infants of four tertiary hospitals in Henan Province from May to October 2020 were enrolled. The general information questionnaire, the readiness for hospital discharge scale- (RHDS-) parent form, and the quality of discharge teaching scale- (QDTS-) parent form were used for data collection. Spearman correlation analysis and descriptive statistics were used to analyze the data. Results The total score for hospital discharge readiness was high (8.05 ± 1.11). The total score of the quality of discharge guidelines was moderate (7.44 ± 1.44). Moreover, the discharge teaching quality was positively correlated with the parents' readiness. Positive correlations were found between PRHDS and QDTS subscales, including content received and delivery, physical-emotional status, knowledge, and expected support. Conclusion The quality of the discharge guidelines perceived by parents of premature infants was moderate, which may have reduced their readiness for hospital discharge. Relevance to Clinical Practice. This study furnishes basic information on the importance of readiness of discharge for the parents of premature infants. The teaching guides nurses to enhance the quality of discharge teaching and the readiness of parents for discharge from the hospital.
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Affiliation(s)
- Li Meng
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhang Lingling
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Zhang Haihong
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Zhang Xiaobai
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Huang Dandan
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Wu Shaoyan
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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19
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Chen Y, Chen Y, Qin T, Fu G, Bai J. Associations of readiness for hospital discharge with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home: A prospective study. J Oncol Pharm Pract 2022:10781552221100720. [PMID: 35548956 DOI: 10.1177/10781552221100720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Readiness for hospital discharge is associated with patients' health outcomes after they return home. However, little is known about this association among cancer patients receiving oral chemotherapy at home. This study aimed to examine whether patients' reported readiness for hospital discharge was associated with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home. METHODS A prospective study was conducted, and 151 cancer patients receiving oral chemotherapy were recruited from a provincial level hospital in South China between October 2018 and December 2019. The primary outcome was readiness for hospital discharge assessed by the Readiness for Hospital Discharge Scale-Short Form on the day of discharge. The secondary endpoints were symptoms assessed by MD Anderson Symptom Inventory and non-routine utilization of post-discharge services within one cycle of chemotherapy at home (21 days). RESULTS Among these 151 participants, 74.2% of them reported as ready for discharge. Patients who were employed, lived in suburban area or villages, had a higher Eastern Cooperative Oncology Group score, took Tegafur as oral chemotherapy, and took oral chemotherapy for the first time reported lower readiness for hospital discharge. These five factors explained 28.1% of variance in readiness for hospital discharge. Patients who were not ready for discharge were prone to report higher symptom severity (p = 0.038). No differences in non-routine utilization of post-discharge services were found between the readiness versus non-readiness for discharge groups (p = 0.891). CONCLUSIONS Most cancer patients receiving oral chemotherapy at home were ready for discharge, which was influenced by employment status, residence status, Eastern Cooperative Oncology Group score, type of oral chemotherapy drug, and the experience of taking oral chemotherapy at home. Patients with lower readiness reported worse symptom severity at home. Routine assessment was suggested to recognize unready patients, and more extensive preparations for discharge were recommended to help them manage symptoms at home.
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Affiliation(s)
- Yongfeng Chen
- Nursing Department, Guangxi Academy of Medical Sciences, 477292The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanrong Chen
- Department of Chemotherapy, Guangxi Academy of Medical Sciences, 477292The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Ting Qin
- Department of Chemotherapy, Guangxi Academy of Medical Sciences, 477292The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Nursing Department, Guangxi Academy of Medical Sciences, 477292The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinbing Bai
- 15792Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
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20
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You H, Lei A, Li X, Liao X, Chang J. Discharge teaching, patient-reported discharge readiness and postsurgical outcomes in gynecologic patients undergoing day surgery: a generalized estimating equation. BMC Surg 2022; 22:166. [PMID: 35538567 PMCID: PMC9092867 DOI: 10.1186/s12893-022-01607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Gynecologic patients undergoing day surgery are discharged in an intermediate stage of recovery. The quality of discharge teaching and discharge readiness are important to patients’ postsurgical outcomes, but little research has focused on them. Methods Quality of discharge teaching and discharge readiness were measured, and Spearman correlations were conducted. Postsurgical outcomes were recorded on postoperative Day 1, postoperative Day 7, and postoperative Day 28. Generalized estimating equations were used to explore factors that influence postsurgical outcomes. Results Discharge teaching was verified to be positively correlated with the discharge readiness of participants. The generalized estimating equations indicated that discharge teaching skills, effects of doctors and nurses, patient-reported physical conditions and social support following discharge were protective factors for postsurgical outcomes. Conclusions Doctors and nurses should improve discharge teaching skills and effects to improve the postsurgical outcomes of gynecological patients undergoing day surgery. At discharge, doctors and nurses should assess patients’ physical condition and facilitate a social support system.
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Affiliation(s)
- Huaxuan You
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Anjiang Lei
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xin Li
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Xu Liao
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Jing Chang
- Department of Obstetrics and Gynecology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
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21
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Buek KW, O'Neil M, Mandell DJ. Opportunities and challenges for family-centered postpartum care during the COVID-19 pandemic: a qualitative study of nurse perspectives. BMC Nurs 2022; 21:99. [PMID: 35473562 PMCID: PMC9042661 DOI: 10.1186/s12912-022-00875-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background The global COVID-19 pandemic has forced the health care sector to make wide-ranging changes to protect patients as well as providers from the risk of infection. Many of these changes are likely to have greatest impact in contexts of care that employ family-centered care (FCC) models, including perinatal and maternity care. Research conducted in perinatal care settings during the pandemic has shown that some of these restrictions have negatively impacted patient and family experiences and outcomes, while others have been perceived as beneficial. The present qualitative study aimed to understand what changes have occurred in postpartum nursing practice during the pandemic, and how these changes have affected nurses, women and families during their stay in the hospital following a new birth. Methods Structured interviews were completed with 20 postpartum nurses from five hospitals across Texas. The interview protocol was designed to elicit information about changes to hospital policies in postpartum units during the pandemic, nurses’ attitudes about these changes, perceived benefits and challenges for performance of their duties, and perceived effects on patients and their families. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by video conference using Zoom and lasted approximately 30 to 45 min. Data were analyzed using a qualitative descriptive approach. Results Participants reported that their hospitals placed restrictions on the number and mobility of support persons allowed to stay with the mother in the unit and prohibited all other visitation. Some challenges of these policies included reduced opportunities for hands-on learning and an increased number of patients opting for early discharge. Perceived benefits for patient education and outcomes included improved frequency and effectiveness of nurse-family communication, increased father involvement, and greater opportunities for maternal rest, breastfeeding, skin-to-skin care and family bonding. Conclusions Study findings suggest that some limitations on postpartum hospital visitation may achieve important, family-centered goals. Protected time for family-bonding, maternal rest, breastfeeding, father involvement and individualized education are critical to quality FCC. Research must examine which visitation policies maximize these benefits while preserving patient access to family and social support.
