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Yang J, Pu Y, Jiang X, Yao Q, Luo J, Wang T, Zhang X, Yang Z. Association between quality of discharge teaching and self-management in patients after percutaneous coronary intervention: A chain mediation model. J Clin Nurs 2024. [PMID: 38764246 DOI: 10.1111/jocn.17204] [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: 01/24/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/21/2024]
Abstract
AIMS To examine chain mediating effect of discharge readiness and self-efficacy between quality of discharge teaching and self-management in patients after percutaneous coronary intervention (PCI). BACKGROUND Although self-management after PCI has significant benefits in controlling risk factors and delaying disease progression, the status of self-management remains unoptimistic. A large number of studies have explored the close relationship between the quality of discharge teaching and patients self-management, but little is known about the underlying mechanisms. METHODS The cross-sectional samples was collected from a tertiary hospital in China. Self-reported questionnaires were used to assess quality of discharge teaching, discharge readiness, self-efficacy and self-management. Pearson correlation analysis and mediation effect analysis were used for statistical analysis. REPORTING METHOD The study used the STROBE checklist for reporting. RESULTS A total of 198 patients with a mean age of 64.99 ± 11.32 (34-85) were included. The mean score of self-management was 88.41 ± 11.82. Quality of discharge teaching, discharge readiness, self-efficacy and self-management were all positively correlated. Mediation effect analysis showed that the mediating effects of discharge readiness, self-efficacy, discharge readiness and self-efficacy between quality of discharge teaching and self-management were 0.157, 0.177 and 0.049, respectively, accounting for 21.96%, 24.76% and 6.85% of the total effect. CONCLUSION The quality of discharge teaching for patients after PCI not only directly affects self-management, but also can indirectly affect self-management through discharge readiness and self-efficacy. RELEVANCE TO CLINICAL PRACTICE To improve the life quality of patients after PCI, medical staff should pay attention to the influence of self-management of quality of discharge teaching, and develop intervention strategies based on the path of discharge readiness and self-efficacy. PATIENT OR PUBLIC CONTRIBUTION Questionnaires filled out by patients were used to understand the association between quality of discharge teaching, discharge readiness, self-efficacy and self-management.
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Affiliation(s)
- Jin Yang
- Chengdu Medical College, Chengdu, China
- Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - You Pu
- Department of Oncology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Xia Jiang
- Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Qian Yao
- Chengdu Medical College, Chengdu, China
| | - Jian Luo
- Chengdu Medical College, Chengdu, China
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Gao S, Huang N, Huang W, Lian Y, Xiao H, Yao S. Position Adherence in Patients Underwent Pars Plana Vitrectomy with Silicone Oil Tamponade. Patient Prefer Adherence 2024; 18:829-838. [PMID: 38645698 PMCID: PMC11027915 DOI: 10.2147/ppa.s453683] [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: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Position adherence of patients with Pars Plana Vitrectomy with Silicone Oil Tamponade after discharge is of positive significance. However, patients undergoing a day surgery makes the quality of discharge teaching and readiness for hospital discharge is insufficient, which will influence their position adherence at home. Aim This study aimed to find the correlation of discharge teaching, readiness for hospital discharge, and position adherence in patients who underwent PPV with silicone oil tamponade from the day ward. Methods This was a cross-sectional survey. One hundred ninety-four patients with day surgery were recruited by convenient sampling from Zhongshan Ophthalmic Center, China. Data were collected using the quality of discharge teaching scale, readiness for hospital discharge scale, and position adherence scale. Results Patients' education level, residence, poor postoperative vision, ophthalmic surgery history, and quality of discharge teaching are the main factors of readiness for discharge. Only 41(21%) patients had good position adherence, and education level and readiness for discharge are the main factors of position adherence. Discussion Discharge teaching improves patients' knowledge and competence of self-care and helps patients prepare for the transition from hospital to home, and readiness for hospital discharge significantly influences position adherence after discharge and indirectly plays a vital role in postoperative vision recovery and surgical effect.
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Affiliation(s)
- Saiyu Gao
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | - Nanqi Huang
- Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Wenmin Huang
- Ocular Emergency and Trauma Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of China
| | - Yu Lian
- Ocular Emergency and Trauma Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of China
| | - Huiming Xiao
- Ocular Emergency and Trauma Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of China
| | - Shuyu Yao
- Ocular Emergency and Trauma Department, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People’s Republic of 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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Wu M, Zhou W, Hu S, Peng F, Yang F, Zhang L. Parenting self-efficacy and parenting stress mediates the effects of the association of perceived social support and readiness for discharge among parents of children with primary nephrotic syndrome. J Pediatr Nurs 2024; 75:e93-e101. [PMID: 38199933 DOI: 10.1016/j.pedn.2023.12.035] [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: 06/30/2023] [Revised: 11/12/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To investigate the level of readiness for discharge among parents of children with primary nephrotic syndrome and to explore the mediating role of parenting self-efficacy and parenting stress between perceived social support and readiness for discharge. DESIGN AND METHODS A cross-sectional study was conducted in five large tertiary general hospitals in Hunan, China. Data related to demographics, perceived social support, parenting self-efficacy, parenting stress, and readiness for discharge were collected from 350 parents of children diagnosed with primary nephrotic syndrome. Path analysis was used to determine the mediating roles of parenting self-efficacy and parenting stress in the relationship between perceived social support and readiness for discharge. RESULTS Parents of children with nephrotic syndrome in China experienced low perceived social support, low readiness for discharge, and high parenting stress. Factors influencing readiness for discharge include the child's age, duration of illness, first episode or relapse, parental literacy and marital status. Parenting self-efficacy and parenting stress mediated the effects of the association of perceived social support and readiness for discharge. CONCLUSION Perceived social support influences the readiness of parents of children with nephrotic syndrome. Parenting self-efficacy and parenting stress have a chain mediating effect of the association of perceived social support and readiness for discharge. PRACTICE IMPLICATIONS This study emphasizes the mediating role of the psychological state of the child's parents. Nurses should take steps to increase perceived social support and parenting self-efficacy of the child's parents and to reduce parenting stress in order to improve readiness for discharge.
