Readiness For Hospital Discharge Research Articles

A cross-sectional study of readiness for discharge, chronic illness resources and postdischarge outcomes in patients with diabetic foot ulcer.

AimTo investigate the correlation of readiness for hospital discharge, the chronic illness resources, and postdischarge outcomes of diabetic foot ulcer patients, which can be help for discharged patient rehabilitation.DesignA cross‐sectional study.MethodsOne hundred and seventy‐nine patients were recruited from the Endocrinology units of two tertiary hospitals between November 2018–September 2019, in Guangdong, China. The methods used were Readiness for Hospital Discharge Scale, The Chronic Illness Resources Survey and one‐on‐one telephone interviews.ResultsPearson correlation coefficients indicated moderate correlation between the readiness for discharge and resource availability for chronic illnesses (r = .446, p < .001). Multiple linear regression analysis showed that Chronic Illness Resources Survey, self‐care ability, methods of wound treatments after discharge, and living alone were the main predictors of readiness for hospital discharge among diabetic foot ulcer patients (F = 12.272, p < .001, R 2 = .621, Rad2 = .571). The study was limited by location, patient's recall bias and lack of BADL scale, which can be further improved in subsequent studies by developing multi‐centre clinical study and adopting more objective assessment tools.

Unreadiness for hospital discharge predicts readmission among cardiac patients: results from the national DenHeart survey.

Readiness for hospital discharge describes a patient's perception of feeling prepared to leave the hospital. In mixed patient populations, readiness for hospital discharge has shown to predict readmission and mortality in the short term. The objectives of a population of men and women with cardiac diseases, were to investigate: (i) whether readiness for hospital discharge predicts readmission and mortality within 1-year post-discharge, as well as (ii) the association between 'physical stability', 'adequate support', 'psychological ability', and 'adequate information and knowledge' and readiness for hospital discharge. Data from the national cross-sectional survey DenHeart were used and included patients with cardiac diseases at hospital discharge. Readiness for hospital discharge was evaluated by one self-reported question, and attributes were illuminated by Short-Form-12, the Edmonton Symptom Assessment Scale and ancillary questions. Data were combined with national registries at baseline and at 1-year follow-up. Cox proportional-hazards model were used to regress readmission and mortality. The analysis included 13114 patients (response rate: 52%). The majority responded that they felt ready for hospital discharge (95%). Feeling unready (n = 618) was a predictor of 1 year, all-cause readmission among women and men [hazard ratio (HR) = 1.43, 95% confidence interval (CI) 1.18-1.74; HR = 1.59, 95% CI 1.34-1.90]. No significant results were found on all-cause mortality. The four attributes were associated with unreadiness at hospital discharge. Not feeling ready for hospital discharge was a predictor of increased readmission risk in women and men with cardiac disease during 1 year after hospital discharge. Four attributes were significantly impaired in patients feeling unready for hospital discharge.

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

BackgroundTo investigate the readiness for hospital discharge of patients discharged with tubes from the department of hepatobiliary surgery and to explore the influencing factors.MethodsA cross-sectional survey was conducted for the 161 patients with tubes who were discharged from the department of hepatobiliary surgery of Shaoxing Second Hospital by using the modified Chinese version of Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). General data of the patients, such as gender, age, BMI (body mass index), and educational level, were collected.ResultsAccording to the statistical results, the total score of the RHDS was 142.40 ± 23.98, and that of the QDTS was 148.14 ± 17.74. Multiple linear step-wise regression analysis revealed that the total score of the QDTS, residence and educational level were the independent influencing factors of the readiness for hospital discharge (p < 0.05).ConclusionThe level of the readiness for hospital discharge of the 161 discharged patients with tubes from the department of hepatobiliary surgery was in the middle and lower level. For the patients who are far away from the hospital and have a low education level, we should pay more attention to health education and discharge teaching, so as to improve the readiness for hospital discharge of relatively vulnerable patients, reduce the incidence of adverse events after discharge with tubes, and ensure the health and safety of patients.

Patient-Readiness for Discharge and 30-Day Adherence to Treatment After Coronary Stent Implantation.

This study aimed to explore the association between readiness for hospital discharge and 30-day adherence to treatment among patients with coronary heart disease who have undergone coronary stent implantation. A prospective, observational study design was adopted. A total of 153 participants were recruited from five cardiovascular units of a tertiary care teaching hospital in China. Data were collected using the Readiness for Hospital Discharge Scale, Morisky, Green, and Levine Adherence Scale, and Patients' Adherence to Treatment Questionnaire. The results showed that patient-readiness for discharge was high whereas the 30-day adherence to treatment remained suboptimal. Readiness for hospital discharge and medical history of hypertension were significantly associated with patients' 30-day adherence to blood pressure self-monitoring and control ( .05). This study demonstrates the importance of paying attention to discharge preparation service as it may improve patients' 30-day adherence to treatment after coronary stent implantation.