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Affiliation(s)
- Katharine W Buek
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA.
| | - Molly O'Neil
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA
| | - Dorothy J Mandell
- Population Health, Office of Health Affairs, University of Texas System, University of Texas Health Science Center at Tyler, 210 W. 7th St, Austin, TX, 78701, USA
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22
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Smith H, Harvey C, Portela A. Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature. BMC Pregnancy Childbirth 2022; 22:281. [PMID: 35382773 PMCID: PMC8985304 DOI: 10.1186/s12884-022-04577-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existence of global recommendations, postnatal care provided following childbirth is variable and often fails to address a woman's concerns about herself and the parents' concerns about their baby. Discharge from a facility after birth is a key moment to ensure the woman, parents and newborn receive support for the transition to care in the home. We mapped the current policies, guidance and literature on discharge preparation and readiness to identify key concepts and evidence and inform recommendations to be considered in a World Health Organization (WHO) guidance on postnatal care. METHODS We were guided by the Johanna Briggs Institute approach, and developed inclusion criteria based on existing defintions of discharge preparation and readiness, and criteria for discharge readiness compiled by international professional organisaitons. To identify guidelines and policies we searched websites and archives of guideline organisations, and contacted individuals and professional societies working on postnatal care. We searched 14 electronic databases to locate published research and other literature on discharge preparation and readiness. For documents that met the inclusion criteria we extracted key characteristics, summarised discharge readiness criteria and components and discharge preparation steps, and characterised interventions to improve discharge preparation. RESULTS The review provides a systematic map of criteria for discharge that are in use and the common steps healthcare providers take in preparing women and newborns for the transition home. The mapping also identified interventions used to strengthen discharge preparation, theories and models that conceptualise discharge preparation, scales for measuring discharge readiness and qualitative studies on the perspectives of women, men and healthcare providers on postnatal discharge. CONCLUSIONS The findings highlight contrasts between the research literature and policy documents. They indicate potential gaps in current discharge policies, and point to the need for more comprehensive discharge assessment and education to better identify and meet the needs of women, parents/caregivers and families prior to discharge and identify those who may require additional support. PROTOCOL REGISTRATION DETAILS The protocol for the review was registered with protocols.io on 23 November 2020: https://doi.org/10.17504/protocols.io.bpzymp7w.
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Affiliation(s)
- Helen Smith
- International Health Consulting Services Ltd, Merseyside, UK.
| | | | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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23
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Li W, Zhang Y, Wei L. Postdischarge coping difficulties and influencing factors of pregnant women with gestational diabetes mellitus: A cross-sectional study. Nurs Open 2022; 9:1625-1634. [PMID: 35240006 PMCID: PMC8994934 DOI: 10.1002/nop2.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/01/2021] [Accepted: 01/09/2022] [Indexed: 11/29/2022] Open
Abstract
Aims and objectives To identify coping difficulties after discharge and influencing factors of pregnant women with gestational diabetes mellitus. Design A cross‐sectional descriptive survey was conducted with gestational diabetes mellitus women from four tertiary hospitals in the Shandong Peninsula in China. Methods The study consists of 252 gestational diabetes mellitus women. Survey measures included demographic information, quality of discharge teaching scale, readiness for hospital discharge scale and postdischarge coping difficulty scale. Multiple linear regression analysis was used to explore the factors of coping difficulties after discharge. Results The situation of coping difficulties in pregnant women with gestational diabetes mellitus after discharge is not optimistic. Age, education level, type of birth, parity, quality of discharge teaching and discharge readiness are six factors that significantly influence postdischarge coping difficulties.
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Affiliation(s)
- Wen Li
- Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Yan Zhang
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Wei
- The Affiliated Hospital of Qingdao University, Qingdao, China
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Gooding C, Lavin T, van Rooyen E, Bergh AM, Preen DB. Evaluating Maternal Discharge Readiness in Kangaroo Mother Care. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2324-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zhang X, Tang C, Xiao X, Sun M, Wang H. Readiness for Hospital Discharge and Its Correlates Among People Living With HIV in Hunan, China: A Cross-sectional Study. J Assoc Nurses AIDS Care 2021; 32:619-628. [PMID: 34115720 DOI: 10.1097/jnc.0000000000000278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We aimed to (a) describe the readiness for hospital discharge in people living with HIV and (b) explore factors associated with readiness for hospital discharge. A cross-sectional survey was conducted at two infectious disease hospitals in Hunan, China, from May to November 2017. The readiness for hospital discharge scale (RHDS) was used to assess discharge readiness. The average item mean for the RHDS ranges from 0 to 10, and higher scores represent a higher level of readiness for hospital discharge. The mean score of the RHDS was 7.78 (95% confidence interval 7.586-7.968), and 27.6% of participants (n = 56/203) felt unready for discharge (RHDS <7). We found that older age, lack of medical insurance, lower self-rated health status, poorer quality of discharge teaching, and more severe depressive symptoms were significantly associated with a lower level of readiness for hospital discharge. Interventions are needed to improve readiness of people living with HIV for hospital discharge in Hunan, China, especially for those of advanced age, without medical insurance, with worse self-rated health status, and those with higher levels of depressive symptoms.
