Effectiveness of a Patient-oriented Discharge Summary for Older Inpatients Discharged Home.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 111
- 试验地点
- 2
- 主要终点
- Quality of care transition measured with the Care Transition Measure Tool (CTM-15)
研究概览
简要总结
The discharge preparation is a difficult time to provide teaching, as older patients and their caregivers are often overwhelmed by a substantial amount of information and stressed about leaving hospital. As a result, 40-80% of patients forget or remember incorrectly the information discussed during hospitalisation, resulting in unmet needs, poor adherence to postdischarge care and increased use of health care services in the postdischarge period. The Patient-Oriented Discharge Summary (PODS) is a simple, one-page tool to be completed with key information, such as the reason for hospitalisation, warning signs to look out for, contact information, treatment plan and upcoming medical appointments. The PODS study will assess the effectiveness of the PODS on the quality of the transition between hospital and patients' home and problems and unmet needs after discharge.
详细描述
Full Title: The effectiveness of a patient-oriented discharge summary for older inpatients discharged home Primary objective: To evaluate the effectiveness of a patient-oriented discharge summary on the quality of care transition for older patients discharged home Secondary objective: To evaluate the effectiveness of a patient-oriented discharge summary on caregivers' perceived self-efficacy in the transition and older patients' problems and unmet needs after hospitalization.
Hypothesis are that:
H1. Patients exposed to the PODS, compared with patients receiving usual discharge preparation, would have improved quality of care transition H2. Patients exposed to the PODS, compared with patients receiving usual discharge preparation, would have less problems and unmet needs during the postdischarge period, including 7-days readmission and unplanned use of healthcare services H3. Caregivers of patients exposed to the PODS would have improved perceived self-efficacy in the transition compared to patients receiving usual discharge preparation
Study design: This monocentric study has a quasi-experimental design, using a non-randomised 2 group pre/post-intervention comparative design. This design was chosen to provide preliminary evidence on the effectiveness of the proposed intervention. As the implementation of evidence-based interventions is a major objective of health care services, this pilot study is prerequisite for judging the relevance and evaluate if the patient-oriented discharge summary is likely to be effective for a future randomized clinical study. The recruitment period is planned for 8 months. Project duration for each patient will correspond to the duration between recruitment day and 5-7 days post-discharge.
Study intervention:
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Quality of care transition measured with the Care Transition Measure Tool (CTM-15)
时间窗: 5-7 days after discharge
Quality of care transition will be measured by the Care Transition Measure Tool (CTM-15) at 5-7 days post-discharge. The CTM is a 15-item self-report questionnaire to evaluate the quality of the posthospital care transition experience from patient's perspective, in four factors: critical understanding, preferences important, management preparation, care plan. Responses for each item range from 1 = ''strongly disagree,'' to 4 = "strongly agree". A mean score is calculated by adding the value of each responded item ad divide this score by the number of answered items. The score is converted on a 0-100 scale using the formula: ((mean score - 1)/3)\*100. Cronbach's alpha for the CTM-15 is 0.93. Construct validity showed that CTM scores had a small negative correlation with age (r = -0.16, p = 0.03 and length of stay (r = 0.14, p = 0.05).
次要结局
- Family Caregiver Activation in Transitions (FCAT)(5-7 days after discharge)
- Problems and unmet needs experienced during the week after discharge(5-7 days after discharge)
研究者
Dr. Sc. Cedric Mabire, RN PhD
Associate Professor
University of Lausanne