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Affiliation(s)
- Mengyu Wu
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China; Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Wen Zhou
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Shengnan Hu
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China
| | - Fangrong Peng
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Fang Yang
- Department of Pediatric, The Second Xiangya Hospital of Central South University, Changsha City, Hunan Province 410011, PR China
| | - Liuyi Zhang
- Department of Nursing, Medical College of Hunan Normal University, Changsha city, Hunan Province 410013, PR China.
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Yu Q, He LJ, Zhong JD, Zhang JE. Readiness for hospital discharge and its association with post-discharge outcomes among oesophageal cancer patients after oesophagectomy: A prospective observational study. J Clin Nurs 2024. [PMID: 38323735 DOI: 10.1111/jocn.17055] [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: 03/04/2023] [Revised: 09/25/2023] [Accepted: 11/14/2023] [Indexed: 02/08/2024]
Abstract
AIM To examine the level and influencing factors of discharge readiness among patients with oesophageal cancer following oesophagectomy and to explore its association with post-discharge outcomes (post-discharge coping difficulty and unplanned readmission). BACKGROUND Oesophageal cancer is common and usually treated via oesophagectomy in China. The assessment of patient's discharge readiness gradually attracts attention as patients tend to be discharged more quickly. DESIGN Prospective observational study. The STROBE statement was followed. METHODS In total, 154 participants with oesophageal cancer after oesophagectomy were recruited in a tertiary cancer centre in Southern China from July 2019 to January 2020. The participants completed a demographic and disease-related questionnaire, the Quality of Discharge Teaching Scale and Readiness for Hospital Discharge Scale before discharge. Post-discharge outcomes were investigated on the 21st day (post-discharge coping difficulty) and 30th day (unplanned readmission) after discharge separately. Multiple linear regressions were used for statistical analysis. RESULTS The mean scores of discharge readiness and quality of discharge teaching were (154.02 ± 31.58) and (138.20 ± 24.20) respectively. The quality of discharge teaching, self-care ability, dysphagia and primary caregiver mainly influenced patient's discharge readiness and explained 63.0% of the variance. The low discharge readiness could predict more risk of post-discharge coping difficulty (r = -0.729, p < 0.01) and unplanned readmission (t = -2.721, p < 0.01). CONCLUSIONS Discharge readiness among patients with oesophageal cancer following oesophagectomy is influenced by various factors, especially the quality of discharge teaching. A high discharge readiness corresponds to good post-discharge outcomes. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Healthcare professionals should improve the discharge readiness by constructing high-quality discharge teaching, cultivating patients' self-care ability, mobilizing family participation and alleviating dysphagia to decrease adverse post-discharge outcomes among patients with oesophageal cancer. PATIENTS OR PUBLIC CONTRIBUTION Patients with oesophageal cancer after oesophagectomy who met the inclusion criteria were recruited.
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Affiliation(s)
- Qian Yu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Le-Jian He
- Outpatient Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jiu-di Zhong
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun-E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Wang Y, Li J, Zhai M, Zhao Y, Li Q. Exploring readiness for discharge, quality of discharge teaching, and fear of disease progression in lung cancer patients undergoing chemotherapy: A correlation analysis. Thorac Cancer 2024; 15:66-76. [PMID: 37984977 PMCID: PMC10761620 DOI: 10.1111/1759-7714.15164] [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] [Received: 09/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND To explore the correlation between the current status of discharge preparation, quality of discharge teaching, and fear of disease progression among patients with lung cancer undergoing chemotherapy to provide a basis for improving patients' level of preparation. METHODS In this cross-sectional study, convenience sampling was used to select 452 patients with lung cancer who received chemotherapy and were admitted to the Department of Medical Oncology of the Cancer Hospital, between February 2023 and April 2023. A general information questionnaire, discharge preparation scale, quality of discharge teaching scale, and fear of disease progression scale were used to conduct surveys 2 h before the patients were discharged. RESULTS The score for discharge preparation among lung cancer patients with chemotherapy was 99.11 ± 14.79 and the item score was 8.26 ± 1.23. The score for quality of discharge teaching was 193.23 ± 37.69, and that for fear of disease progression was 25.47 ± 8.92. Multiple linear regression analysis showed that sex, marital status, treatment period, quality of discharge teaching, and fear of disease progression influenced discharge readiness among patients with lung cancer receiving chemotherapy. Pearson's correlation analysis showed that the total quality of the discharge guidance score was positively correlated with the discharge readiness score (r = 0.288, p < 0.001). In contrast, the total fear of disease progression score was negatively correlated with the discharge preparation score (r = -0.252, p < 0.001). CONCLUSION Discharge readiness among patients with lung cancer receiving chemotherapy was relatively at the good level, and there was a significant correlation between readiness for discharge, discharge teaching and fear of disease progression in these patients. Therefore, it is necessary to provide effective discharge guidance and implement targeted intervention measures to further improve patient preparation, reduce the fear of disease progression, and promote patient ability of coping with the disease and overall satisfaction.