Analysis on influencing factors of readiness for hospital discharge among patients with liver cancer under the concept of enhanced recovery after surgery

Analysis on influencing factors of readiness for hospital discharge among patients with liver cancer under the concept of enhanced recovery after surgery

Evaluating Maternal Discharge Readiness in Kangaroo Mother Care

To develop and apply a tool for measuring hospital discharge readiness of mothers practicing continuous kangaroo mother care (KMC) in a tertiary setting. A 22-item questionnaire was adapted from an existing tool. After a pilot (n=20), the survey was administered to 200 mothers in the KMC unit, Kalafong Hospital, South Africa from 2017-2018. Two items which asked participants how confident and ready they felt overall were used to categorize women as 'ready' or 'less ready' for discharge. Most women (n=168, 88.0%) were categorized as ready for discharge. The mean (SD) score for all 22 questions was 9.4 (0.7). Women categorized as 'less ready' scored lower overall (mean difference: 1.3) and within all four questionnaire categories compared to women who were discharge ready (P<0.05). Although most women in this study reported high levels of discharge readiness, further research is needed to see if results are comparable across settings.

Survey on the Readiness for Hospital Discharge and Its Influencing Factors among Patients with Cardiac Valve Replacement

Background: There are about 200,000 patients in China who need to undergo valve replacement surgery each year. With the promotion and application of the Fast-Track Surgery concept and the increase in hospital bed turnover rate, the average hospital stay of patients undergoing CVR surgery has been significantly shortened, and thus the patients are still in the recovery stage rather than fully recovered when they are discharged from the hospital. Good preparation for discharge can improve patients’ post-discharge self-care ability, reduce the risk of re-admission, and save medical resources. Objective: To describe the status of readiness for hospital discharge among postoperative patients that have undergone CVR, and to explore its influencing factors. Methods: The general information questionnaire, the Readiness for Hospital Discharge Scale and the Quality of discharge Teaching Scale were utilized to investigate 130 post-CVR patients admitted to the Cardiothoracic Surgery Department of a tertiary A-Class hospital in Guangzhou from July 2019 to October 2020. Results: The Readiness for Hospital Discharge Scale was at a moderate level with a total score of 163.88 ± 39.082, while the Quality of Discharge Teaching Scale was also at a moderate level with a total score of 194.09 ± 40.643. Multiple linear regression analysis revealed that the quality of discharge guidance, gender, and occupation were the influencing factors of CVR patient’s readiness for hospital discharge. These three variables jointly explained 45.8% of the total variation. Conclusion: The level of CVR patients’ readiness for hospital discharge is at a moderate level, and the quality of discharge guidance positively affects patients’ readiness for discharge. Therefore, in clinical work, attention should be paid to patient discharge guidance. Personalized health education should be implemented to improve the quality of patient guidance.

Dahili Kliniklerde Yatan Hastaların Hemşirelik Bakım Memnuniyeti ve Taburculuğa Hazır Olma Durumları: Tanımlayıcı Kesitsel Araştırma Örneği

Objective: This descriptive and cross-sectional study was conducted to evaluate the nursing care satisfaction and readiness for hospital discharge of patients hospitalized in internal medicine clinics. Material and Methods: The universe of this study consisted of patients treated in the internal clinics of Atatürk University hospital between May and September 2019. The sample of the study, on the other hand, consisted of 372 patients aged 18 and over who did not have hearing, vision and mental problems, voluntarily accepted to participate in the study, had cognitive competence to answer the questions. The data were collected by using 'personal information form', 'Newcastle Nursing Care Satisfaction Scale', and 'Readiness for Hospital Discharge Scale'. Results: It was found that average age of the patients in the study was 58.7±17.5 years; 50.8% were male, 29.8% were illiterate, 90.6% were married, 78.5% had a moderate level of income, 59.4% were hospitalized from the outpatient clinics and 70.7% were very satisfied with nursing care. Average nursing care satisfaction of the patients was found to be 88.23±12.5. Readiness for hospital discharge total score of the patients was 6±1.99 and the highest score was taken from expected support sub-dimension (9.05±1.83), while the lowest score was taken from knowledge (4.18±4.15) sub-dimension. A statistically significant inverse relationship was found between the age and number of hospitalizations of the patients and the total score of the Readiness for Hospital Discharge Scale, personal care and coping skills sub-dimension scores (p<0.05). Conclusion: It was found that the patients had high nursing care satisfaction levels and that they were not sufficiently ready for discharge.

