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

Abstract

Accessible summary What is known on the subject? The attributes of readiness for hospital discharge (RHD) have been identified to be physical stability, adequate support, psychological ability, and adequate information and knowledge. Patient‐reported RHD has been regarded as an outcome indicator, and poor RHD leads to unplanned readmission, emergency department visits and even death. Knowledge regarding patient‐reported RHD and its factors among patients with depression is limited. What the paper adds to existing knowledge? RHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. The knowledge dimension of the RHDS among patients with depression should be further strengthened. The length of stay, content received and delivery dimensions of the QDTS were significantly associated with RHD. What are the implications for practice? This study encourages nurses to assess patient‐reported RHD at discharge in mental health settings. Nurses should pay more attention to patients with hospital stays longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content. Nurses’ managers could develop programmes to improve teaching skills via Internet technology, such as simulated patients and online interprofessional discharge planning. Abstract IntroductionLow readiness for hospital discharge (RHD) can be followed by negative healthcare outcomes. However, no studies have investigated RHD among patients with depression. AimThis study aimed to examine patient‐reported RHD and its factors among patients with depression. MethodIn total, 367 inpatients with depression were recruited and completed the Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). A binary logistic regression analysis was performed to explore the factors of RHD among patients with depression. ResultsThe total RHDS score was 7.70 ± 1.52. Approximately 28.9% of the participants had low RHD (RHDS score < 7). The results revealed that RHD was significantly associated with the length of stay, content received and delivery. DiscussionRHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. To improve RHD, enhancing the quality of discharge teaching is imperative for patients with depression. Implications for PracticeNurses should pay more attention to patients with a hospital stay longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content.

Readiness for Hospital Discharge of Adult Patients with Major Depressive Disorder in China: A Cross-Sectional Study

“… 16 The result is in accordance with the results of previous studies. 21 , 24 It confirms that patients may overestimate their readiness for discharge or may report false information due to misinterpreting the question or longing for going home.…”

“…The RHDS from Huang’s study was lower than ours; 27 On the contrary, the RHDS from Wang’s study was higher than ours. 24 The differences might be due to small sample sizes, non-randomized sampling, the homogeneity of the participants, etc., across the three studies, including the present one. More evidence would be needed in the future.…”

“…The score of “knowledge” dimension was the lowest one in the four dimensions of RHDS in our study, which is consistent with the findings of most research about RHD in China, but is inconsistent with studies done in other countries where the dimension with the lowest score varied. 19 , 24 , 40 , 41 Differences in discharge teaching might be one rationale. Discharge teaching in China is usually delivered by nurses on the day of discharge, it is difficult for nurses to provide individual discharge teaching in such a limited time period, and patients are also eager to go home rather than concentrating on learning.…”

“…Wang et al investigated the status quo of RHD and its influencing factors among 367 patients with depression. 24 However, the age of the study population in Wang’s study ranged from 12 to 87 years old and they reported age on average rather than age groups. Clinical discharge guidance for adolescent patients with depression is mainly provided to their caregivers, and in most cases, their discharge decisions are made by their caregivers and doctors.…”

“…Two studies have been found to discuss RHD of patients with depression in China. 24 , 27 Huang et al found RHD of patients with depression was at a moderate level, 27 but they did not determine the influencing factors of RHD. The influencing factors from studies among patients with somatic diseases may not necessarily apply to patients with mental diseases.…”