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Affiliation(s)
- Yan Wang
- Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jinping Li
- Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Minfeng Zhai
- Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yang Zhao
- Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Qiuyue Li
- School of NursingPeking Union Medical CollegeBeijingChina
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Calvillo-Ortiz R, Polanco-Santana JC, Watkins AA, Castillo-Angeles M, Anguiano-Landa L, Callery MP, Kent TS. Patients' perceptions of the post-pancreatectomy discharge process. HPB (Oxford) 2023; 25:1179-1186. [PMID: 37407398 DOI: 10.1016/j.hpb.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Complications after pancreatectomies contribute to poor outcomes. Patients are expected to identify signs/symptoms leading to these complications but may be poorly educated on how to identify them. We assessed the impact of an educational tool on patient perceptions of, and satisfaction with the discharge process, and its effect on readmission rates. METHODS A prospective cohort study with retrospective chart review including patients who underwent pancreatic resection was undertaken. An interactive educational module (iBook) that provided information about the procedure, possible complications, and peri-discharge information was implemented. English-speaking patients were equally divided into the pre- and post-iBook cohorts. Primary outcome was patients' satisfaction with discharge; Secondary outcomes were 30- and 90-day readmission rates. RESULTS 100 patients were included. Mean age was 65.5 ± 12.6, 46% were female, and 92.3% were white. Most patients underwent Whipple procedures (72%), and distal pancreatectomies (26%). In the post-implementation group, 92% were satisfied with the discharge process, and 89% reported it was a good tool. There were no statistical differences in 30- and 90-day readmission rates between cohorts. CONCLUSION The iBook positively impacted patients' satisfaction and preparedness for discharge. Readmission rates were not statistically significantly impacted but could be investigated with further studies of greater sample sizes.
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Affiliation(s)
| | - J C Polanco-Santana
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ammara A Watkins
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, MA, United States
| | - Manuel Castillo-Angeles
- Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States
| | - Luis Anguiano-Landa
- Department of Surgery, Instituto Tecnológico de Estudios Superiores de Monterrey, Mexico
| | - Mark P Callery
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Tara S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States.
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Johnson KH, Gardener H, Gutierrez C, Marulanda E, Campo-Bustillo I, Gordon Perue G, Hlaing W, Sacco R, Romano JG, Rundek T. Disparities in transitions of acute stroke care: The transitions of care stroke disparities study methodological report. J Stroke Cerebrovasc Dis 2023; 32:107251. [PMID: 37441890 PMCID: PMC10529930 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107251] [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] [Received: 04/19/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVE The Transitions of Stroke Care Disparities Study (TCSD-S) is an observational study designed to determine race-ethnic and sex disparities in post-hospital discharge transitions of stroke care and stroke outcomes and to develop hospital-level initiatives to reduce these disparities to improve stroke outcomes. MATERIALS AND METHODS Here, we present the study rationale, describe the methodology, report preliminary outcomes, and discuss a critical need for the development, implementation, and dissemination of interventions for successful post-hospital transition of stroke care. The preliminary outcomes describe the demographic, stroke risk factor, socioeconomic, and acute care characteristics of eligible participants by race-ethnicity and sex. We also report on all-cause and vascular-related death, readmissions, and hospital/emergency room representations at 30- and 90-days after hospital discharge. RESULTS The preliminary sample included data from 1048 ischemic stroke and intracerebral hemorrhage discharged from 10 comprehensive stroke centers across the state of Florida. The overall sample was 45% female, 22% Non-Hispanic Black and 21% Hispanic participants, with an average age of 64 ± 14 years. All cause death, readmissions, or hospital/emergency room representations are 10% and 19% at 30 and 90 days, respectively. One in 5 outcomes was vascular-related. CONCLUSIONS This study highlights the transition from stroke hospitalization as an area in need for considerable improvement in systems of care for stroke patients discharged from hospital. Results from our preliminary analysis highlight the importance of investigating race-ethnic and sex differences in post-stroke outcomes.