Modified protocol for Enhanced Recovery After Surgery is beneficial for achalasia patients undergoing peroral endoscopic myotomy: a randomized prospective trial

IntroductionEnhanced Recovery After Surgery (ERAS) protocols have been proven to promote postoperative recovery. However, limited evidence is available on ERAS protocols in patients undergoing peroral endoscopic myotomy (POEM).AimTo study the safety and effectiveness of an ERAS protocol in terms of the standard postoperative length of stay (LOS) and QoR-15 (Quality of Recovery) score of patients undergoing POEM.Material and methodsEighty patients were randomly divided into the ERAS or conventional group. The ERAS group received ERAS management, while the conventional group received normal management. The ERAS protocol included sufficient preoperative education, shortening time of preoperative fasting, maintaining intraoperative normothermia, intraoperative fluid management, and improving analgesia. We compared the results between the two groups in term of standard postoperative LOS and cost, QoR-15 score, postoperative pain and complications.ResultsPatients showed an improvement in the ERAS group in terms of earlier readiness for hospital discharge (40.21 ±8.42 h vs. 48.63 ±10.42 h; p < 0.001), earlier resumption of oral feeding (31.80 ±8.7 h vs. 42.35 ±10.80 h; p < 0.001), lower VAS, and higher QoR-15 score (139.29 ±2.21 vs. 137.03 ±3.77; p = 0.002) on postoperative day 2. For post-operative complications, there was no significant difference between the two groups.ConclusionsThe ERAS protocol is feasible and safe for POEM, and may decrease standard postoperative LOS, shorten recovery of gastrointestinal function, and improve postoperative patient satisfaction.

Impact of readiness for discharge from the hospital on the implementation of the therapeutic plan

Introduction. Adherence to therapeutic recommendations regarding pharmacotherapy and lifestyle modification reduces the risk of complications in patients after myocardial infarction. The assessment of readiness for discharge allows to get knowledge about patient’s preparation for functioning at home. The aim of the study is to assess the relationship between the readiness for discharge of patients after myocardial infarction and adherence to pharmacotherapy based of the analysis of prescription filling. Material and methods. The study is a single-center, prospective, observational cohort clinical trial with a one-year follow-up period. The study population include 225 patients (26.7% women and 73.3% men) aged 30–91years (62.9 ± 11.9). The RHD-MIS (Readiness for Hospital Discharge after Myocardial Infarction Scale) was used to assess the readiness for discharge. Adherence to medication has been studied in relation to ACE inhibitors, P2Y12 receptor inhibitors and statins. Results. Patients with a high overall RHD MIS score compared to those with an average result were more likely to have any breaks in therapy, p = 0.01 (breaks < 30 days, p = 0.03 and breaks ≥ 30 days, p = 0.005) for either drug. Patients declaring that their disease is not serious have significantly lower adherence to P2Y12 receptor inhibitor (28 ± 27% vs 72 ± 38%, p = 0.047) and statins (36 ± 41% vs 76 ± 33% p = 0.024) in the 1st quarter after discharge and to statins (23 ± 18% vs 65 ± 32% p = 0.014) during whole one-year follow-up. Conclusion. The readiness for discharge from the hospital assessed with the RHD-MIS does not clearly affect the implementation of the therapeutic plan in the long-term follow-up in patients after myocardial infarction. Data suggesting a negative impact of some aspects of readiness for discharge on adherence to treatment require further, in-depth research.

Ready to Go Home? Assessment of Shared Mental Models of the Patient and Discharging Team Regarding Readiness for Hospital Discharge.

A critical task of the inpatient interprofessional team is readying patients for discharge. Assessment of shared mental model (SMM) convergence can determine how much team members agree about patient discharge readiness and how their mental models align with the patient's self-assessment. Determine the convergence of interprofessional team SMMs of hospital discharge readiness and identify factors associated with these assessments. We surveyed interprofessional discharging teams and each team's patient at time of hospital discharge using validated tools to capture their SMMs. Discharge events (N = 64) from a single hospital consisting of the patient and their team (nurse, coordinator, physician). Clinician and patient versions of the validated Readiness for Hospital Discharge Scales/Short Form (RHDS/SF). We measured team convergence by comparing the individual clinicians' scores on the RHDS/SF, and we measured team-patient convergence as the absolute difference between the Patient-RHDS/SF score and the team average score on the Clinician-RHDS/SF. Discharging teams assessed patients as having high readiness for hospital discharge (mean score, 8.5 out of 10; SD, 0.91). The majority of teams had convergent SMMs with high to very high interrater agreement on discharge readiness (mean r*wg(J), 0.90; SD, 0.10). However, team-patient SMM convergence was low: Teams overestimated the patient's self-assessment of readiness for discharge in 48.4% of events. We found that teams reporting higher-quality teamwork (P = .004) and bachelor's level-trained nurses (P < .001) had more convergent SMMs with the patient. Measuring discharge teams' SMM of patient discharge readiness may represent an innovative assessment tool and potential lever to improve the quality of care transitions.

