Perceived readiness for hospital discharge: Patients with spinal cord injury versus physiotherapists

Abstract

BackgroundSuccessful discharge from rehabilitation for patients with spinal cord injury (PWSCI) relies on a smooth transition home. Assessing readiness for hospital discharge (RHD) is important in reducing secondary health conditions and improving satisfaction and function. Perception of PWSCI on RHD may be different from their physiotherapists, leading to difficulties.ObjectiveTo compare the perceptions of PWSCI and physiotherapists with regard to RHD.MethodA comparative cross-sectional study included 50 PWSCI and their physiotherapists in Tshwane. They completed the Readiness for Hospital Discharge Scale (RHDS) and their responses to the subscales were compared. Data were analysed using descriptive and inferential statistics. Relationships between variables of interest and the general perception of RHD were determined using Pearson’s chi-square test. An independent samples t-test was used to analyse the difference in RHDS scores (including subscale scores) between PWSCI and physiotherapists. Results were significant if p < 0.05.ResultsThe total score of the RHDS was not significantly different (t = 1.31, df = 98, p = 0.19). Patients had higher perceptions in coping ability and expected support subscales (t = 3.15, df = 85.97, p = 0.002 and t = 4.23, df = 98, p = 0.0001, respectively). Physiotherapists had higher perceptions in the knowledge subscale regarding what to do and not do at home (t = -2.05, df = 82.08, p = 0.044) and follow-up sessions (t = 2.625, df = 85.28, p = 0.010).ConclusionThere was no difference in perception of readiness to go home, although physiotherapists gave lower scores for emotional readiness and ability to handle demands at home and higher scores for knowledge.Clinical implicationsThe use of the RHDS in the spinal cord rehabilitation units will better align the goals of rehabilitation and discharge planning to improve overall satisfaction with care and discharge outcomes. All members of a multidisciplinary team can achieve consensus and comparisons can be made on their patient’s perceived RHD.

Readiness for hospital discharge and influencing factors: a cross-sectional study on patients discharged with tubes from the department of hepatobiliary surgery

“…Patients undergoing laryngectomy [ 22 ] a 202 22 – 7.76 ± 1.76 4. Patients with spinal cord injury [ 23 ] a 50 21 150.78 ± 27.06 – This study 161 22 142.40 ± 23.98 6.45 ± 1.09 a Studies related to discharge readiness …”

The factors of patient‐reported readiness for hospital discharge in patients with depression: A cross‐sectional study

“…A patient's RHD can be assessed by different individuals such as patients, family members and healthcare practitioners (Weiss & Piacentine, 2006). These individuals may have different perceptions regarding the same patient (Du Plessis et al., 2018; Yiu et al., 2011). Currently, the patient's readiness and concerns are not integrated as a part of the nurse clinician's evaluation tools for discharge (Vat et al., 2015); however, paying attention to the patient's perspective is critical for informing appropriate avenues for quality improvement (Howard‐Anderson et al., 2016).…”

“…A patient's RHD can be assessed by different individuals such as patients, family members and healthcare practitioners (Weiss & Piacentine, 2006). These individuals may have different perceptions regarding the same patient (Du Plessis et al, 2018;Yiu et al, 2011).…”

The three-stage assessment to support hospital–home care coordination in Tshwane, South Africa

“…22 Even though they are critical to the effective management of South African health in the context of the quadruple burden of disease, the interfaces between community-based and facility services are inconsistent and weakly supported 24 and, as elsewhere, downward referrals from facilities to the community are the exception rather than the rule. 24 , 25 , 26 , 27 …”

“…22 Even though they are critical to the effective management of South African health in the context of the quadruple burden of disease, the interfaces between community-based and facility services are inconsistent and weakly supported 24 and, as elsewhere, downward referrals from facilities to the community are the exception rather than the rule. 24,25,26,27 Given the very limited understanding of the organisational and practice changes in care-coordination needed to improve health outcomes, 16,17 Tshwane Rehabilitation Hospital is a rehabilitation hospital offering in-and out-patient services to adults and children in Gauteng and neighbouring provinces. 28 It provides comprehensive physical rehabilitation services for patients with stroke, spinal cord injuries, amputation, head injuries and other neurological conditions.…”