The Extent of Nurses' Discharge Education to the Patient's Preparedness for Self-Management
DOI:
https://doi.org/10.31674/mjn.2024.v15i03.001Abstract
Background: Nurses are known for providing their patients with comprehensive care; patient education through discharge instructions typically falls short of expectations due to understaffing and work overload. Patient self-management of their health conditions at home demands adequate discharge education. Insufficient discharge education can compromise patients' ability to manage their health conditions at home, causing unplanned hospital readmissions. When the patients feel that they are being cared for through the provision of discharge education, they are likely to comply with the instructions given, which may contribute to the patient's optimal well-being and may prevent hospital re-admission. Objective: This study aimed to determine the correlation between nurses' extent of discharge education and patients' preparedness for self-management. Methods: A descriptive-correlational research design was used to determine the correlation between nurses' extent of discharge education and patients' preparedness for self-management. One hundred eight (108) respondents were selected through consecutive sampling. They answered the Medication, Exercise, Health Teaching, Outpatient Patient Department Visit, Referral, Diet, and Spirituality (MEHORDS) discharge assessment tool. MEHORDS is a researcher-made questionnaire with 0.756 and 0.789 reliability coefficients for assessing nurses' extent of discharge education and patients' preparedness for self-management, respectively. Results: The study shows that most of the respondents are middle-aged adults (22.22%), male (57%), married (63.89%), high school graduates (69.44%), unemployed (61.11%), with cerebrovascular disease (35.91%), and have experienced at least one hospital readmission (37.96%). The study revealed that respondents received a poor level of discharge education (x=1.49) during their discharge process and had no overall preparedness (x=1.75) for self-management. Moreover, there is a significant positive correlation between the nurses' discharge education and patients' preparedness for self-management (p=0.001). Conclusion: This study highlighted the importance of providing nurses comprehensive discharge education in promoting patients' self-management. Incorporating the MEHORDS contents may not only assist the nurses in managing their time in the provision of discharge education to patients but also serve as a guide to nurses in delivering a thorough discharge education.
Keywords:
Filipino, Patient Discharge, Patient Education, Patient ReadmissionDownloads
References
AlHadlaq, R. K., Swarelzahab, M. M., AlSaad, S. Z., AlHadlaq, A. K., Almasari, S. M., Alsuwayt, S. S., & Alomari, N. A. (2019). Factors affecting self-management of hypertensive patients attending family medicine clinics in Riyadh, Saudi Arabia. Journal of Family Medicine and Primary Care, 8(12), 4003. https://doi.org/10.4103/jfmpc.jfmpc_752_19
Al-Salmi, N., Cook, P., & D’souza, M. S. (2022). Diet adherence among adults with type 2 diabetes mellitus: A concept analysis. Oman Medical Journal, 37(2), e361. https://doi.org/10.5001/omj.2021.69
Balane, J. A. L., Yap, C. D. D., Villanueva, C. A. G., Palileo-Villanueva, L. A. M., & Tamondong-Lachica, D. R. (2023). Predictors of readmission in a medical department of a tertiary university hospital in the Philippines. BMC Health Services Research, 23(1), 1-8. https://doi.org/10.1186/s12913-023-09608-z
Bernal-Jimenez, M. A., Calle-Perez, G., Gutierrez-Barrios, A., Gheorghe, L., Solano-Mulero, A. M., Rodriguez-Martin, A., ... & Santi-Cano, M. J. (2021). Lifestyle and treatment adherence intervention after a coronary event based on an interactive web application (EVITE): randomized controlled clinical trial protocol. Nutrients, 13(6), 1818. https://doi.org/10.3390/nu13061818
Bowen, J. F., Rotz, M. E., Patterson, B. J., & Sen, S. (2017). Nurses’ attitudes and behaviors on patient medication education. Pharmacy Practice (Granada), 15(2). https://dx.doi.org/10.18549/pharmpract.2017.02.930
Cai, J., & Islam, M. S. (2023). Interventions incorporating a multi‐disciplinary team approach and a dedicated care team can help reduce preventable hospital readmissions of people with type 2 diabetes mellitus: A scoping review of current literature. Diabetic Medicine, 40(1), e14957. https://doi.org/10.1111/dme.14957
