Graumlich James F, Novotny Nancy L, Aldag Jean C
Department of Medicine, University of Illinois College of Medicine, 530 NE Glen Oak Avenue, Peoria, IL 61637, USA.
J Hosp Med. 2008 Nov-Dec;3(6):446-54. doi: 10.1002/jhm.316.
Adverse events occur when patients transition from the hospital to outpatient care. For quality improvement and research purposes, clinicians need appropriate, reliable, and valid survey instruments to measure and improve the discharge processes.
The object was to describe psychometric properties of the Brief PREPARED (B-PREPARED) instrument to measure preparedness for hospital discharge from the patient's perspective.
The study was a prospective cohort of 460 patient or proxy telephone interviews following hospital discharge home. We administered the Satisfaction with Information about Medicines Scale and the PREPARED instrument 1 week after discharge. PREPARED measured patients' perceptions of quality and outcome of the discharge-planning processes. Four weeks after discharge, interviewers elicited emergency department visits. The main outcome was the B-PREPARED scale value: the sum of scores from 11 items. Internal consistency, construct, and predictive validity were assessed.
: The mean B-PREPARED scale value was 17.3 +/- 4.2 (SD) with a range of 3 to 22. High scores reflected high preparedness. Principal component analysis identified 3 domains: self-care information, equipment/services, and confidence. The B-PREPARED had acceptable internal consistency (Cronbach's alpha 0.76) and construct validity. The B-PREPARED correlated with medication information satisfaction (P < 0.001). Higher median B-PREPARED scores appropriately discriminated patients with no worry about managing at home from worriers (P < 0.001) and predicted patients without emergency department visits after discharge from those who had visits (P = 0.011).
The B-PREPARED scale measured patients' perceptions of their preparedness for hospital discharge home with acceptable internal consistency and construct and predictive validity. Brevity may potentiate use by patients and proxies. Clinicians and researchers may use B-PREPARED to evaluate discharge interventions.
患者从医院过渡到门诊护理时会发生不良事件。为了提高质量和进行研究，临床医生需要合适、可靠且有效的调查工具来衡量和改进出院流程。
目的是描述简版出院准备度评估量表（B-PREPARED）从患者角度衡量出院准备度的心理测量特性。
该研究是一项前瞻性队列研究，对460名患者或代理人在出院回家后进行电话访谈。出院1周后，我们使用了药物信息满意度量表和出院准备度评估量表。出院准备度评估量表衡量患者对出院计划流程质量和结果的认知。出院4周后，访员询问急诊就诊情况。主要结果是B-PREPARED量表值：11个项目得分之和。评估了内部一致性、结构效度和预测效度。
B-PREPARED量表的平均分值为17.3±4.2（标准差），范围为3至22。高分反映出准备充分。主成分分析确定了3个领域：自我护理信息、设备/服务和信心。B-PREPARED具有可接受的内部一致性（Cronbach's α系数为0.76）和结构效度。B-PREPARED与药物信息满意度相关（P<0.001）。较高的B-PREPARED中位数得分能够恰当地区分不担心在家自理的患者和有担忧的患者（P<0.001），并预测出院后未去急诊就诊的患者与有就诊的患者（P = 0.011）。
B-PREPARED量表以可接受的内部一致性、结构效度和预测效度衡量了患者对出院回家准备度的认知。简短性可能会提高患者及其代理人的使用意愿。临床医生和研究人员可以使用B-PREPARED来评估出院干预措施。