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Affiliation(s)
- Xiaoxia Zhang
- Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China
- Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China
- Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China
| | - Chulei Tang
- Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China
- Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China
- Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China
| | - Xueling Xiao
- Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China
- Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China
- Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China
| | - Manman Sun
- Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China
- Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China
- Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China
| | - Honghong Wang
- Xiaoxia Zhang, RN, MSN, is an Assistant Professor, Department of Nursing, Henan Medical College, Henan, China; and a Graduate Student, Xiangya Nursing School of Central South University, Hunan, China
- Chulei Tang, RN, BSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Xueling Xiao, RN, MSN, is a PhD Student, Xiangya Nursing School of Central South University, Hunan, China
- Manman Sun, RD, MSM, is an Assistant Professor, Department of Preclinical Medicine, Henan Medical College, Henan, China
- Honghong Wang, RN, PhD, is a Professor, Xiangya Nursing School of Central South University, Hunan, China
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Xiong L, Liu Y, Chen Q, Tian Y, Yang M. Readiness for Hospital Discharge of Adult Patients with Major Depressive Disorder in China: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:1681-1692. [PMID: 34354344 PMCID: PMC8331081 DOI: 10.2147/ppa.s319447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/15/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Being ready for discharge is vital to successful hospital-to-home transitions. However, despite a wealth of evidence on its effectiveness, little is known about readiness for hospital discharge (RHD) in adult patients with major depressive disorder (MDD) and its influencing factors. In this study, we investigated the patient-reported RHD and its influencing factors among Chinese adult patients with MDD. PATIENTS AND METHODS In this cross-sectional design study, 230 adult patients with MDD were recruited according to the inclusion and exclusion criteria, 6 were excluded due to incomplete questionnaires, finally 224 patients were included in our study. Data were collected from March to September 2019 in a tertiary general hospital in Hunan Province (China). The general information, RHD, quality of discharge teaching and level of depression were assessed by using questionnaires. Univariate analysis and ordinal logistic regression analysis were performed to explore the influencing factors of RHD. RESULTS The RHD score was 7.37 ± 1.40, and 36.2% of participants were not ready for discharge. The score of quality of discharge teaching scale (QDTS) was 6.36 ± 1.89, the dimension of delivery scored highest, followed by content-needed and content-received. The proportions of patients with no, mild, moderate, moderately severe and severe depression were 12.5%, 27.7%, 25.0%, 25.4% and 9.4%, respectively. The following factors were associated with RHD: the level of depression (OR=0.66), the content-received dimension of QDTS (OR=1.16), education level (OR=1.24), work status (OR=1.76) and length of hospitalization (OR=0.53). CONCLUSION The RHD among participants was at a moderate level. It is strongly suggested to take the assessment of RHD as a routine process. High education level, employment and the content-received dimension of QDTS were protective factors of participants' RHD, and long-term hospitalization, the high level of depression were its risk factors.
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Affiliation(s)
- Lile Xiong
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Yingying Liu
- West China Hospital Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Qiongni Chen
- The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Yusheng Tian
- The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Min Yang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People’s Republic of China
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Wang M, Wang Y, Meng N, Li X. The factors of patient-reported readiness for hospital discharge in patients with depression: A cross-sectional study. J Psychiatr Ment Health Nurs 2021; 28:409-421. [PMID: 32981173 DOI: 10.1111/jpm.12693] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/25/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The attributes of readiness for hospital discharge (RHD) have been identified to be physical stability, adequate support, psychological ability, and adequate information and knowledge. Patient-reported RHD has been regarded as an outcome indicator, and poor RHD leads to unplanned readmission, emergency department visits and even death. Knowledge regarding patient-reported RHD and its factors among patients with depression is limited. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: RHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. The knowledge dimension of the RHDS among patients with depression should be further strengthened. The length of stay, content received and delivery dimensions of the QDTS were significantly associated with RHD. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study encourages nurses to assess patient-reported RHD at discharge in mental health settings. Nurses should pay more attention to patients with hospital stays longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content. Nurses' managers could develop programmes to improve teaching skills via Internet technology, such as simulated patients and online interprofessional discharge planning. ABSTRACT: Introduction Low readiness for hospital discharge (RHD) can be followed by negative healthcare outcomes. However, no studies have investigated RHD among patients with depression. Aim This study aimed to examine patient-reported RHD and its factors among patients with depression. Method In total, 367 inpatients with depression were recruited and completed the Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). A binary logistic regression analysis was performed to explore the factors of RHD among patients with depression. Results The total RHDS score was 7.70 ± 1.52. Approximately 28.9% of the participants had low RHD (RHDS score < 7). The results revealed that RHD was significantly associated with the length of stay, content received and delivery. Discussion RHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. To improve RHD, enhancing the quality of discharge teaching is imperative for patients with depression. Implications for Practice Nurses should pay more attention to patients with a hospital stay longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content.
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Affiliation(s)
- Mengmeng Wang
- West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, China
| | - Ya Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Na Meng
- Mental Health Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Li
- West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, China
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Wang M, Lv L, Yu Z, Gao L, Lu Q, Ou J, Luo S. A cross-sectional study of readiness for discharge, chronic illness resources and postdischarge outcomes in patients with diabetic foot ulcer. Nurs Open 2021; 8:2645-2654. [PMID: 33730433 PMCID: PMC8363364 DOI: 10.1002/nop2.813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/25/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022] Open
Abstract
Aim To investigate the correlation of readiness for hospital discharge, the chronic illness resources, and postdischarge outcomes of diabetic foot ulcer patients, which can be help for discharged patient rehabilitation. Design A cross‐sectional study. Methods One hundred and seventy‐nine patients were recruited from the Endocrinology units of two tertiary hospitals between November 2018–September 2019, in Guangdong, China. The methods used were Readiness for Hospital Discharge Scale, The Chronic Illness Resources Survey and one‐on‐one telephone interviews. Results Pearson correlation coefficients indicated moderate correlation between the readiness for discharge and resource availability for chronic illnesses (r = .446, p < .001). Multiple linear regression analysis showed that Chronic Illness Resources Survey, self‐care ability, methods of wound treatments after discharge, and living alone were the main predictors of readiness for hospital discharge among diabetic foot ulcer patients (F = 12.272, p < .001, R2 = .621, Rad2 = .571). The study was limited by location, patient's recall bias and lack of BADL scale, which can be further improved in subsequent studies by developing multi‐centre clinical study and adopting more objective assessment tools.
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Affiliation(s)
- Mingzhu Wang
- Department of Nursing, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China.,Department of Endocrinology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China
| | - Lixue Lv
- Department of Endocrinology, Traditional Chinese Medicine of Foshan Hospital, Foshan, China
| | - Zhaohong Yu
- Department of Endocrinology, Traditional Chinese Medicine of Foshan Hospital, Foshan, China
| | - Limei Gao
- Department of Nursing, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China
| | - Qiaocong Lu
- Department of Nursing, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China
| | - Jiefen Ou
- Department of Nursing, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China
| | - Shaozhuang Luo
- Department of Endocrinology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China
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Weiss ME, Piacentine LB, Candela L, Bobay KL. Effectiveness of using a simulation combined with online learning approach to develop discharge teaching skills. Nurse Educ Pract 2021; 52:103024. [PMID: 33774567 DOI: 10.1016/j.nepr.2021.103024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/19/2021] [Accepted: 03/06/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Despite evidence of the impact of discharge teaching on patient outcomes, nursing students are poorly prepared in the pedagogical skills necessary for their role as patient and family educators in clinical practice. This study evaluated the effectiveness of simulation combined with online learning to improve nursing students' discharge teaching skills. METHODS The module included simulations before and after an online module on patient/family teaching for hospital discharge. Evaluation measures were student and independent rater evaluations using the Quality of Discharge Teaching Scale- Evaluation form (QDTS-E). RESULTS Students (n = 153) improved their performance on both content and delivery subscales of the QDTS-E by 20% (student self-evaluations) and 18% (independent raters). However, correlations between student and rater scores were low (r = 0.08-0.22). CONCLUSION Use of simulation with online learning in a discharge teaching module can help students build patient education skills to improve post-discharge patient outcomes, contributing to national health priorities to reduce hospital readmissions. With further refinement and testing, the learning module and QDTS-E evaluation form may also be useful for evaluation and continuing education of clinical nursing staff.
