Waisman Yehezkel, Siegal Naomi, Chemo Michal, Siegal Gil, Amir Lisa, Blachar Yoram, Mimouni Marc
Department of Emergency Medicine, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Isr Med Assoc J. 2003 Aug;5(8):567-70.
Understanding discharge instructions is crucial to optimal healing but may be compromised in the hectic environment of the emergency department.
To determine parents' understanding of ED discharge instructions and factors that may affect it.
A convenience sample of parents of children discharged home from the ED of an urban tertiary care pediatric facility (n = 287) and a suburban level II general hospital (n = 195) completed a 13 item questionnaire covering demographics, level of anxiety, and quality of physician's explanation. Parents also described their child's diagnosis and treatment instructions and indicated preferred auxiliary methods of delivery of information. Data were analyzed using the BMPD statistical package.
Full understanding was found in 72% and 78% of the parents at the respective centers for the diagnosis, and in 82% and 87% for the treatment instructions (P = NS between centers). There was no statistical correlation between level of understanding and parental age, gender, education, level of anxiety before or after the ED visit, or time of day. The most contributory factor to lack of understanding was staff use of medical terminology. Parents suggested further explanations by a special discharge nurse and written information as auxiliary methods.
Overall, parental understanding of ED discharge instructions is good. However, there remains a considerable number (about 20%) who fail to fully comprehend the diagnosis or treatment directives. This subset might benefit from the use of lay terminology by the staff, institution of a special discharge nurse, or use of diagnosis-specific information sheets.
理解出院指导对于实现最佳康复至关重要，但在急诊科忙碌的环境中可能会受到影响。
确定家长对急诊科出院指导的理解以及可能影响理解的因素。
从一家城市三级护理儿科机构的急诊科（n = 287）和一家郊区二级综合医院（n = 195）出院回家的患儿家长组成的便利样本，完成了一份包含13个项目的问卷，内容涵盖人口统计学、焦虑程度和医生解释的质量。家长们还描述了孩子的诊断和治疗指导，并指出了首选的辅助信息传递方式。使用BMPD统计软件包对数据进行分析。
在各自中心，72%和78%的家长对诊断完全理解，82%和87%的家长对治疗指导完全理解（中心之间P = 无显著差异）。理解程度与家长的年龄、性别、教育程度、急诊科就诊前后的焦虑程度或就诊时间之间无统计学相关性。导致理解不足的最主要因素是工作人员使用医学术语。家长们建议由专门的出院护士进行进一步解释，并以书面信息作为辅助方式。
总体而言，家长对急诊科出院指导的理解良好。然而，仍有相当一部分人（约20%）未能完全理解诊断或治疗指示。这部分人可能会受益于工作人员使用通俗易懂的术语、设立专门的出院护士或使用针对特定诊断的信息表。
