Nursing Discharge Teaching for Multimorbid Inpatients to Self-manage Their Health at Home: a Pilot Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Disease
- Sponsor
- University of Lausanne
- Enrollment
- 225
- Locations
- 3
- Primary Endpoint
- Change in Patient Activation Measure (PAM)
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The objective of this study is to estimate the effect size of a nursing discharge teaching intervention on multimorbid inpatients activation level, health confidence, readiness for hospital discharge, experience with discharge care and rate and time to 7-days readmission.
Detailed Description
Seniors returning home from hospital have to manage several chronic conditions in addition to their daily tasks. The teaching provided by nurses during hospitalization is essential care to prepare them to manage their health at home. Nevertheless, there is often a gap between professionals' belief that the teaching they have provided to patients has met their needs, and patients' perceptions of the relevance of the teaching content to their home situation. The time available to conduct this teaching is also short during the hospital stay and there is limited knowledge about how to adapt this teaching for patients who must manage multiple chronic conditions at the same time. Thus, there is a real need to develop and test a new teaching nursing intervention to prepare for the return home that takes into account the unique and complex needs and characteristics of patients with multiple chronic conditions. Tailoring teaching to seniors' life situation and level of activation (i.e., knowledge, skills and confidence in managing their health) would best meet the needs of these patients for managing their health at home. An intervention that takes these characteristics into account has been developed and will be tested in this study.
Investigators
Dr. Sc. Cedric Mabire, RN PhD
Dr.Sc.
University of Lausanne
Eligibility Criteria
Inclusion Criteria
- •2 chronic diseases or more
- •Being discharged home
- •Able to speak, read and write in French
Exclusion Criteria
- •Insufficient capacity to consent assessed with the University of California San Diego Brief Assessment of Capacity to Consent (UBACC).
Outcomes
Primary Outcomes
Change in Patient Activation Measure (PAM)
Time Frame: change from hospital admission to the day of discharge and 7-10 days after discharge
The patient activation measure (PAM) is a 13-item self-report questionnaire to measure patient activation level. Stages of activation are distributed as follows in the PAM items: items 1-2: believing an active role is important; items 3-8: having confidence and knowledge to take action; items 9-11: taking action; and items 12-13: continuing healthy behaviors under stress. PAM raw score can be calculated by adding all of the responses to the 13 questions. This score is then converted into an activation score ranging from 0 = no activation to 100 = high activation using a calibration table. Psychometric properties of the PAM in hospitalized multimorbid patients showed a satisfying reliability (Cronbach's alpha = 0.88) and a content validity index of 0.91.
Secondary Outcomes
- Discharge Care Experiences Survey (DICARES)(7-10 days after discharge)
- Change in Health Confidence Score (HCS)(change from hospital admission to the day of discharge and 7-10 days after discharge)
- Readiness for Hospital Discharge Scale-Short Form (RHDS-SF)(At the end of the hospital stay, an average of 7-10 days after admission)
- Readmission rate and time to readmission(7-10 days after discharge)