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Affiliation(s)
- Karlon H Johnson
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA.
| | - Hannah Gardener
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Carolina Gutierrez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Erika Marulanda
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Iszet Campo-Bustillo
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Gillian Gordon Perue
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - WayWay Hlaing
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Ralph Sacco
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Jose G Romano
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
| | - Tatjana Rundek
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, CRB 919, Miami, Florida 33136, USA
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Jones KC, Austad K, Silver S, Cordova-Ramos EG, Fantasia KL, Perez DC, Kremer K, Wilson S, Walkey A, Drainoni ML. Patient Perspectives of the Hospital Discharge Process: A Qualitative Study. J Patient Exp 2023; 10:23743735231171564. [PMID: 37151607 PMCID: PMC10159238 DOI: 10.1177/23743735231171564] [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] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Care transitions after hospitalization require communication across care teams, patients, and caregivers. As part of a quality improvement initiative, we conducted qualitative interviews with a diverse group of 53 patients who were recently discharged from a hospitalization within a safety net hospital to explore how patient preferences were included in the hospital discharge process and differences in the hospital discharge experience by race/ethnicity. Four themes emerged from participants regarding desired characteristics of interactions with the discharge team: (1) to feel heard, (2) inclusion in decision-making, (3) to be adequately prepared to care for themselves at home through bedside teaching, (4) and to have a clear and updated discharge timeline. Additionally, participants identified patient-level factors the discharge planning team should consider, including the social context, family involvement, health literacy, and linguistic barriers. Lastly, participants identified provider characteristics, such as a caring and empathetic bedside manner, that they found valuable in the discharge process. Our findings highlight the need for shared decision-making in the discharge planning process to improve both patient safety and satisfaction.
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Affiliation(s)
- Kayla C Jones
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
| | - Kirsten Austad
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
- Department of Family Medicine, Boston
University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Santana Silver
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
| | - Erika G Cordova-Ramos
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
- Department of Pediatrics, Boston Medical Center, Evans Center for Implementation & Improvement Sciences
(CIIS), Boston University Chobanian & Avedisian School of Medicine, Boston, MA,
USA
| | - Kathryn L Fantasia
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
- Section of Endocrinology, Diabetes and
Nutrition, Department of Medicine, Boston University Chobanian & Avedisian
School of Medicine, Boston, MA, USA
| | - Daisy C Perez
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Kristen Kremer
- Department of Ambulatory Operations, Boston Medical Center, Boston, MA, USA
| | - Sophie Wilson
- Department of Quality and Patient Safety,
Boston Medical Center, Boston, MA, USA
| | - Allan Walkey
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
- Section of Pulmonary, Allergy, Critical
Care and Sleep, Department of Medicine, Boston University Chobanian & Avedisian
School of Medicine, Boston, MA, USA
| | - Mari-Lynn Drainoni
- Evans Center for Implementation &
Improvement Sciences (CIIS), Department of Medicine, Boston University Chobanian
& Avedisian School of Medicine, Boston, MA, USA
- Section of Infectious Diseases,
Department of Medicine, Boston University Chobanian & Avedisian School of
Medicine, Boston, MA, USA
- Department of Health Law Policy &
Management, Boston University School of Public
Health, Boston, MA, USA
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10
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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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11
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Eskolin SE, Inkeroinen S, Leino-Kilpi H, Virtanen H. Instruments for measuring empowering patient education competence of nurses: Systematic review. J Adv Nurs 2023. [PMID: 36808623 DOI: 10.1111/jan.15597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/04/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
AIM This review aimed to identify validated self-reported instruments used to measure nurses' competence or attribute(s) of competence in empowering patient education, to describe their development and main content and critically appraise and summarize the quality of the instruments. DESIGN Systematic review. DATA SOURCES Electronic databases of PubMed, CINAHL and ERIC were searched from January 2000 to May 2022. REVIEW METHODS Data was extracted following predetermined inclusion criteria. With the support of the research group, two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN). RESULTS A total of 19 studies reporting 11 instruments were included. The instruments measured varied attributes of competence and the contents were heterogenous reflecting the complex nature of both empowerment and competence as concepts. Overall, the reported psychometric properties of the instruments and methodological quality of the studies were at least adequate. However, there was variation in the testing of the instruments' psychometric properties and lack of evidence limited the evaluation of both the methodological quality of the studies and quality of instruments. CONCLUSION The psychometric properties of the existing instruments assessing nurses' competence in empowering patient education need to be tested further, and future instrument development should be built on a clearer definition of empowerment as well as on more rigorous testing and reporting. In addition, continued efforts to clarify and define both empowerment and competence on the conceptual level are needed. IMPACT Evidence on nurses' competence in empowering patient education and its valid and reliable assessment instruments is scarce. Existing instruments are heterogenous and are often missing proper testing of validity and reliability. These findings contribute to further research on developing and testing the instruments of competence in empowering patient education and strengthening nurses' empowering patient education competence in the clinical practice.
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Affiliation(s)
| | - Saija Inkeroinen
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Sciences, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Sciences, University of Turku, Turku, Finland
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12
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Dini AP, Okabe JDS, Kalvan SZ, Simplicio C, Gasparino RC. Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension. Rev Bras Enferm 2023; 76:e20220530. [PMID: 36995824 PMCID: PMC10042477 DOI: 10.1590/0034-7167-2022-0530] [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: 09/20/2022] [Accepted: 11/11/2022] [Indexed: 03/29/2023] Open
Abstract
Objectives: to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care. Methods: methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients. Results: in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7. Conclusions: the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.
