The association between patient-reported readiness for hospital discharge and outcomes in patients diagnosed with anxiety disorders: A prospective and observational study.

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.

Meng N ，Liu R ，Wong M ，Liao J ，Feng C ，Li X ... -  《-》

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.

Wang M ，Wang Y ，Meng N ，Li X ... -  《-》

Factors and post-discharge outcomes associated with patients' readiness for discharge from the emergency medicine ward: A prospective study.

Discharging patients with a self-reported low readiness for hospital discharge (RHD) may be challenging, as these patients may be vulnerable to risks and adaptation issues that can delay recovery. However, little is known about whether emergency medicine ward (EMW) patients are sufficiently prepared for discharge to home. Therefore, the aim of this study is to examine the factors and outcomes associated with patients' RHD in an EMW setting. One hundred and eighty-four patients were recruited from the EMW of a tertiary hospital in Hong Kong. Cross-sectional data were collected from self-administered questionnaires and patients' medical records at the time of discharge and 1 month later. Descriptive statistics were obtained, and the variables were subjected to multivariable regression analyses. Seventy-three patients (40%) reported a low RHD at the time of discharge. Living with someone was a factor contributing to a patient's perceived RHD. A greater RHD was associated with a lower risk of 30-day emergency department readmission (odds ratio [OR] = 0.75; 95% confidence interval [CI] = 0.57-0.99) and hospital readmission (OR = 0.59; 95% CI = 0.38-0.91). However, patients who reported higher scores on the knowledge RHD subscale had a higher risk of hospital readmission (OR = 2.34; 95% CI = 1.38-3.98). These findings demonstrate the importance of paying careful attention to social support network of patients and the provision of patient education, as these may improve patients' RHD prior to discharge from the EMW. (242 words).

Siow E ，Lo SM ，Yeung KL ，Yeung RSD ，Choi KC ，Chair SY ... -  《-》

Perceived readiness for hospital discharge in adult medical-surgical patients.

Weiss ME ，Piacentine LB ，Lokken L ，Ancona J ，Archer J ，Gresser S ，Holmes SB ，Toman S ，Toy A ，Vega-Stromberg T ... -  《Clinical Nurse Specialist》

Surgical patients' experiences of readiness for hospital discharge and perceived quality of discharge teaching in acute care hospitals.

To examine the level of perception of the quality of discharge teaching and its associations with the readiness for hospital discharge among surgical patients in acute care hospitals. Discharge teaching is a primary strategy to facilitate patients' readiness for hospital discharge. The extent to which the surgical ward was perceived as providing patient-focused education when discharged has never been explored. Its impact on a patient's readiness is also unknown in the Indonesian context. A correlational descriptive study was used to collect data from four hospitals in Indonesia. Ninety-six surgical patients who were in the discharge process enrolled in this study. The demographic form, the quality of discharge teaching scale (QDTS) and the readiness for hospital discharge scale (RHDS) were utilised for data collection. Data were collected from January-February 2018. Descriptive statistics and Spearman rank-order correlation were applied for data analysis. The discharge teaching quality was perceived as being at a low level. The readiness for hospital discharge was reported to be at a moderate level. Overall, the discharge teaching quality was not statistically associated with the patients' readiness. However, positive correlations were found in QDTS and RHDS subscales such as content received and delivery, knowledge, coping ability and expected support. Patient's readiness for hospital discharge was also greater for those who had a caregiver, a short hospital stay, a health insurance and occupation. Surgical patients perceived a low quality of discharge teaching, which may decrease their readiness for hospital discharge. This study provides baseline information reflecting the patient learning needs in discharge preparation to guide surgical nurses for improving the discharge teaching quality and enhancing the patients' readiness for hospital discharge.

Nurhayati N ，Songwathana P ，Vachprasit R 《-》