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Affiliation(s)
- Marianne E Weiss
- College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI, 53201-1881, USA.
| | - Linda B Piacentine
- College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI, 53201-1881, USA
| | - Lori Candela
- School of Nursing, University of Nevada Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA.
| | - Kathleen L Bobay
- Marcella Niehoff School of Nursing, Loyola University Chicago, 2160 South First Avenue, Maywood, IL, 60153, USA.
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Blessings and Curses: Exploring the Experiences of New Mothers during the COVID-19 Pandemic. NURSING REPORTS 2020; 10:207-219. [PMID: 34968364 PMCID: PMC8608056 DOI: 10.3390/nursrep10020023] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to explore the postpartum experiences of new parents during the COVID-19 pandemic. The postpartum period can be a time of significant transition, both positive and negative, for parents as they navigate new relationships with their babies and shifts in family dynamics. Physical distancing requirements mandated by public health orders during the COVID-19 pandemic had the potential to create even more stress for parents with a newborn. Examining personal experiences would provide health care professionals with information to help guide support during significant isolation. Feminist poststructuralism guided the qualitative research process. Sixty-eight new mothers completed an open-ended on-line survey. Responses were analyzed using discourse analysis to examine the beliefs, values, and practices of the participants relating to their family experiences during the pandemic period. It was found that pandemic isolation was a time of complexity with both ‘blessings and curses’. Participants reported that it was a time for family bonding and enjoyment of being a new parent without the usual expectations. It was also a time of missed opportunities as they were not able to share milestones and memories with extended family. Caring for a newborn during the COVID-19 pandemic where complex contradictions were constructed by competing social discourses created difficult dichotomies for families. In acknowledging the complex experiences of mothers during COVID-19 isolation, nurses and midwives can come to understand and help new parents to focus on the blessings of this time while acknowledging the curses.
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Ollivier R, Aston DM, Price DS, Sim DM, Benoit DB, Joy DP, Iduye D, Nassaji NA. Mental Health & Parental Concerns during COVID-19: The Experiences of New Mothers Amidst Social Isolation. Midwifery 2020; 94:102902. [PMID: 33421662 DOI: 10.1016/j.midw.2020.102902] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in an unprecedented situation for new parents, with public health orders greatly affecting daily life as well as various aspects of parenting and new parent wellbeing. OBJECTIVES To understand the impact of the COVID-19 pandemic on mothers/parents across Nova Scotia who are caring for a child 0-12 months of age. DESIGN This study utilized an online qualitative survey to collect data. Feminist poststructuralism and discourse analysis guided the analysis and discussion. SETTING Nova Scotia, Canada PARTICIPANTS: : 68 participants were recruited from across the province of Nova Scotia. FINDINGS Mental health and socialization were both major concerns for new mothers/parents, as many expressed feelings of worry, anxiety, loneliness, isolation, and stress. KEY CONCLUSIONS Online support was sought by many new mothers/parents as a way of supporting their own mental health. Some found ways to make it meaningful for them, while others believed that it could not replace or offer the same benefits as in-person interaction and support. IMPLICATIONS FOR PRACTICE Informal and formal support systems are both essential for new mothers. As public health systems and health care services learn to adapt to COVID-19, further research is required to examine how health services may best meet the needs of new mothers/parents.
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Affiliation(s)
- Rachel Ollivier
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Megan Aston
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Sheri Price
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Meaghan Sim
- Nova Scotia Health Authority, Healthy Populations Institute, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Dr Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, C251, Camden Hall, PO Box 5000, 2340 Notre Dame Avenue, Antigonish, Nova Scotia, Canada B2G 2W5.
| | - Dr Phillip Joy
- Applied Human Nutrition, Mount Saint Vincent University, 166 Bedford Highway, Halifax, Nova Scotia, Canada B3M 2J6.
| | - Damilola Iduye
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
| | - Neda Akbari Nassaji
- School of Nursing, Dalhousie University, PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2.
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Soghier LM, Kritikos KI, Carty CL, Glass P, Tuchman LK, Streisand R, Fratantoni KR. Parental Depression Symptoms at Neonatal Intensive Care Unit Discharge and Associated Risk Factors. J Pediatr 2020; 227:163-169.e1. [PMID: 32681990 DOI: 10.1016/j.jpeds.2020.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support. STUDY DESIGN Parents participating in the Giving Parents Support trial (n = 300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors. RESULTS At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P = .02), female infant (P = .02), and longer length of stay (P = .045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37 weeks compared with gestational age <28 weeks. Parental NICU stress was higher in younger parents (P < .01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P < .001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms. CONCLUSION The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.
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Affiliation(s)
- Lamia M Soghier
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
| | - Katherine I Kritikos
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Cara L Carty
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Penny Glass
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Lisa K Tuchman
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC
| | - Randi Streisand
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Karen R Fratantoni
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Division of General and Community Pediatrics, Children's National Hospital, Washington, DC
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Hua W, Wang L, Li C, Simoni JM, Yuwen W, Jiang L. Understanding preparation for preterm infant discharge from parents' and healthcare providers' perspectives: Challenges and opportunities. J Adv Nurs 2020; 77:1379-1390. [PMID: 33249653 DOI: 10.1111/jan.14676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/03/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
AIM To describe the facilitating/inhibiting factors of preparation for preterm infant discharge and recommendations for increasing discharge readiness from parents' and healthcare providers' perspectives based on Meleis's Transitions Theory. DESIGN A qualitative cross-sectional descriptive design. METHODS We selected a purposive sample of 17 parents (9 fathers and 8 mothers) and 13 healthcare providers (10 nurses and 3 clinicians) from the neonatal intensive care unit of a tertiary hospital in Eastern China. Data were collected between May -July 2018. Data from audio-recorded semi-structured individual interviews were coded with content analysis both inductively and deductively. RESULTS The analyses yielded four themes: personal conditions, community conditions, nursing therapeutics, and patterns of response. Parents and healthcare providers had unique opinions about the themes. CONCLUSION Meleis's Transitions Theory seems to be an applicable and practicable framework for understanding the discharge preparation of parents with preterm infants and may be used to help healthcare providers to develop appropriate interventions on discharge preparation practice. IMPACT To address the lack of discharge readiness of preterm infants in China and countries with a similar clinical context, healthcare providers should help parents play a more active role to promote their engagement in discharge preparation. In a wider global community, healthcare providers should consider parents' personal conditions and their practical needs in performing discharge preparation.