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Affiliation(s)
| | | | | | - Carla Simplicio
- Universidade Estadual de Campinas. Campinas, São Paulo, Brazil
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13
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Dini AP, Okabe JDS, Kalvan SZ, Simplicio C, Gasparino RC. Adaptação e validação de instrumento de classificação de paciente adulto com ênfase na dimensão familiar. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0530pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
RESUMO Objetivos: adaptar e validar um instrumento para classificação de pacientes adultos que enfatiza a rede de suporte familiar na demanda de cuidados de enfermagem. Métodos: estudo metodológico, realizado em três fases: adaptação de um instrumento considerando a realidade de pacientes adultos; validação de conteúdo com sete especialistas e avaliação das propriedades de medida (validade de construto e consistência interna) com 781 pacientes internados. Resultados: na validação de conteúdo, os indicadores alcançaram os valores estabelecidos para o Índice de Validade de Conteúdo (0,85-1,00). Na análise fatorial confirmatória, os 11 indicadores foram distribuídos em três domínios e apresentaram variância média extraída e carga fatorial superiores a 0,5. A confiabilidade composta foi superior a 0,7. Conclusões: o presente estudo adaptou e disponibilizou, com evidências de validade e confiabilidade, um instrumento para classificação de pacientes adultos que considera a rede de suporte familiar na demanda de cuidados de enfermagem.
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14
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Schnitman G, Gomes D, Deckelbaum D, Utiyama EM. Feasibility of multimedia animations as preoperative guides for urgent abdominal surgeries in a public hospital in Brazil. HEALTH EDUCATION RESEARCH 2022; 37:333-354. [PMID: 36125090 DOI: 10.1093/her/cyac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Health literacy, culture and language play vital roles in patients' understanding of health issues. Obstacles are more evident in low- and middle-income countries (LMICs), where inadequate patient education levels are higher and hospital resources are lower. This is a prospective pilot study assessing the feasibility of digital preoperative animations as guides for surgical patients. Patients admitted to a public hospital in Brazil for acute cholecystitis or appendicitis were included. Feasibility was represented by acceptability rate and ease of integration with department protocols. Thirty-four patients were included, and 26 patients concluded the intervention (76.5% acceptability rate). Demographic factors seemed to affect the results, indicated by higher acceptability from those with lower education levels, from younger patients and from women. Few studies have evaluated the use of multimedia resources for surgical patients, and no studies assessed the use of animations as digital patient education resources in an LMIC. This study demonstrated that the use of animations for patient education in LMICs is feasible. A step-based approach is proposed to aid the implementation of patient education digital interventions. The use of digital multimedia animations as preoperative guides in LMICs is feasible. It may help improve patient education and promote clinical benefits.
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Affiliation(s)
- Gabriel Schnitman
- Centre for Global Surgery, Department of Experimental Surgery, McGill University, 1650 Cedar Avenue, Room L9-505, Montreal, QC H3G 1A4, Canada
| | - Danila Gomes
- Hospital das Clínicas, Universidade de São Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP 05403-000, Brazil
| | - Dan Deckelbaum
- Centre for Global Surgery, Department of Experimental Surgery, McGill University, 1650 Cedar Avenue, Room L9-505, Montreal, QC H3G 1A4, Canada
| | - Edivaldo Massazo Utiyama
- Hospital das Clínicas, Universidade de São Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP 05403-000, Brazil
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15
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Burmeister S, Nickasch B. Promoting the Teach-Back Method during hospital admissions. Nursing 2022; 52:52-56. [PMID: 35752912 DOI: 10.1097/01.nurse.0000832360.31971.6b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Samantha Burmeister
- Sam Burmeister completed her DNP-FNP at the University of Wisconsin Oshkosh, where Bonnie Nickasch is an associate professor
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16
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Huang L, Peng S. Status Quo and Influencing Factors of Discharge Readiness of Patients with Bilateral Ureteral Stoma After Radical Cystectomy. Front Surg 2022; 9:860162. [PMID: 36034344 PMCID: PMC9407034 DOI: 10.3389/fsurg.2022.860162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
Bladder cancer is a common malignancy of the urinary system, which occurs mostly in elderly men, and the incidence is increasing year by year. To analyze the status quo and related factors of discharge readiness of patients with bilateral ureteral stoma after radical cystectomy, a retrospective, noncomparative was performed. 544 patients with bilateral ureteral stoma after radical cystectomy in our hospital from December 2018 to December 2020 were selected. The self-designed questionnaire, discharge readiness scale (RHDS) and discharge guidance quality scale (QDTS) were used to investigate the general data, and multiple linear regression was used to analyze the related influencing factors. The total score of RHDS was (72.57 ± 18.56) and the total score of QDTS was (105.63 ± 24.18); the total score of RHDS was positively correlated with the total score of QDTS (r = 0.882, p = 0.000); the results of multiple linear regression showed that age, discharge direction and care mode were the main factors influencing the discharge readiness of patients (p < 0.05). In conclusions, the discharge readiness of patients with bilateral ureteral stoma after radical cystectomy is in the medium level, and there is a large space for improvement. Nurses should strengthen the guidance and nursing of patients’ discharge preparation to reduce the incidence of postoperative complications and readmission rate.
