Factors Influencing Readiness for Hospital Discharge Among Thai Older Persons with Chronic Obstructive Pulmonary Disease
Keywords:
Care coordination, Chronic obstructive pulmonary disease, Discharge instructions, Older patients, Readiness for hospital discharge, Theory of transitions, ThailandAbstract
Readiness for hospital discharge is an indicator of successful health and illness transition. Identification of factors predicting readiness for hospital discharge is essential to the provision of effective nursing intervention. This cross-sectional study aimed to determine the predictive power of factors on readiness for hospital discharge among older persons with chronic obstructive pulmonary disease. These selected factors included age, gender, family income, educational level, living arrangements, a sense of coherence, uncertainty in illness, previous admissions, the length of the hospital stay, care coordination for discharge, and quality of discharge teaching. The sample consisted of 207 older patients hospitalized with an exacerbation of chronic obstructive pulmonary disease at 15 community hospitals in the northern provinces of Thailand. Six instruments were used in data collection: Demographic Data Form, Sense of Coherence Scale, Mishel Uncertainty in Illness Scale, Patient Continuity of Care Questionnaire, Quality of Discharge Teaching Scale, and Readiness for Hospital Discharge Scale. Data were analyzed using descriptive statistics and hierarchical multiple regression analysis.
Findings indicated that all the predictive factors jointly explained 74.2% of the variances in readiness for hospital discharge in which living arrangements, sense of coherence, uncertainty in illness, previous admissions, care coordination for discharge, and the quality of discharge teaching were significant predictors of readiness for hospital discharge. Thus, nurses, including advanced practice nurses, should work together to develop better discharge planning to support and educate older patients with chronic obstructive pulmonary disease, and their family caregivers, to ensure they are ready for discharge and to improve their self-management.
References
2. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. Chronic disease surveillance 2010. [cited 2012 May 21]. Available from https://www.boe.moph. go.th/files/report/20120220_61501917.pdf. [in Thai].
3. Garvey C, Ortiz G. Exacerbations of chronic obstructive pulmonary disease. Open Nurs J. 2012;6:13-9.
4. Meleis AI, Trangenstein PA. Facilitating transitions: Redefinition of the nursing mission. Nurs Outlook. 1994;42(6):255-9.
5. Meleis AI, Sawyer LM, Im EO, Messias DKH, Schumacher K. Experiencing transitions: An emerging middle-range theory. Adv Nurs Sci. 2000;23(1):12-28.
6. Schumacher KL, Meleis AI. Transitions: A central concept in nursing. Image J Nurs Sch. 1994;26(2):119-27.
7. Weiss ME, Piacentine LB, Lokken L, Ancona J, Archer J., Gresser S, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec. 2007; 21(1):31-42.
8. Bobay KL, Jerofke TA, Weiss ME, Yakusheva O. Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge. Geriatr Nurs. 2010;31(3): 178-87.
9. Kunthakhu S, Watthanakitkrileart D, Pongthavornkamol K, Dumavibhat C. Factors influencing readiness for hospital discharge in acute myocardial infarction patients. J Nurs Sci. 2009;27(2 Suppl. 1):83-91. [in Thai].
10. Sriprasong S, Hanucharurnkul S, Panpukdee O, Krittayaphong R, Pongthavornkamol K, Vorapongsathorn T. Personal factors related to perceived readiness for hospital discharge of patients with acute myocardial infarction. Thai Journal of Cardio- Thoracic Nursing. 2011;22(2):44-57. [in Thai].
11. Moosiri S. Factors related to discharge readiness in patients with closed fracture of a leg undergoing internal fixation surgery [Master thesis]. Chonburi: Burapha University; 2013. [in Thai].
12. Coffey A, McCarthy GM. Older people’s perception of their readiness for discharge and postdischarge use of community support and services. Int J Older People Nurs. 2013;8(2): 104-15.
13. Sriprasong S, Hanucharurnkul S, Panpukdee O, Krittayaphong R, Pongthavornkamol K, Vorapongsathorn T. Functional status model: An empirical test among discharged acute myocardial infarction patients. Thai J Nurs Res. 2009;13(4):268-84.
14. Brent L, Coffey A. Patients’ perception of their readiness for discharge following hip fracture surgery. Int J Orthop Trauma Nurs. 2013;17(1):190-8.
15. Delgado C. Sense of coherence, spirituality, stress and quality of life in chronic illness. J Nurs Scholarsh. 2007;39(3):229-34.
16. Warwick M, Gallagher R, Chenoweth L, Stein-Parbury J. Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease. J Adv Nurs. 2010;66(4):784-93.
17. Naklamai A, Wattanakitkrileart D, Pongthavornkamol K, Chuchottaworn C. The influences of perceived severity, social support, and uncertainty in illness on health status of patients with chronic obstructive pulmonary disease. J Nurs Sci. 2011;29(2):46-55. [in Thai].
