Enhancing Postpartum Discharge Instructions

Not Applicable

Completed

• Conditions: Health Literacy; Postpartum; Cesarean Delivery Affecting Newborn; Randomized Controlled Trial
• Interventions: Other: Standard Instructions; Other: Visual Aid

• Registration Number: NCT03592628
• Lead Sponsor: Thomas Jefferson University

Brief Summary

Post-cesarean delivery discharge instructions are not currently at an appropriate health literacy level. Enhancing discharge instructions with a visual aid did not improve scores on comprehension quizzes, either immediately or two-weeks post-discharge. However, participants preferred to have access to visual images with discharge instructions.

Detailed Description

Objective:

To evaluate the effect of a visual aid on improving comprehension of hospital discharge instructions for cesarean wound care.

Methods:

A randomized control trial with a 1:1 allocation ratio and an intention to treat analysis was performed at an urban, tertiary care center from June-November 2017. Fifty English-speaking patients ages 18-50 who had undergone a cesarean delivery were randomized to receive either standard or enhanced discharge instructions regarding post-cesarean incision care. Enhanced instructions included a visual aid not present in the standard instructions. Participants completed a comprehension quiz prior to hospital discharge and again 2 weeks after discharge as well as the REALM literacy assessment prior to discharge.

Study Timeline

• Study Start: 2017-06-01
• Primary Completion: 2017-11-30
• Status Verified: 2018-07
• Study Completion: 2018-07-03
• Study First Submitted: 2018-07-05
• Study First Submitted QC: 2018-07-17
• Last Update Submitted: 2018-07-17
• Study First Posted: 2018-07-19
• Last Update Posted: 2018-07-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 50

Inclusion Criteria

• Able to consent
• Identified as English speaking
• Had a cesarean delivery during the index hospitalization for delivery of their living newborn

Exclusion Criteria

• Non-English speaking
• Declined to participate
• Required a translator for communication
• Intellectual disability (as self-identified or as determined by healthcare provider)
• Currently incarcerated

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard Instructions	Standard Instructions	Subjects enrolled in this arm received standardized teach-back regarding discharge instructions as well as the standard printed discharge instructions regarding post-cesarean wound care.
Enhanced Instruction	Visual Aid	Subjects enrolled in this arm received standardized teach-back regarding discharge instructions as well as the standard printed discharge instructions regarding post-cesarean wound care AND they received an additional printed visual diagram.

Primary Outcome Measures

Name	Time	Method
Comprehension Score Two Weeks Post-Discharge	Two weeks	Total score on 11-point quiz (Discharge Instructions Comprehension Quiz) administered via phone two weeks post-discharge, score range 1-11 with one point assigned for each correct answer (no subtractions for incorrect answers); higher scores are favorable indicating answers consistent with higher comprehension

Secondary Outcome Measures

Name	Time	Method
Immediate Comprehension	15 minutes	Total score on 11-point quiz (Discharge Instructions Comprehension Quiz) administered immediately after discharge instructions reviewed, score range 1-11 with one point assigned for each correct answer (no subtractions for incorrect answers), higher scores are favorable indicating answers consistent with higher comprehension

Trial Locations

Locations (1)

Thomas Jefferson University Hospital; 🇺🇸 Philadelphia, Pennsylvania, United States