Readiness for Hospital Discharge Scale for older people: psychometric testing and short form development with a three country sample.

Abstract

To develop and psychometrically test Readiness for Hospital Discharge Scale for older people and to reduce the scale to a more practical short form. The Readiness for Hospital Discharge Scale is the only available and validated scale measuring patients' perceived readiness just prior to discharge. Secondary analysis of hospital studies data from three countries. Data were collected between 2008-2012. The study sample comprised 998 medical-surgical older patients. Factor analysis was undertaken to identify the factor structure of the Readiness for Hospital Discharge Scale. Group comparisons for construct validity and predictive validity for readmission were also conducted. The Readiness for Hospital Discharge Scale original four factor solution does not appear to be consistent with the observed data of older people in the three countries. Confirmatory factor analysis revealed that a 17-item scale with three factors produced the best model fit. Nine items, three from each factor, loaded consistently on their respective factors in each country sample. Confirmatory factor analysis of this short form model indicated that the model adequately fit the data. Patients who lived alone, were older, or who indicated 'not ready' for discharge had lower Readiness for Hospital Discharge Scale for Older People scores, which were also associated with readmission risk. The revised three factor structure of the Readiness for Hospital Discharge Scale for Older People in long and short forms more adequately assesses core components of discharge readiness in the older adult population than the original adult form.