Cameron, K. V., Ponsford, J. L., & Stolwyk, R. J. (2019). Do stroke survivors agree with their clinicians on the extent of their post-stroke activity limitation and participation restriction? Neuropsychological Rehabilitation. https://doi.org/10.1080/09602011.2019.1586734
Cariñgal, K. S., Medina Jr, M. F., & Umali, M. J. P. S. (2022). A study on the association of perceived spiritual beliefs, practices, and well-being of breast cancer patients in a tertiary general hospital. Acta Medica Philippina, 56(3). https://doi.org/10.47895/amp.vi0.3172
Chaboyer, W., Harbeck, E., Lee, B. O., & Grealish, L. (2021). Missed nursing care: An overview of reviews. The Kaohsiung Journal of Medical Sciences, 37(2), 82-91. https://doi.org/10.1002/kjm2.12308
Dalley, M. T., Baca, M. J., Raza, C., Boge, L., Edwards, D., Goldszer, R., ... & Farcy, D. (2021). Does a standardized discharge communication tool improve resident performance and overall patient satisfaction?. Western Journal of Emergency Medicine, 22(1), 52. https://doi.org/10.5811/westjem.2020.9.48604
DeKoninck, B., Hawkins, L. A., Fyke, J. P., Neal, T., & Currier, K. (2016). Spiritual care practices of advanced practice nurses: a multinational study. The Journal for Nurse Practitioners, 12(8), 536-544. https://doi.org/10.1016/j.nurpra.2016.05.023
DeSai, C., Janowiak, K., Secheli, B., Phelps, E., McDonald, S., Reed, G., & Blomkalns, A. (2021). Empowering patients: simplifying discharge instructions. BMJ Open Quality, 10(3), e001419. https://bmjopenquality.bmj.com/content/10/3/e00141
Fares, M., Khachman, D., Salameh, P., & Lahoud, N. (2020). Evaluation of discharge instructions among hospitalized Lebanese patients. Pharmacy Practice (Granada), 18(1). https://dx.doi.org/10.18549/pharmpract.2020.1.1686
Feo, R., Urry, K., Conroy, T., & Kitson, A. L. (2023). Why reducing avoidable hospital readmissions is a ‘wicked’problem for leaders: A qualitative exploration of nursing and allied health perceptions. Journal of Advanced Nursing, 79(3), 1031-1043. https://doi.org/10.1111/jan.15220
Gustafsson, N., Leino-Kilpi, H., Prga, I., Suhonen, R., Stolt, M., & RANCARE consortium COST Action–CA15208. (2020). Missed care from the patient’s perspective–a scoping review. Patient Preference and Adherence, 383-400. https://doi.org/10.2147/PPA.S238024
Hawthorne, D. M., & Gordon, S. C. (2020). The invisibility of spiritual nursing care in clinical practice. Journal of Holistic Nursing, 38(1), 147-155. https://doi.org/10.1177/0898010119889704
Hesselink, G., Sir, Ö., Koster, N., Tolsma, C., Munsterman, M., Rikkert, M. O., & Schoon, Y. (2022). Teach-back of discharge instructions in the emergency department: a pre–post pilot evaluation. Emergency Medicine Journal, 39(2), 139-146. https://doi.org/10.1136/emermed-2020-210168
Hessler, D. M., Fisher, L., Bowyer, V., Dickinson, L. M., Jortberg, B. T., Kwan, B., ... & Dickinson, W. P. (2019). Self-management support for chronic disease in primary care: frequency of patient self-management problems and patient reported priorities, and alignment with ultimate behavior goal selection. BMC Family Practice, 20, 1-10. https://doi.org/10.1186/s12875-019-1012-x
Horstman, M. J., Mills, W. L., Herman, L. I., Cai, C., Shelton, G., Qdaisat, T., ... & Naik, A. D. (2017). Patient experience with discharge instructions in postdischarge recovery: a qualitative study. BMJ Open, 7(2), e014842. https://doi.org/10.1136/bmjopen-2016-014842
Jiang, Y., Shorey, S., Nguyen, H. D., Wu, V. X., Lee, C. Y., Yang, L. F., ... & Wang, W. (2020). The development and pilot study of a nurse-led HOMe-based HEart failure self-Management Programme (the HOM-HEMP) for patients with chronic heart failure, following Medical Research Council guidelines. European Journal of Cardiovascular Nursing, 19(3), 212-222. https://doi.org/10.1177/1474515119872853
Jurado, L. F. M., & Saria, M. G. (2018). Filipino nurses in the United States. Nursing Management, 49(3), 36-41. https://doi.org/10.1097/01.NUMA.0000530423.71453.58
Kang, E., Tobiano, G. A., Chaboyer, W., & Gillespie, B. M. (2020). Nurses' role in delivering discharge education to general surgical patients: a qualitative study. Journal of Advanced Nursing, 76(7), 1698-1707. https://doi.org/10.1111/jan.14379
Kannan, S., Avudaiappan, S., & Annamalai, M. (2020). Patients' satisfaction with nursing care quality in medical wards at selected hospital in Chennai, South India. Iranian Journal of Nursing and Midwifery Research, 25(6), 471. https://doi.org/10.4103/ijnmr.ijnmr_142_19
Kuhara, S., Itoh, H., Araki, M., Yamato, H., & Saeki, S. (2022). Excessive workload beyond measured exercise tolerance affects post-discharge mental health in workers with heart disease: a case-based observational study. Journal of Occupational and Environmental Medicine, 64(5), e310-e315. https://doi.org/10.1097/jom.0000000000002514