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Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, PR China
| | - Liying Wang
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing and Healthcare Leadership, University of Washington, Tacoma, WA, USA
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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Zhang A, Feng X, Qiu C. Discharge teaching, readiness for hospital discharge and post-discharge outcomes in cataract patients: A structural equation model analysis. J Nurs Manag 2020; 29:543-552. [PMID: 32985037 DOI: 10.1111/jonm.13169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/02/2020] [Accepted: 09/21/2020] [Indexed: 02/05/2023]
Abstract
AIM To explore the interaction mechanism of cataract patients' quality of discharge teaching, discharge readiness and post-discharge outcomes using structural equation model analysis. BACKGROUND The quality of discharge teaching and discharge readiness are two indicators used to evaluate the quality of hospital discharge services. Little research has been done on the quality of discharge teaching, discharge readiness and post-discharge outcomes in cataract patients, especially in China. METHODS Four questionnaires were administered to 192 patients, and the results were analysed using Spearman's correlation and structural equation model. RESULTS The statistical analysis showed low-to-moderate correlations among the quality of discharge teaching, discharge readiness and post-discharge outcome variables; discharge readiness played an intermediary role in the interaction mechanism of the three variables. CONCLUSION The cataract patients demonstrated satisfactory quality of discharge teaching, discharge readiness and post-discharge outcomes. Quality of discharge teaching affected post-discharge outcomes through the intermediary role of discharge readiness. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers should recognize the importance of discharge services, pay more attention to improve the quality of discharge teaching and strengthen discharge readiness to prevent the risks of post-discharge complications and readmission.
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Affiliation(s)
- Aihua Zhang
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Xianqiong Feng
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Chujin Qiu
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Hua W, Yuwen W, Simoni JM, Yan J, Jiang L. Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants. J Clin Nurs 2020; 29:3754-3763. [PMID: 32644290 DOI: 10.1111/jocn.15405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the extent to which parental readiness for hospital discharge mediates the relationship between quality of discharge teaching and parental self-efficacy in parents of preterm infants. BACKGROUND Parental readiness for hospital discharge and self-efficacy should be considered to establish whether preterm infants and their families are prepared for the discharge. High-quality discharge teaching could facilitate a smooth discharge transition. However, little is known about how quality of discharge teaching influences parental readiness for hospital discharge and self-efficacy. DESIGN This was a descriptive cross-sectional study of 202 parents with preterm infants in a tertiary hospital in Eastern China. METHODS The key variables of interest were measured using the Chinese versions of the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale-Parent Form, and Preterm Parenting and Self-Efficacy Checklist. Path analyses were conducted to test the mediation models. STROBE checklist was used to compile the study's report. RESULTS Parental readiness for discharge (overall and knowledge dimension) partially mediated the relationship between the quality of discharge teaching and parental self-efficacy. The two dimensions (content received and delivery) of quality of discharge teaching positively influenced parental self-efficacy by improving parental readiness for discharge. CONCLUSIONS Parental readiness for hospital discharge, especially the knowledge dimension, was an important factor in quality of discharge teaching's association with self-efficacy in parents of preterm infants. Improving the quality of discharge teaching could increase parental readiness for discharge and thus promote parental self-efficacy. RELEVANCE TO CLINICAL PRACTICE Improving discharge instructions is essential to help parents of preterm infants prepare for the transition to home care. Assessing readiness and confidence at an early stage and continuing to do so throughout the hospital stay may provide additional ways for nurses to identify parents' knowledge gaps and to provide tailored interventions at more opportune times before hospital discharge.
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Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Weichao Yuwen
- Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Jie Yan
- Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Jiang
- Chief Nursing Officer, Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Salmani N, Zare Marvast M, Kahdouei S, Weiss ME. Adaptation of the parent readiness for hospital discharge scale with mothers of preterm infants discharged from the neonatal intensive care unit. J Clin Nurs 2020; 29:4544-4553. [PMID: 32886812 DOI: 10.1111/jocn.15479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/24/2020] [Accepted: 08/13/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the psychometric properties of a new Persian translation of the Readiness for Hospital Discharge Scale. BACKGROUND Globally, one in 10 newborns are born preterm and many require care in a neonatal intensive care unit (NICU). A primary role of NICU nurses is to assure parents are well prepared to take their newborns home from the hospital. Assessment of parent perception of discharge readiness provides important input into discharge decisions. The availability of reliable and valid instruments tested within the geographical and cultural context is needed for a comprehensive assessment of predischarge readiness, so that parent needs can be identified and the necessary interventions designed and implemented. DESIGN This psychometrics study included a convenience sample of 200 mothers with preterm infants being discharged from the NICU of Shahid Sadoughi Hospital in Yazd, Iran. The original 29-item version of the Readiness for Hospital Discharge Scale-Parent questionnaire was translated into Persian using the standard forward-backward method. Face, content and construct validity (principal components analysis), and reliability (internal consistency-Cronbach's alpha) were assessed. Methods followed STROBE criteria as applicable (see Appendix S1). RESULTS The content validity index and content validity ratio were both 0.93. Construct validity testing identified 6 factors (mother and infant physical-psychological readiness, expected support, knowledge of future events and care, knowledge of infant personal care, pain and therapeutic interventions). Using Cronbach's alpha coefficient, the reliability of the whole instrument was estimated to be 0.87. CONCLUSION The Persian Readiness for Hospital Discharge-Parental Form for use with mothers of preterm infants being discharged from an Iranian NICU has acceptable validity and reliability. RELEVANCE TO PRACTICE This tool can be used before discharge to determine the needs of mothers and design the necessary measures to improve quality of discharge care.
