| Description |
Purpose: The purpose of this study was to explore 1) quantitative patient-caregiver ratings of discharge readiness using the Readiness for Hospital Discharge Scale (RHDS), and 2) perceptions of caregivers regarding their discharge preparation and whether and how discharge preparation impacted post-discharge patient outcomes. Methods: This study utilized a convergent mixed-methods design as part of a larger parent study to improve hospital discharge quality. RHDS surveys were conducted with fourteen English-speaking dyads of adult surgical patients (31-75 years of age) discharged to home from the University of Utah Hospital in February-March 2020 and their identified caregivers on day of discharge. Interviews were conducted using semistructured guides with four additional English-speaking caregivers (61-75 years of age) who provided consent to be contacted by telephone several weeks post-discharge. Results: Although not statistically significant likely due to the small sample size, caregiver scores on the RHDS subscales of Personal Status, Knowledge, and Perceived Coping ability were less than those of patients, suggesting lower readiness for discharge on the part of the family caregiver. Analysis of the qualitative interviews revealed that caregivers reported clear discharge instructions, yet passive involvement in discharge teaching. Once home, caregivers reported gaps in their knowledge of how to care for the patient. Two of the four caregiver participants attributed hospital readmission related to these post-discharge knowledge gaps. Conclusion: The trend of caregivers reporting lower readiness than patients is an area worthy of investigation in future studies powered to detect these differences, especially since our qualitative data show that caregivers describe only passive involvement in discharge teaching. The potential consequence of limited involvement in discharge by caregivers may be lower readiness for discharge and the various complications described in our interviews, suggesting the potential utility of structured programs to increase caregiver involvement in discharge education, planning, and post-discharge support to families. |
