Clinical nurse specialist CNS · 2007
Perceived readiness for hospital discharge in adult medical-surgical patients.
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Weiss Marianne E, Piacentine Linda B, Lokken Lisa, Ancona Janice, Archer Joanne, Gresser Susan, Holmes Sue Baird, Toman Sally, Toy Anne, Vega-Stromberg Teri
Аннотация
PURPOSE: The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients' perceptions of their readiness for hospital discharge.
DESIGN: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables.
SETTING: Midwestern tertiary medical center.
SAMPLE: 147 adult medical-surgical patients.
METHODS: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services.
FINDINGS: Living alone, discharge teaching (amount of content received and nurses' skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions.
CONCLUSIONS: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis' transitions theory as a useful model for conceptualizing and investigating the discharge transition.
IMPLICATIONS FOR PRACTICE: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes.
DESIGN: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables.
SETTING: Midwestern tertiary medical center.
SAMPLE: 147 adult medical-surgical patients.
METHODS: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services.
FINDINGS: Living alone, discharge teaching (amount of content received and nurses' skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions.
CONCLUSIONS: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis' transitions theory as a useful model for conceptualizing and investigating the discharge transition.
IMPLICATIONS FOR PRACTICE: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes.
Предметные рубрики MeSH
Adaptation, PsychologicalAdultAnalysis of VarianceAttitude to HealthContinuity of Patient CareFactor Analysis, StatisticalFamilyFemaleHumansLongitudinal StudiesMaleMiddle AgedMidwestern United StatesNeeds AssessmentNurse CliniciansNurse's RoleNursing AssessmentNursing Methodology ResearchPatient DischargePatient Education as TopicPatient ReadmissionPredictive Value of TestsPsychological TheoryRegression AnalysisResidence CharacteristicsRisk FactorsSelf-AssessmentSocial SupportSurveys and Questionnaires