Perceived readiness for hospital discharge in adult medical-surgical patients

Clin Nurse Spec. 2007 Jan-Feb;21(1):31-42. doi: 10.1097/00002800-200701000-00008.

Abstract

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.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Analysis of Variance
  • Attitude to Health*
  • Continuity of Patient Care
  • Factor Analysis, Statistical
  • Family / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Midwestern United States
  • Needs Assessment
  • Nurse Clinicians / organization & administration
  • Nurse's Role
  • Nursing Assessment
  • Nursing Methodology Research
  • Patient Discharge*
  • Patient Education as Topic
  • Patient Readmission
  • Predictive Value of Tests
  • Psychological Theory
  • Regression Analysis
  • Residence Characteristics
  • Risk Factors
  • Self-Assessment*
  • Social Support
  • Surveys and Questionnaires