Translation and psychometric evaluation of a French version of the Readiness for Hospital Discharge Scale

Theoretical concepts and instruments for measuring hospital discharge readiness: A scoping review

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.

Cross-Cultural Adaptation and Validation of the Dagbani Readiness for Hospital Discharge Scale-New Mother

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.

Measurement tools that assess the quality of transitional care from patients' perspective: A literature review

AIM

Transitional care is important for improving the quality of life of patients discharged from hospitals. Patient-reported experience measures help improve transitional care quality. Thus, this literature review aimed to identify and appraise measurement tools that assess transitional care quality from the patient's perspective and identify its components.

METHODS

Development and validation studies were systematically searched in the PubMed and CINAHL databases. The review team appraised the methodological quality and statistical results of measurement properties using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

RESULTS

A total of 30 studies and seven instruments were identified. The target population was patients discharged from hospital to a home or nursing home (mean age = 52-84 years). The measurement time was before or after the discharge. The number of items in the original versions of the measures ranged from eight to 41, with short versions ranging from three to 12. The overall methodological quality of structural validity, internal consistency, and hypotheses testing was mostly "very good or adequate," according to COSMIN criteria. However, content validity and development were mostly "inadequate or doubtful" or not reported. The main components of included measures comprised "self-care after discharge," "providing information to the patient," "patient engagement in the care plan," and "dealing with patient's concerns."

CONCLUSION

The quality appraisal results and identified components are useful for choosing measurement tools in clinical practice and research. The Care Transitions Measure is the most widely validated measurement tool.

The factors of patient-reported readiness for hospital discharge in patients with depression: A cross-sectional study

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.

A Chinese version of the chemotherapy-induced alopecia distress scale based on reliability and validity assessment in breast cancer patients

PURPOSE

Chemotherapy-induced alopecia is a common and emotionally traumatic side effect on breast cancer patients. In order to make up for the deficiency of measuring tools in China, our study aims at translating the chemotherapy-induced alopecia distress scale (CADS) into Chinese and evaluating the psychometric properties of the Chinese version of CADS (CADS-C) in breast cancer patients.

METHODS

The validity and reliability of CADS-C were measured by a questionnaire survey among 301 breast cancer patients from Chinese mainland. Construct validity was assessed through factor analysis and contrasted group comparisons. The validity of the content was examined by an experts group. The internal consistency and test-retest reliability were evaluated by calculating Cronbach's alpha and the intraclass correlation coefficient.

RESULTS

The content validity index was 0.94; a structure with three factors was revealed by exploratory factor analysis which explained 65.40% of the variance and proved by confirmatory factor analysis. The contrasted group comparisons showed significant differences among different degrees of alopecia. The average variance extracted and composite reliability and correlations between CADS and body image, quality of life and self-esteem proved the convergent validity. The Cronbach's alpha and the intraclass correlation coefficient of the total scale were 0.90 and 0.89 respectively, indicating satisfactory internal consistency and time stability.

CONCLUSION

The scale appears to be a reliable and valid tool to measure chemotherapy-induced alopecia distress among breast cancer patients in China.

Psychometric properties of the Chinese Version of the Readiness for Hospital Discharge Scale for people living with HIV

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.

A Chinese version of the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale: Reliability and validity assessment in chronically ill patients

AIMS AND OBJECTIVES

To translate the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale (PPPNBS) into Chinese and to psychometrically test the Chinese version of PPPNBS (PPPNBS-C) in chronically ill patients.

BACKGROUND

The growing prevalence and burden of chronic illnesses became the driving force for the need of empowerment as an approach to engage patients in self-management. The PPPNBS was developed to assess patient perceptions of the process of empowerment during hospitalisation. Extending its application to different clinical context and ethnicities is worth pursuing.

DESIGN

A cross-sectional survey.

METHODS

The PPPNBS was translated according to Brislin's translation guidelines and was culturally adapted. A questionnaire survey was carried out to determine the reliability and validity of the PPPNBS-C among a total of 517 hospitalised patients with chronic illnesses.

RESULTS

The content validity was found to be good with a content validity index of 0.94. Exploratory factor analysis identified six factors explaining 68.56% of the total variance and confirmatory factor analysis confirmed this six-factor structure. The hypothesised differences were demonstrated through contrasted group comparisons by time since diagnosis and length of hospital stay. The score of the PPPNBS-C was significantly and positively associated with that of the Client Satisfaction Questionnaire, as was the Self-Efficacy for Managing Chronic Disease 6-Item Scale score, providing evidence of convergent validity. The Cronbach's alpha coefficient was 0.960 and the intraclass correlation coefficient was 0.86 for the total scale, explaining good internal consistency and time stability.

CONCLUSIONS

The PPPNBS-C has preliminary verification of the validity and reliability and could be useful in measuring patient perceptions of patient-empowering nurse behaviours.

RELEVANCE TO CLINICAL PRACTICE

The PPPNBS-C can be applied to chronically ill patients as a metric of the implementation status of patient-empowering nurse behaviours and can be used as a guide to encourage nurse's intentional utilisation of empowering behaviours.

Cross-cultural adaptation of the instrument Readiness for Hospital Discharge Scale - Adult Form

ABSTRACT Objective: to perform the cross-cultural adaptation of the Readiness for Hospital Discharge Scale - (RHDS) Adult Form for use in Brazil. Method: a methodological study was conducted in 2015, in Brazil’s federal capital, following the eight stages scientifically established. Results: analysis proved the maintenance of semantic, idiomatic, cultural, and conceptual equivalences and kept both the face and content validity of the original version. The judging committee and the pre-test participants declared they understood the RHDS items and answer scale. Conclusion: the instrument is culturally adapted for Brazil and can be used as one of the stages for planning hospital discharge.

Readiness for hospital discharge: A concept analysis

AIM

To report on an analysis on the concept of 'readiness for hospital discharge'.

BACKGROUND

No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research.

DESIGN

Literature review and concept analysis.

METHOD

A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied.

RESULTS

Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge.

CONCLUSION

This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital.