Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Heart Institute, University of Cincinnati, College of Medicine, Cincinnati, OH.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Heart Institute, University of Cincinnati, College of Medicine, Cincinnati, OH.
J Pediatr. 2023 Jun;257:113361. doi: 10.1016/j.jpeds.2023.02.008. Epub 2023 Feb 24.
To assess discharge readiness and clinical engagement post-discharge in families of children undergoing congenital heart surgery.
This prospective cross-sectional study was performed at a major tertiary pediatric cardiac referral center. Eligible parents and caregivers completed a discharge readiness tool, the Readiness for Hospital Discharge Scale for Parents of Hospitalized Children, via online survey on the day of discharge. Clinical engagement data included subsequent phone calls, clinic visits, emergency department visits, and hospital readmissions. Readiness for Hospital Discharge Scale for Parents of Hospitalized Children scores were measured as follows: very high (9-10), high (8-8.9), moderate (7-7.9), and low (<7). Descriptive statistics were used to describe demographic data.
In total, 128 families enrolled between April and December 2021. Parent discharge readiness scores ranged from "high" to "very high." Families with lower socioeconomic status and younger patients (especially single-ventricle infants or "interstage") had a greater proportion of clinic visits, emergency department visits, and hospital readmissions within 30-days postdischarge compared with other groups.
Discharge readiness scores were not associated with clinical engagement. We identified vulnerable populations as evidenced by a greater frequency of clinical engagement in the immediate postoperative period, particularly younger patients and first-time surgeries. Although these visits may be appropriate, novel programs could enhance education and emotional support to prevent delay in seeking care or creating excessive stress and anxiety after discharge.
评估先天性心脏病患儿家庭在出院后的出院准备情况和临床参与度。
这是一项在主要的三级儿科心脏转诊中心进行的前瞻性横断面研究。符合条件的父母和照顾者在出院当天通过在线调查完成了出院准备工具，即住院儿童父母出院准备量表。临床参与数据包括随后的电话随访、就诊、急诊就诊和住院再入院。住院儿童父母出院准备量表的评分如下：很高（9-10 分）、高（8-8.9 分）、中（7-7.9 分）和低（<7 分）。采用描述性统计方法描述人口统计学数据。
2021 年 4 月至 12 月期间共有 128 个家庭入组。家长的出院准备评分从“高”到“很高”不等。与其他组相比，社会经济地位较低和年龄较小的患者（尤其是单心室婴儿或“过渡期”）的家庭在出院后 30 天内就诊、急诊就诊和住院再入院的比例更高。
出院准备评分与临床参与度无关。我们发现，一些脆弱人群在术后早期的临床参与度更高，这表明存在更高的风险，尤其是年龄较小的患者和初次手术的患者。尽管这些就诊可能是合适的，但新的项目可以加强教育和情感支持，以防止在出院后出现寻求医疗服务的延迟或产生过度的压力和焦虑。