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Affiliation(s)
- Naiire Salmani
- School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marzieh Zare Marvast
- School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Chen C, Zhang X, Tang C, Xiao X, Tao Z, Wang H. Psychometric properties of the Chinese Version of the Readiness for Hospital Discharge Scale for people living with HIV. Int J Nurs Sci 2020; 7:220-227. [PMID: 32685620 PMCID: PMC7355158 DOI: 10.1016/j.ijnss.2019.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/04/2019] [Accepted: 12/25/2019] [Indexed: 11/24/2022] Open
Abstract
Objective The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS-CH) for people living with HIV (PLWH). Methods From May 2017 to November 2017, a cross-sectional survey was performed in two AIDS inpatient departments located in two cities in Hunan, China. Reliability was evaluated by examining the internal consistency and split-half reliability of the items. A confirmatory factor analysis was performed to assess the factor structure of the RHDS-CH, and the model was revised according to the modification index. Results Cronbach’s α for the RHDS-CH was 0.912, and the split-half reliability of the total scale was 0.831. Initially, the results of the confirmatory factor analysis indicated that the sample did not fit this four-factor model and its 23 items well (χ2/df = 3, GFI =0.772, TLI = 0.823, CFI = 0.844, RMSEA = 0.100). To improve the model fit indices, we performed model modification with the guidance of modification indices. Finally, the model fit indices showed an acceptable fit to the data (χ2/df = 2.141, GFI = 0.844, TLI = 0.899, CFI = 0.915, RMSEA = 0.075). Coefficients of corrected item-total correlation of the RHDS-CH ranged from 0.435 to 0.726. Conclusion This study is the first to examine the psychometric properties of the RHDS-CH for PLWH. Our findings showed good reliability and confirmed the four-factor structure model for PLWH.
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Affiliation(s)
- Chen Chen
- School of Nursing, Central South University, Hunan, China
| | - Xiaoxia Zhang
- Nursing Faculty, Henan Medical College, Henan, China
| | - Chulei Tang
- School of Nursing, Central South University, Hunan, China
| | - Xueling Xiao
- School of Nursing, Central South University, Hunan, China
| | - Zirong Tao
- Nursing Department, Xiangya Hospital, Central South University, Hunan, China
| | - Honghong Wang
- School of Nursing, Central South University, Hunan, China
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Hariati S, Sutomo R, Lusmilasari L, Febriani ADB, Kadar K. Discharge readiness of Indonesian mother with preterm infant in NICU. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shih TY, Lin LC, Wu SC, Yang MH. The effect of caregiver's and nurse's perception of a patient's discharge readiness on postdischarge medical resource consumption. J Adv Nurs 2020; 76:1355-1363. [PMID: 32056269 DOI: 10.1111/jan.14329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/23/2020] [Accepted: 02/04/2020] [Indexed: 11/27/2022]
Abstract
AIMS The purpose of this study was to validate patient's primary caregiver and their nurse's perception of patient discharge readiness assessment and their association with postdischarge medical consumption. DESIGN The study employed a descriptive research, prospective longitudinal study design. METHOD The study was performed in a ward of a medical centre in Taipei, Taiwan, from June 2017-May 2018. Obtained data were analysed using an independent t test, one-way ANOVA and logistic regression approach. RESULTS/FINDINGS The number of comorbidities and the number of days of hospital stay were positively associated with post discharge emergency room visits. Caregiver readiness for hospital discharge had significant negative correlation with patient's 30-day readmission. Both caregiver and nurse readiness for the hospital discharge scale score were not factors associated with the patients' 30-day emergency room visit. CONCLUSION Based on the research findings, to assess the discharge readiness as perceived by caregivers at patients' discharge is recommended. IMPACT Caregiver and nurse scores on readiness for hospital discharge showed a significant positive correlation. The higher the score of a caregiver's readiness for a patient's hospital discharge, the lower the 30-day readmission rate. Family-centred care enables patients to safely pass though the transition phase from hospital to community and reduces the postrelease consumption of medical resources. The discharge readiness perceived by caregivers should be included in any decision-making.
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Affiliation(s)
| | - Li-Chan Lin
- Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Shiao-Chi Wu
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Man-Hua Yang
- Institute of Clinical Nursing, National Yang-Ming University, Taipei, Taiwan, R.O.C
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Yang J, He Y, Jiang L, Li K. Colorectal patients' readiness for hospital discharge following management of enhanced recovery after surgery pathway: A cross-sectional study from China. Medicine (Baltimore) 2020; 99:e19219. [PMID: 32080116 PMCID: PMC7034666 DOI: 10.1097/md.0000000000019219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to ascertain the status quo of perceived readiness for hospital discharge in colorectal cancer patients who underwent enhanced recovery pathway and identify the variables that affect patients' perceptions about their readiness for discharge.A cross-sectional survey was conducted in West China Hospital, Sichuan University. The Readiness for Hospital Discharge Scale and the Quality of Discharge Teaching Scale were delivered to 130 colorectal cancer (CRC) patients who underwent enhanced recovery pathway. Data collection was carried out 4 hours before discharge.The total score of readiness for hospital discharge was 149.86 ± 33.65. The multiple linear regression analysis revealed that the quality of discharge teaching, discharge to a rehabilitative institution were associated with the readiness for hospital discharge.The level of CRC patients' readiness for hospital discharge needs to be improved. Medical staff should improve the quality of discharge guidance and pay more attention to patients transferred to rehabilitation institutions when they leave hospital.
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Affiliation(s)
- Jie Yang
- Department of Gastrointestinal Surgery, West China Hospital
| | - Yuhua He
- Department of Gastrointestinal Surgery, West China Hospital
| | - Lili Jiang
- Department of Gastrointestinal Surgery, West China Hospital
| | - Ka Li
- West China School of Nursing, Sichuan University, Chengdu 610041, PR China
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Weiss ME, Lerret SM, Sawin KJ, Schiffman RF. Parent Readiness for Hospital Discharge Scale: Psychometrics and Association With Postdischarge Outcomes. J Pediatr Health Care 2020; 34:30-37. [PMID: 31575440 DOI: 10.1016/j.pedhc.2019.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/21/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The purpose of this study is to validate the Readiness for Hospital Discharge Scale (RHDS) for use with parents of hospitalized children. PedRHDS is a structured tool for a discharge readiness assessment before pediatric discharge. METHODS Using combined data from four studies with 417 parents, psychometric testing and item reduction proceeded with principal component analysis for factor structure delineation, Cronbach's alpha for reliability estimation, and regression analysis for predictive validity. RESULTS A 23-item PedRHDS retained the a priori factor structure. Reliability ranged from 0.73 to 0.85 for the 23-item and 10- and 8-item short scales. PedRHDS (all forms) was associated with postdischarge coping difficulty (explaining 12%-16% of variance) and readmission (odds ratio = 0.71-0.80). DISCUSSION The PedRHDS and both short forms (PedRHDS-SF10 and PedRHDS-SF8) are reliable and valid measures of parental discharge readiness that can be used as outcome metrics of hospital care and risk indicators for postdischarge coping difficulty and readmission.
