Keçeci Ayla, Demiray Ayşe, Kızıltepe Selin Keskin, İlaslan Nagihan, Açıl Ayşegül, Ertürk Filiz
Faculty of Health Sciences, Nursing Department, Düzce University, Düzce, Türkiye.
Faculty of Health Sciences, Düzce University, Simulation Centre, Düzce, Türkiye.
BMC Nurs. 2025 Jul 6;24(1):856. doi: 10.1186/s12912-025-03394-1.
Basically, although all members of the health care team are responsible for the education of the patient and his/her family, discharge planning to provide self-care skills is the responsibility of the nurse. However, unfortunately, the satisfaction of patients with discharge education is not at the desired level. This study aims to examine the improvement of nursing students' discharge education competencies through simulation method aligned with the IDEAL discharge planning model-Include, Discuss, Educate, Assess, and Listen-developed by the Agency for Healthcare Research and Quality (AHRQ).
A mixed-method design was used in the study. Nineteen second-year nursing students enrolled in surgical nursing courses during the 2023-2024 academic year participated in a five-session simulation, with each session lasting approximately one hour. General Self-Efficacy Scale and Simulation Design Scale were used to obtain quantitative data, and semi-structured individual in-depth interview form was used to obtain qualitative data. Mean, standard deviation, and paired t-test were used to evaluate quantitative data; descriptive content analysis was used to analyze qualitative data, and participants were selected through purposive sampling based on their involvement in all simulation activities.
Quantitative results showed an increase in post-test scores across all discharge education sessions (General total pretest = 55.86 ± 6.59, posttest = 57.63 ± 6.70). The most significant improvement was observed in the "continuation effort and persistence" sub-dimension of the General Self-Efficacy Scale during the fourth session (p <.05). Among the Simulation Design Scale components, support sub-dimension received the lowest (X ± sd = 4.24 ± 0.56) and fidelity the highest (X ± sd = 4.58 ± 0.52) scores. Qualitative findings indicated that as simulation sessions progressed, students reported greater confidence and communication skills; however, challenges remained in applying some IDEAL components, particularly discussing patient goals and involving families in the process.
As a result, it was determined that the simulation intervention improved the discharge education skills of nursing students and increased their self-confidence. Incorporating the "IDEAL" framework can foster more patient-centered care by emphasizing the inclusion of patients and their families in the discharge planning process. By supporting patients' understanding of post-discharge instructions, this approach can promote greater adherence to treatment plans and contribute to improved long-term health outcomes.
基本上，虽然医疗团队的所有成员都负责对患者及其家属进行教育，但提供自我护理技能的出院计划是护士的职责。然而，不幸的是，患者对出院教育的满意度未达到理想水平。本研究旨在通过与美国医疗保健研究与质量局（AHRQ）开发的IDEAL出院计划模型（包括、讨论、教育、评估和倾听）相一致的模拟方法，检验护理专业学生出院教育能力的提升情况。
本研究采用混合方法设计。2023 - 2024学年参加外科护理课程的19名二年级护理专业学生参加了为期五节的模拟课程，每节课程持续约一小时。使用一般自我效能量表和模拟设计量表获取定量数据，使用半结构化的个人深度访谈表格获取定性数据。使用均值、标准差和配对t检验来评估定量数据；使用描述性内容分析来分析定性数据，根据参与所有模拟活动的情况通过目的抽样选择参与者。
定量结果显示，所有出院教育课程的后测分数均有所提高（一般总量表前测 = 55.86 ± 6.59，后测 = 57.63 ± 6.70）。在第四节课期间，在一般自我效能量表的“持续努力和坚持”子维度中观察到最显著的改善（p <.05）。在模拟设计量表的各个组成部分中，支持子维度得分最低（X ± sd = 4.24 ± 0.56），保真度得分最高（X ± sd = 4.58 ± 0.52）。定性研究结果表明，随着模拟课程的推进，学生们报告说他们的自信心和沟通技巧有所提高；然而，在应用一些IDEAL组件方面仍然存在挑战，特别是讨论患者目标以及让家属参与这一过程。
结果表明，模拟干预提高了护理专业学生的出院教育技能并增强了他们的自信心。纳入“IDEAL”框架可以通过强调让患者及其家属参与出院计划过程来促进更以患者为中心的护理。通过支持患者理解出院后的指导说明，这种方法可以促进对治疗计划的更大依从性，并有助于改善长期健康结果。