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17
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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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18
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Saunders R, Dineen D, Gullick K, Seaman K, Graham R, Finlay S. Exploring orthopaedic patients’ experiences of hospital discharge: Implications for nursing care. Collegian 2022. [DOI: 10.1016/j.colegn.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Kim JH, Shin YS. Discharge Transition Experience for Lumbar Fusion Patients: A Qualitative Study. J Neurosci Nurs 2021; 53:228-232. [PMID: 34620802 PMCID: PMC8575165 DOI: 10.1097/jnn.0000000000000616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT BACKGROUND: Support should be provided to individuals who are ready to be discharged; however, quantitative research is lacking in understanding the challenges of postsurgery lumbar fusion patients' discharge and transition. This article delves into the in-depth experience of lumbar fusion patients with discharge transitions. METHODS: We conducted semistructured individual interviews with 11 patients who had lumbar fusion surgery at one of Korea's most equipped general hospitals. These interviews focused on the patients' discharge transition experiences. The data were analyzed using phenomenological analysis. RESULTS: Lumbar fusion patients' experiences of discharge transition fit into 4 categories: anticipation of surgical transition, the process of transition to discharge, the difficult process of recovery, and recovery strategy. CONCLUSION: To further expedite the discharge process and make better use of cooperative hospital resources, conducting preoperative treatment planning, identifying family and social support systems, and sharing treatment procedures are all required. Furthermore, thorough health information services and step-by-step courses on predicted problems and everyday living after surgery should be considered for postoperative education. It is critical to broadening the scope of preoperative and postoperative education programs, as well as assistance for the social support system, such as the family-based support system and cooperative hospitals.
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20
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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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21
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Ko YJ, Lee JH, Baek SH. Discharge transition experienced by older Korean women after hip fracture surgery: a qualitative study. BMC Nurs 2021; 20:112. [PMID: 34182981 PMCID: PMC8237510 DOI: 10.1186/s12912-021-00637-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/10/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This study aimed to explore older Korean women's discharge transition experiences after hip fracture surgery. METHODS This was a descriptive qualitative study. Face-to-face interviews following hip fracture surgery were conducted on 12 women aged 65-87 years. Data were collected 1 to 2 days before discharge and again 4 weeks after discharge following hip fracture surgery, and were analyzed using qualitative content analysis. RESULTS Four main themes were identified: (1) challenge of discharge transition: unprepared discharge, transfer into other care settings, and eagerness for recovery; (2) physical and psychological distress against recovery: frail physical state and psychological difficulties; (3) dependent compliance: absolute trust in healthcare providers, indispensable support from the family, and passive participation in care; and (4) walking for things they took for granted: hope of walking and poor walking ability. CONCLUSIONS After their hip fracture surgeries, older women hoped to be able to walk and perform simple daily chores they previously took for granted. Considering the physical and psychological frailty of older women undergoing hip surgery, systematic nursing interventions including collaboration and coordination with other healthcare professionals and settings are necessary to ensure the quality of continuous care during their post-surgery discharge transition. Encouraging partial weight bearing and initiating intervention to reduce fear of falling at the earliest possible time are essential to attain a stable discharge transition. Additionally, older women should be invited to participate in their care, and family involvement should be encouraged during the discharge transition period in South Korea.
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Affiliation(s)
- Young Ji Ko
- Department of Nursing, Daegu Haany University, Daegu, South Korea.
| | - Ju Hee Lee
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Seung-Hoon Baek
- Department of Orthopedic Surgery, Kyungpook National University, Daegu, South Korea.,Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, South Korea
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22
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Byrne MHV, Mehmood A, Summers DM, Hosgood SA, Nicholson ML. A systematic review of living kidney donor enhanced recovery after surgery. Clin Transplant 2021; 35:e14384. [PMID: 34101263 DOI: 10.1111/ctr.14384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/20/2022]
Abstract
Enhanced recovery after surgery (ERAS) reduces complications and shortens hospital stay without increasing readmission or mortality. However, its role in living donor nephrectomy (LDN) has not yet been defined. Medline, Embase, CINAHL, PsycINFO, and Cochrane Central were searched prior to 08/01/21 for all randomized controlled and cohort studies comparing ERAS to standard of care in LDN. The study was registered on PROSPERO (CRD: CRD42019141706). One thousand, three hundred seventy-seven patients were identified from 14 studies (698 patients with ERAS and 679 patients without). There were considerable differences in the protocols used, and compliance with general ERAS recommendations was poor. Meta-analysis of laparoscopic procedures (including hand- and robot-assisted) revealed that duration of stay was significantly reduced by 0.98 days with ERAS (95% CI = 0.36-1.60, P = .002) and opiate requirement by 32.4 mg (95% CI = 1.1-63.7, P = .04). There was no significant difference n readmission rates or complications. Quality of evidence was low to moderate assessed using the GRADE tool. This review suggests there is a positive benefit of ERAS in laparoscopic LDN. However, there was considerable variation in ERAS protocols used, and the quality of evidence was low; as such, a guideline for ERAS in LDN should be developed and validated.