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Gupta M, Pursley DM, Smith VC. Preparing for Discharge From the Neonatal Intensive Care Unit. Pediatrics 2019; 143:peds.2018-2915. [PMID: 31053622 DOI: 10.1542/peds.2018-2915] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Discharge readiness is a key determinant of outcomes for families in the NICU. Since 2003, using a broad set of outcome and process measures, we have conducted an ongoing quality improvement initiative to improve the discharge preparation process in our NICU and readiness of families being discharged from the NICU. METHODS Iterative improvements to the discharge preparation process were made by a multidisciplinary committee. Discharge readiness was measured by using a parental and nurse survey for all families discharged from our NICU. Primary outcome measures included parental self-assessment of discharge readiness and nurse assessment of the family's emotional and technical discharge readiness. Secondary outcome measures included assessment of specific technical skills and emotional factors. Process measures included nursing familiarity with family at discharge. Improvement over time was analyzed by using statistical process control charts. RESULTS Significant improvement was seen in all primary outcome measures. Family self-assessment of discharge readiness increased from 85.1% to 89.1%; nurse assessment of the family's emotional discharge readiness increased from 81.2% to 90.5%, and technical discharge readiness increased from 81.4% to 87.7%. Several secondary outcome measures revealed significant improvement, whereas most remained stable. Nurse familiarity with the family at discharge increased over time. CONCLUSIONS Quality improvement methodology can be used to measure and improve discharge readiness of families with an infant in the NICU. This model can provide the necessary framework for a structured approach to systematically evaluating and improving the discharge preparation process in a NICU.
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Affiliation(s)
- Munish Gupta
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - DeWayne M Pursley
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Vincent C Smith
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
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Mogos MF, Piano MR, McFarlin BL, Salemi JL, Liese KL, Briller JE. Heart Failure in Pregnant Women: A Concern Across the Pregnancy Continuum. Circ Heart Fail 2019; 11:e004005. [PMID: 29330153 DOI: 10.1161/circheartfailure.117.004005] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 11/30/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Heart failure (HF) is a leading cause of maternal morbidity and mortality in the United States, but prevalence, correlates, and outcomes of HF-related hospitalization during antepartum, delivery, and postpartum periods remain unknown. The objective was to examine HF prevalence, correlates, and outcomes among pregnancy-related hospitalizations among women 13 to 49 years of age. METHODS AND RESULTS We used the 2001 to 2011 Nationwide Inpatient Sample. Rates of HF were calculated by patient and hospital characteristics. Survey logistic regression was used to estimate adjusted odds ratios representing the association between HF and each outcome, stratified by antepartum, delivery, and postpartum periods. Joinpoint regression was used to describe temporal trends in HF and in-hospital mortality. Over 50 million pregnancy-related hospitalizations were analyzed. The overall rate of HF was 112 cases per 100 000 pregnancy-related hospitalizations. Although postpartum encounters represented only 1.5% of pregnancy-related hospitalizations, ≈60% of HF cases occurred postpartum, followed by delivery (27.3%) and antepartum (13.2%). Among postpartum hospitalizations, there was a significant 7.1% (95% confidence interval, 4.4-9.8) annual increase in HF from 2001 to 2006, followed by a steady rate through 2011. HF rates among antepartum hospitalizations increased on average 4.9% (95% confidence interval, 3.0-6.8) annually from 2001 to 2011. Women with a diagnosis of HF were more likely to experience adverse maternal outcomes, as reflected by outcome-specific adjusted odds ratios during antepartum (2.7-25), delivery (6-195), and postpartum (1.5-6.6) periods. CONCLUSIONS HF is associated with increased risk of maternal mortality and morbidities. During hospitalization, high-risk mothers need to be identified and surveillance programs developed before discharge.
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Affiliation(s)
- Mulubrhan F Mogos
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.).
| | - Mariann R Piano
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.)
| | - Barbara L McFarlin
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.)
| | - Jason L Salemi
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.)
| | - Kylea L Liese
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.)
| | - Joan E Briller
- From the College of Nursing, Department of Women, Children, and Family Health Science (M.F.M., B.L.M., K.L.L.) and Division of Cardiology, Department of Medicine (J.E.B.), University of Illinois at Chicago; School of Nursing, Vanderbilt University, Nashville, TN (M.R.P.); and Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX (J.L.S.)
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Wallace AS, Pierce NL, Davisson E, Manges K, Tripp-Reimer T. Social resource assessment: Application of a novel communication tool during hospital discharge. PATIENT EDUCATION AND COUNSELING 2019; 102:542-549. [PMID: 30287147 DOI: 10.1016/j.pec.2018.09.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/25/2018] [Accepted: 09/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate an interactive tool designed to help patients communicate their social resources supportive of home recovery to health care providers. METHODS Seventy medical and surgical inpatients completed the D-CEGRM social resource interview, demographic queries, and discharge readiness surveys (RHDS) at discharge. Two weeks later, patients completed post-discharge coping difficulty surveys (PDCDS). Nurses unassociated with patients' clinical care reviewed structured clinical notes created from the D-CEGRM and categorized patients as likely to have "inadequate" or "adequate" supportive resources for home self-management. Nurse decision making was tracked using an adjudication process, and post-hoc comparisons in patient characteristics, RHDS, and PDCDS were conducted. RESULTS Nurses categorized 36 patients (51%) as having inadequate resources. Number and accessibility of supports, presence of negative relationships, and previous struggles meeting health-related needs were important decision-making factors. Post-hoc comparisons revealed significant differences in demographic risk factors and discharge readiness ratings for those with inadequate vs. adequate resources. CONCLUSION The D-CEGRM may be an efficient tool for patients to communicate access to social resources, and an effective facilitator of transitional care planning. PRACTICE IMPLICATIONS The D-CEGRM may provide a useful assessment of patients' home context and guide for transitional care planning.