18. Hoth KF, Wamboldt FS, Strand M, Ford DW, Sandhaus RA, Strange C, et al. Prospective impact of illness uncertainty on outcomes in chronic lung disease. Health Psychol. 2013; 32(11):1170-4.
19. Weiss ME, Piacentine LB. (2006). Psychometric properties of the Readiness for Hospital Discharge Scale. J Nurs Meas. 2006;14(3):163-80.
20. Weiss M, Johnson NL, Malin S, Jerofke T, Lang C, Sherburne E. Readiness for discharge in parents of hospitalized children. J Pediatr Nurs. 2008;23(4):282-95.
21. Lindström B, Eriksson M. Salutogenesis. J Epidemiol Community Health. 2005;59(6):440-2.
22. Antonovsky A. The structure and properties of the sense of coherence scale. Soc Sci Med. 1993;36(6):725-33.
23. Mishel MH. Re-conceptualization of the uncertainty in illness theory. Image J Nurs Sch. 1990;22(4):256-62.
24. Yormprakhon S, Wattanakitkrileart D, Pongthavornkamol K, Chuchottaworn C. The influence of health literacy, perceived social support, and uncertainty in illness on functional status in patients with chronic obstructive pulmonary disease. J Nurs Sci. 2014;32(3):64-73. [in Thai].
25. Wallace AS, Perkhounkova Y, Bohr NL, Chung SJ. Readiness for hospital discharge, health literacy, and social living status. Clin Nurs Res. 2016;25(5):494-511.
26. Thukchai R. Factors related to readiness for hospital discharge among older patients undergone coronary artery bypass grafting [Master Thesis]. Chiang Mai: Chiang Mai University; 2016. [in Thai].
27. Poncharoen P, Samartkit N, Keeratiyutawong P. Factors related to discharge readiness in patients with congestive heart failure. Nursing Journal of the Ministry of Public Health. 2015;25(2):130-43. [in Thai].
28. Niraso S. Predicting factors of readiness for hospital discharge among older patients with acute myocardial infarction [Master thesis]. Chiang Mai: Chiang Mai University; 2015. [in Thai].
29. Anusasananun B, Sucamwang K, Udomkhamsuk W, Sangwattanarat W, Tinnakorn Na Ayutthaya K. Predicting factors of readiness for hospital discharge among surgical hospitalized patients in tertiary hospitals. Nursing Journal. 2015;42(Supplement December):24-34. [in Thai].
30. Suwan P, Boonyong S, Somana P, Bourchum U, Yotchai B, Sunpakaew N, et al. Predicting factors of readiness for hospital discharge among hospitalized cancer patients receiving chemotherapy at Maharaj Nakorn Chiang Mai hospital. Chiang Mai Medical Journal. 2016;55(1):27-40. [in Thai].
31. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23(10):433-41.
32. Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. 8th ed. Philadelphia: Lippincott Williams & Wilkins/Wolters Kluwer; 2008.
33. Hanucharurnkul S, Intharasombat P, Putthawattana P. Daily hasseles, a sense of coherence, and perceived general well-being of nursing faculty members. Thai Journal of Nursing. 1989;38:169-190. [in Thai].
34. Sucamvang K. A causal model of quality of life among the elderly with osteoarthritis [Doctoral dissertation]. Bangkok: Mahidol University; 1997. [in Thai].
35. Mishel M. Uncertainty in illness scales manual. Chapel Hill, NC: University of North Carolina; 1997.
36. Pochanart A, Wonghongkul T, Sukonthasarn A. Effect of supportive-educative nursing system on uncertainty in illness among newly diagnosed breast cancer patients. Nursing Journal. 2013;40(3):75-84. [in Thai].
37. Hadjistavropoulos H, Biem H, Sharpe D, Bourgault-Fagnou M, Janzen J. Patient perceptions of hospital discharge: Reliability and validity of a Patient Continuity of Care Questionnaire. Int J Qual Health Care. 2008;20(5):314-23.
38. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268-74.
39. Nilsen V, Bakke PS, Rohde G, Gallefoss F. Is sense of coherence a predictor of lifestyle changes in subjects at risk for type 2 diabetes? Public Health. 2015;129(2): 155-61.
40. Chittem M, Lindström B, Byrapaneni R, Espnes GA. Sense of coherence and chronic illnesses: Scope for research in India. J Soc Health Diabetes. 2015;3(2):79-83.
41. Apóstolo JLA, Viveiros CSC, Nunes HIR, Domingues HRF. Illness uncertainty and treatment motivation in type 2 diabetes patients. Rev Latino-am Enfermagem. 2007; 15(4):575-82.
Downloads
Published
How to Cite
Issue
Section
License
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