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Affiliation(s)
- Matthew H V Byrne
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Ahmed Mehmood
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Dominic M Summers
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Sarah A Hosgood
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Michael L Nicholson
- Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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Exploring the Role of Social Support between Discharge Teaching and Readiness for Discharge in Ocular Fundus Disease Patients: A Cross-Sectional Study. J Ophthalmol 2021; 2021:5547351. [PMID: 34239719 PMCID: PMC8233073 DOI: 10.1155/2021/5547351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background This study aims to evaluate the quality of discharge teaching and readiness for discharge of fundus disease patients treated with day surgery and understand the role of social support between them. Methods This was a cross-sectional descriptive correlational survey. Through convenient sampling, fundus disease patients treated with day surgery from Zhongshan Ophthalmic Center, China, were recruited. Data were collected using demographic and disease-related information, quality of discharge teaching scale, readiness for hospital discharge scale, and social support scale. Results 255 fundus disease patients treated with day surgery were recruited at last. The mean total score of readiness for discharge, quality of discharge teaching, and social support in patients with fundus disease were 157.91 (SD = 26.68), 122.97 (SD = 21.55), and 36.32 (SD = 7.60), respectively. Participants with stronger social support had better discharge teaching and then had higher readiness for discharge. Social support played a partial mediator role in the relationship between discharge teaching and readiness for discharge. The mediation effect ratio was 5.5%. Conclusions The quality of discharge teaching and social support among fundus disease patients who underwent day surgery was relatively high, and readiness for discharge was good. Social support is essential for the quality of discharge teaching and the improvement of discharge readiness. Clinical nurses need to provide appropriate guidelines to help patients seek effective support and improve quality of discharge teaching to enhance the readiness for discharge of fundus disease patients treated with day surgery.
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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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Reid TD, Shrestha R, Stone L, Gallaher J, Charles AG, Strassle PD. Socioeconomic disparities in ostomy reversal among older adults with diverticulitis are more substantial among non-Hispanic Black patients. Surgery 2021; 170:1039-1046. [PMID: 33933283 DOI: 10.1016/j.surg.2021.03.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/01/2021] [Accepted: 03/22/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND While ostomies for diverticulitis are often intended to be temporary, ostomy reversal rates can be as low as 46%. There are few comprehensive studies evaluating the effects of socioeconomic status as a disparity in ostomy reversal. We hypothesized that among the elderly Medicare population undergoing partial colectomy for diverticulitis, lower socioeconomic status would be associated with reduced reversal rates. METHODS Retrospective cohort study using a 20% representative sample of Medicare beneficiaries >65 years old with diverticulitis who received ostomies between January 1, 2010, to December 31, 2017. We evaluated the effect of neighborhood socioeconomic status, measured by the Social Deprivation Index, on ostomy reversal within 1 year. Secondary outcomes were complications and mortality. RESULTS Of 10,572 patients, ostomy reversals ranged from 21.2% (low socioeconomic status) to 29.8% (highest socioeconomic status), with a shorter time to reversal among higher socioeconomic status groups. Patients with low socioeconomic status were less likely to have their ostomies reversed, compared with the highest socioeconomic status group (hazard ratio 0.83, 95% confidence interval 0.74-0.93) and were more likely to die (hazard ratio 1.21, 95% confidence interval 1.10-1.33). When stratified by race/ethnicity and socioeconomic status, non-Hispanic White patients at every socioeconomic status had a higher reversal rate than non-Hispanic Black patients (White patients 32.0%-24.8% vs Black patients 19.6%-14.7%). Socioeconomic status appeared to have a higher relative impact among non-Hispanic Black patients. CONCLUSION Among Medicare diverticulitis patients, ostomy reversal rates are low. Patients with lower socioeconomic status are less likely to undergo stoma reversal and are more likely to die; Black patients are least likely to have an ostomy reversal.
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Affiliation(s)
- Trista D Reid
- The University of North Carolina-Chapel Hill, Department of Surgery, Chapel Hill, NC.
| | - Riju Shrestha
- The University of North Carolina-Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC
| | - Lucas Stone
- The University of North Carolina-Chapel Hill, Department of Surgery, Chapel Hill, NC
| | - Jared Gallaher
- The University of North Carolina-Chapel Hill, Department of Surgery, Chapel Hill, NC
| | - Anthony G Charles
- The University of North Carolina-Chapel Hill, Department of Surgery, Chapel Hill, NC
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health
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He LJ, Zheng MC, Yuet Wong FK, Ying J, Zhang JE. Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study. Eur J Oncol Nurs 2021; 51:101911. [PMID: 33631511 DOI: 10.1016/j.ejon.2021.101911] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and social domains. Since discharge is an important transition period, the patient experience at that time is worthy of attention. The aim of this study was to explore the immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy in China. METHODS A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living with colostomy in China, who were asked open-ended questions about their postoperative experience. The thematic analysis approach was used to analyze the data. RESULTS Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions (stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings, sexual life compromise and work restriction), (3) stoma care consideration (strong stoma self-care willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support from others (enterostomal nurses, family members and stoma friends). CONCLUSION Colostomy patients experience various obstacles in physiological, psychological, and societal aspect. Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients to psychological care, and promote transitional care.