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Affiliation(s)
- Andrea S Wallace
- University of Utah College of Nursing, 10 South 2000 East Salt, Lake City, UT 84112-5880 United States.
| | - Nicole L Pierce
- University of Iowa College of Nursing 50 Newton Road Iowa City, IA 52242 United States; University of Chicago Medicine, Center for Nursing Professional Practice and Research 5841 S. Maryland Chicago, IL 60637 United States.
| | - Erica Davisson
- University of Iowa College of Nursing 50 Newton Road Iowa City, IA 52242 United States.
| | - Kirstin Manges
- University of Pennsylvania School of Nursing 418 Curie Blvd Philadelphia, PA 19104 United States.
| | - Toni Tripp-Reimer
- University of Iowa College of Nursing 50 Newton Road Iowa City, IA 52242 United States.
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Validation of the Registered Nurse Assessment of Readiness for Hospital Discharge Scale. Nurs Res 2018; 67:305-313. [DOI: 10.1097/nnr.0000000000000293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yanıkkerem E, Esmeray N, Karakuş A, Üstgörül S, Baydar Ö, Göker A. Factors affecting readiness for discharge and perceived social support after childbirth. J Clin Nurs 2018; 27:2763-2775. [DOI: 10.1111/jocn.14248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Emre Yanıkkerem
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Nicole Esmeray
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Aslı Karakuş
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Sema Üstgörül
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Özge Baydar
- Faculty of Health Science Obstetrics and Gynecology Nursing Department Manisa Celal Bayar University Manisa Turkey
| | - Aslı Göker
- Faculty of Medicine Obstetrics and Gynecology Department Manisa Celal Bayar University Hafsa Sultan Hospital Manisa Turkey
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Vikström A, Johansson S, Barimani M. Postnatal
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visits within 30 days—Pattern, risk factors and implications for care. J Clin Nurs 2017; 27:769-776. [DOI: 10.1111/jocn.14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Anna Vikström
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Sven‐Erik Johansson
- The Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Mia Barimani
- Division of Reproductive Health Department of Women′s and Children′s Health Karolinska Institutet Stockholm Sweden
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Abstract
PURPOSE OF REVIEW The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. RECENT FINDINGS Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making. Healthcare providers must consider a variety of infant and maternal characteristics in determining the appropriate time to discharge a dyad, and mothers should be actively involved in the decision-making process. Criteria for infant clinical readiness include the following: establishment of effective feeding, evaluation of jaundice risk, review and discussion of infant and household vaccination status, obtainment of specimen for metabolic screening, tests of hearing ability, assessment of sepsis risk factors, screening for congenital heart disease, and evaluation of parental knowledge about infant safety measures. Important consideration should also be given to the mother's sociodemographic vulnerabilities, maternal confidence and perception of discharge readiness, and availability of postdischarge care continuity. SUMMARY The timing of newborn discharge should be a joint decision made by the mother and healthcare providers based on readiness. The decision should consider the infant's health status, the mother's health status, the mother's perception of readiness, and the availability of social and familial support for the mother and infant. Accessible and comprehensive support postdischarge is also important for helping infants achieve optimal health outcomes.
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McGowan EC, Du N, Hawes K, Tucker R, O'Donnell M, Vohr B. Maternal Mental Health and Neonatal Intensive Care Unit Discharge Readiness in Mothers of Preterm Infants. J Pediatr 2017; 184:68-74. [PMID: 28237375 DOI: 10.1016/j.jpeds.2017.01.052] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/14/2016] [Accepted: 01/20/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate associations between maternal mental health disorders (MHDs) and discharge readiness for mothers of infants born preterm (<37 weeks). We hypothesized that mothers with a history of MHDs would report decreased perceptions of neonatal intensive care unit (NICU) discharge readiness compared with mothers without a history. STUDY DESIGN Mothers of infants born preterm in the NICU >5 days between 2012 and 2015 and participating in a transition home program completed a discharge readiness questionnaire measuring perceptions of staff support, infant well-being (medical stability), maternal well-being (emotional readiness/competency), and maternal comfort (worry about infant). Greater scores are more optimal (range 0-100). Social workers obtained a history of MHDs. Group comparisons and regression analyses were run to predict decreased scores and maternal discharge readiness. RESULTS A total of 37% (315/850) of mothers reported a MHD. They were more likely to be white (64% vs 55% P = .05), single (64% vs 45% P ≤ .001), on Medicaid (61% vs 50% P = .002), and less likely to be non-English speaking (10% vs 22%, P ≤ .001). Mothers with MHD perceived less NICU support (92 ± 13 vs 94 ± 12, P = .005), less emotional readiness for discharge (78 ± 17 vs 81 ± 14, P = .04), and lower family cohesion (81 ± 24 vs 86 ± 19, P = .02) compared with mothers without MHD. Regression modeling (OR; CI) indicated that maternal history of MHDs predicted mother's decreased perception of infant well-being (1.56; 1.05-2.33) and her own well-being (1.99; 1.45-2.8) at discharge. CONCLUSION One-third of mothers reported a history of MHDs. This vulnerable group perceive themselves as less ready for discharge home with their infant, indicating an unmet need for provision of enhanced transition services.
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Affiliation(s)
- Elisabeth C McGowan
- Division of Neonatology, Department of Pediatrics, Women & Infants Hospital, Providence, RI.
| | - Nan Du
- Yale New Haven Children's Hospital, New Haven, CT
| | - Katheleen Hawes
- Division of Neonatology, Department of Pediatrics, Women & Infants Hospital, Providence, RI; College of Nursing, University of Rhode Island, Kingston, RI
| | - Richard Tucker
- Division of Neonatology, Department of Pediatrics, Women & Infants Hospital, Providence, RI
| | - Melissa O'Donnell
- Division of Neonatology, Department of Pediatrics, Women & Infants Hospital, Providence, RI
| | - Betty Vohr
- Division of Neonatology, Department of Pediatrics, Women & Infants Hospital, Providence, RI
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Weiss ME, Sawin KJ, Gralton K, Johnson N, Klingbeil C, Lerret S, Malin S, Yakusheva O, Schiffman R. Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children. J Pediatr Nurs 2017; 34:58-64. [PMID: 28087088 DOI: 10.1016/j.pedn.2016.12.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 12/31/2016] [Accepted: 12/31/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits). DESIGN/METHODS In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits). RESULTS Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%. CONCLUSION There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission. PRACTICE IMPLICATIONS Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.
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Affiliation(s)
- Marianne E Weiss
- College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States.
| | - Kathleen J Sawin
- College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States.
| | - Karen Gralton
- College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States.
| | - Norah Johnson
- College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States.
| | - Carol Klingbeil
- Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States.
| | - Stacee Lerret
- Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States.
| | - Shelly Malin
- Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States.
| | - Olga Yakusheva
- School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, United States.
| | - Rachel Schiffman
- College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States.
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