Lawson, C., Crothers, H., Remsing, S., Squire, I., Zaccardi, F., Davies, M., ... & Khunti, K. (2021). Trends in 30-day readmissions following hospitalisation for heart failure by sex, socioeconomic status and ethnicity. EClinical Medicine, 38. https://doi.org/10.1016/j.eclinm.2021.101008
Meng, Q., Tan, S., Jiang, Y., Han, J., Xi, Q., Zhuang, Q., & Wu, G. (2021). Post-discharge oral nutritional supplements with dietary advice in patients at nutritional risk after surgery for gastric cancer: a randomized clinical trial. Clinical Nutrition, 40(1), 40-46. https://doi.org/10.1016/j.clnu.2020.04.043
Mohammed, M. A., & Sharew, N. T. (2019). Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals. The Pan African Medical Journal, 33. https://doi.org/10.11604/pamj.2019.33.260.14463
Nooriani, N., Mohammadi, V., Feizi, A., Shahnazi, H., Askari, G., & Ramezanzade, E. (2019). The effect of nutritional education based on health belief model on nutritional knowledge, Health Belief Model constructs, and dietary intake in hemodialysis patients. Iranian Journal of Nursing and Midwifery Research, 24(5), 372. https://doi.org/10.4103/ijnmr.IJNMR_124_18
Perera, T., Grewal, E., Ghali, W. A., & Tang, K. L. (2022). Perceived discharge quality and associations with hospital readmissions and emergency department use: a prospective cohort study. BMJ Open Quality, 11(4), e001875. https://doi.org/10.1136/bmjoq-2022-001875
Rashidi, A., Whitehead, L., & Glass, C. (2022). Factors affecting hospital readmission rates following an acute coronary syndrome: A systematic review. Journal of Clinical Nursing, 31(17-18), 2377-2397. https://doi.org/10.1111/jocn.16122
Reyes-García, A., López-Olmedo, N., Basto-Abreu, A., Shamah-Levy, T., & Barrientos-Gutierrez, T. (2022). Adherence to the DASH diet by hypertension status in Mexican men and women: A cross-sectional study. Preventive Medicine Reports, 27, 101803. https://doi.org/10.1016/j.pmedr.2022.101803
Riegel, B., Lee, S., Hill, J., Daus, M., Baah, F. O., Wald, J. W., & Knafl, G. J. (2019). Patterns of adherence to diuretics, dietary sodium and fluid intake recommendations in adults with heart failure. Heart & Lung, 48(3), 179-185. https://doi.org/10.1016/j.hrtlng.2018.12.008
Ryan, C. J., Bierle, R., & Vuckovic, K. M. (2019). The three Rs for preventing heart failure readmission: review, reassess, and reeducate. Critical Care Nurse, 39(2), 85-93. https://doi.org/10.4037/ccn2019345
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12. https://doi.org/10.1097/nor.0000000000000308
Sevilla-Cazes, J., Ahmad, F. S., Bowles, K. H., Jaskowiak, A., Gallagher, T., Goldberg, L. R., ... & Kimmel, S. E. (2018). Heart failure home management challenges and reasons for readmission: A qualitative study to understand the patient’s perspective. Journal of General Internal Medicine, 33, 1700-1707. https://doi.org/10.1007/s11606-018-4542-3
Sukartini, T., Efendi, F., & Putri, N. S. (2022). A phenomenological study to explore patient experience of fluid and dietary restrictions imposed by hemodialysis. Journal of Vascular Nursing, 40(2), 105-111. https://doi.org/10.1016/j.jvn.2022.05.003
Tamayo, R. L. J., Quintin-Gutierrez, M. K. F., Campo, M. B., Lim, M. J. F., & Labuni, P. T. (2022). Rationing of nursing care and its relationship to nurse practice environment in a tertiary public hospital. Acta Medica Philippina, 56(3). https://doi.org/10.47895/amp.vi0.3124
Thannikal, A., Campbell, J., Ellis, L., & Williams, K. S. (2023). Assessing Knowledge and Attitudes of Nursing Staff Regarding Congestive Heart Failure Medication Regimens and Impact on Patient Understanding Post-Discharge. The Guthrie Journal, 75(1), 17-25. https://doi.org/10.3138/guthrie.75.1.03
Unaka, N. I., Statile, A., Haney, J., Beck, A. F., Brady, P. W., & Jerardi, K. E. (2017). Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions. Journal of Hospital Medicine, 12(2), 98-101. https://doi.org/10.12788/jhm.2688
Weber, L. A. F., Lima, M. A. D. D. S., & Acosta, A. M. (2019). Quality of care transition and its association with hospital readmission. Aquichan, 19(4). https://doi.org/10.5294/aqui.2019.19.4.5
Zumstein-Shaha, M., Ferrell, B., & Economou, D. (2020). Nurses’ response to spiritual needs of cancer patients. European Journal of Oncology Nursing, 48, 101792. https://doi.org/10.1016/j.ejon.2020.101792
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The Malaysian Journal of Nursing (MJN)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