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Affiliation(s)
- Le Jian He
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Mei Chun Zheng
- Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | | | - Jin Ying
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jun E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Meng N, Liu R, Wong M, Liao J, Feng C, Li X. The association between patient-reported readiness for hospital discharge and outcomes in patients diagnosed with anxiety disorders: A prospective and observational study. J Psychiatr Ment Health Nurs 2020; 27:380-392. [PMID: 31943521 DOI: 10.1111/jpm.12592] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 02/05/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Readiness for hospital discharge (RHD) has been an important topic for nurses. RHD can be measured by the Readiness for Hospital Discharge Scale (RHDS), including 4 subscales: personal status, knowledge, coping ability and expected support. There are few studies that focus on RHD in patients diagnosed with mental disorders. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Improving patient-reported RHD can decrease the risks of unscheduled post-discharge clinic visits, readmission and poor quality of life (QOL) in patients diagnosed with anxiety disorders. Improving patient-reported personal status can decrease the risk of poor QOL in patients diagnosed with anxiety disorders. Improving patient-reported knowledge can decrease the risks of unscheduled post-discharge clinic visits and readmission in patients diagnosed with anxiety disorders. Improving patient-reported expected support can decrease the risk of unscheduled post-discharge clinic visits in patients diagnosed with anxiety disorders. Improving the methods of discharge teaching and anxiety severity can enhance RHD in patients diagnosed with anxiety disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses could enhance patient-reported RHD to reduce unscheduled post-discharge medical resource utilization or improve QOL by facilitating knowledge acquisition and skill development and improving social support systems. Nurse managers could add RHD assessment to patients' discharge process and train nurses in the methods of discharge education. Nurses could advance their methods of discharge education, such as listening to and answering patients' questions, choosing a convenient time and engaging in online education. ABSTRACT: Introduction The association between readiness for hospital discharge (RHD) and post-discharge outcomes remains unclear in individuals with anxiety disorders. Aim To explore the factors of RHD and the effect of patient-reported RHD on post-discharge outcomes. Method In the observational study, 373 patients diagnosed with anxiety disorders completed the self-administered Readiness for Hospital Discharge Scale (RHDS) on discharge. After 30 days, phone interviews were conducted to collect data on post-discharge outcomes, including self-reported unscheduled medical service utilization, symptom severity and quality of life (QOL). Multiple logistic regression models were built to explore the relationships among sociodemographic characteristics, the RHDS and its subscales, and post-discharge outcomes. Results The unscheduled clinic visits were significantly associated with low RHD, knowledge and expected support. Readmission was significantly associated with low RHD and knowledge. Poor QOL was significantly associated with low RHD and personal status. Delivery, received content and anxiety severity were the predictors of RHD. Discussion Improved RHD is associated with fewer unscheduled clinic visits and readmissions and better QOL. Enhancing discharge education can improve RHD. Implications for practice Nurses should enhance patient-reported RHD to improve post-discharge outcomes by advancing the quality of discharge education in patients diagnosed with anxiety disorders.
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Affiliation(s)
- Na Meng
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Ruian Liu
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Mengmeng Wong
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Jingping Liao
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Chi Feng
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xiaolin Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
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Pritchard E, Cussen A, Delafosse V, Swift M, Jolliffe L, Yeates H. Interventions supporting caregiver readiness when caring for patients with dementia following discharge home: A mixed-methods systematic review. Australas J Ageing 2020; 39:e239-e250. [PMID: 31944506 DOI: 10.1111/ajag.12765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/02/2019] [Accepted: 12/09/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To explore programs and information provided to caregivers of inpatients with dementia to assist with readiness to provide care following discharge. METHODS A mixed-methods systematic review with meta-analysis was conducted. Search terms included dementia, inpatient, caregiver, anxiety, discharge and counselling. RESULTS The search yielded 1938 studies (six databases), 13 met the inclusion criteria. Meta-analysis showed no statistically significant changes in anxiety, depression, burden or quality of life 3 months postintervention. Three emergent qualitative themes for staff consideration are as follows: understanding personal characteristics of both patient and caregiver; presenting an inclusive organisational culture; and providing appropriate information at all stages of admission. A Model of Caregiver Readiness was created from the qualitative results. CONCLUSION The programs did not significantly decrease the outcomes measured. However, caregivers identified that inclusion at all stages during hospital admission was a vital factor to reduce stress and increase caregiver readiness.
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Affiliation(s)
- Elizabeth Pritchard
- Occupational Therapy Department, Alfred Health, Prahran, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Amy Cussen
- Occupational Therapy Department, Alfred Health, Caulfield, Victoria, Australia
| | - Veronica Delafosse
- Caulfield Hospital Library Services, Alfred Health, Caulfield, Victoria, Australia
| | - Miriam Swift
- Occupational Therapy Department, Alfred Health, Caulfield, Victoria, Australia
| | - Laura Jolliffe
- Occupational Therapy Department, Alfred Health, Caulfield, Victoria, Australia
| | - Harriet Yeates
- Occupational Therapy Department, Alfred Health, Caulfield, Victoria, Australia.,Occupational Therapy Department, St Vincent's Health, Fitzroy, Victoria, Australia
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