Coleman Eric A, Chugh Amita, Williams Mark V, Grigsby Jim, Glasheen Jeffrey J, McKenzie Marlene, Min Sung-Joon
1University of Colorado Anschutz Medical Campus, Aurora, CO.
Am J Med Qual. 2013 Sep-Oct;28(5):383-91. doi: 10.1177/1062860612472931. Epub 2013 Jan 25.
Discharge from the acute care hospital is increasingly recognized as a time of heightened vulnerability for lapses in safety and quality. The capacity of patients to understand and execute discharge instructions is critical to promote effective self-care. This study explores factors that predict understanding and execution of discharge instructions in a sample of 237 recently discharged older adults. A study nurse conducted a postdischarge home visit to ascertain patient understanding and assess execution of instructions. Health literacy, cognition, and self-efficacy were important predictors of successful understanding and execution of instructions. Neither discharge diagnosis nor complexity of discharge instructions was found to be a significant predictor of these outcomes. Results indicate a need to implement reliable protocols that identify patients at risk for poor understanding and execution of hospital discharge instructions and provide customized approaches to meet them at their respective levels.
从急症医院出院越来越被认为是安全和质量出现失误的高风险时期。患者理解和执行出院指导的能力对于促进有效的自我护理至关重要。本研究探讨了在237名近期出院的老年人样本中预测出院指导理解和执行情况的因素。一名研究护士在出院后进行了家访，以确定患者的理解情况并评估指导的执行情况。健康素养、认知能力和自我效能感是成功理解和执行指导的重要预测因素。出院诊断和出院指导的复杂性均未被发现是这些结果的显著预测因素。结果表明需要实施可靠的方案，识别出对医院出院指导理解和执行不佳风险的患者，并提供定制化方法以在各自水平上满足他们的需求。