Hospital and patient factors influencing the health status among patients with schizophrenia, thirty days after hospital discharge: multi-level analysis

BackgroundThe time between discharge from hospital and transition to community and home is a critical period for health status among patients with a mental illness, including patients with schizophrenia. This study aimed to investigate crucial patient factors (patient-level) and hospital factors (hospital-level) affecting health status and see whether patient factor effects on health status vary with hospital factors, 30 days after hospital discharge.MethodsThis is a prospective study of 1255 patients with schizophrenia and their primary caregivers from 13 public mental hospitals across Thailand. Logistic regression and multi-level logistic regression was used to investigate the effects of patient and hospital factors simultaneously on health status, 30 days after hospital discharge.ResultsThe intraclass correlation coefficient indicated that 14% of the change in health status was explained by the differences between hospital. Poor health status was identified in 14.26% of patients, 30 days after hospital discharge. The majority of participant patients were male (69.8%), single (71.87%), and the average age was 38.09 (SD = 9.74). The finding also showed that the patient factors; being female (ORadj .53, 95%CI .31,.92), perceived moderate and high levels of positive aspect of caregiving (ORadj .24, 95%CI .14,.42 and ORadj .05, 95%CI .02,.09), perceived readiness for hospital discharge (ORadj .21, 95%CI .13,.33), partial and full adherence to treatment (ORadj .24, 95%CI .14,.42 and ORadj .31, 95%CI .20,.47) showed a reduced likelihood of developing poor health status except substance use (ORadj 1.55, 95%CI .98, 2.44). Hospital factors; discharge planning process and nurse-patient ratio (ORadj 1.64, 95%CI 1.17, 2.30 and ORadj 1.16, 95%CI 1.09, 1.22) showed an increased likelihood of developing poor health status, 30 days after hospital discharge.ConclusionsFindings provide relevant information on how both patient and hospital factors determine health status. These results might lead to better targeting of mental health service policy and enable more precise information gathering and allocation of resources. However, future research should be more focused and continue investigating the pathways through which hospital factors influence health status post-discharge.

Adaptation of the parent readiness for hospital discharge scale with mothers of preterm infants discharged from the neonatal intensive care unit.

To evaluate the psychometric properties of a new Persian translation of the Readiness for Hospital Discharge Scale. Globally, one in 10 newborns are born preterm and many require care in a neonatal intensive care unit (NICU). A primary role of NICU nurses is to assure parents are well prepared to take their newborns home from the hospital. Assessment of parent perception of discharge readiness provides important input into discharge decisions. The availability of reliable and valid instruments tested within the geographical and cultural context is needed for a comprehensive assessment of predischarge readiness, so that parent needs can be identified and the necessary interventions designed and implemented. This psychometrics study included a convenience sample of 200 mothers with preterm infants being discharged from the NICU of Shahid Sadoughi Hospital in Yazd, Iran. The original 29-item version of the Readiness for Hospital Discharge Scale-Parent questionnaire was translated into Persian using the standard forward-backward method. Face, content and construct validity (principal components analysis), and reliability (internal consistency-Cronbach's alpha) were assessed. Methods followed STROBE criteria as applicable (see Appendix S1). The content validity index and content validity ratio were both 0.93. Construct validity testing identified6 factors (mother and infant physical-psychological readiness, expected support, knowledge of future events and care, knowledge of infant personal care, pain and therapeutic interventions). Using Cronbach's alpha coefficient, the reliability of the whole instrument was estimated to be 0.87. The Persian Readiness for Hospital Discharge-Parental Form for use with mothers of preterm infants being discharged from an Iranian NICU has acceptable validity and reliability. This tool can be used before discharge to determine the needs of mothers and design the necessary measures to improve quality of discharge care.

Clinical nurses' perspectives on discharge practice changes from participating in a translational research study.

To describe clinical nurses' experiences with practice change associated with participation in a multi-site nursing translational research study implementing new protocols for hospital discharge readiness assessment. Nurses' participation in translational research studies provides an opportunity to evaluate how implementation of new nursing interventions affects care processes within a local context. These insights can provide information that leads to successful adoption and sustainability of the intervention. Semi-structured focus groups from 30 of 33 participating study hospitals lead by team nurse researchers. Nurses reported improved and earlier awareness of patients' discharge needs, changes in discharge practices, greater patient/family involvement in discharge, synergy and enhanced discharge processes, and implementation challenges. Participating nurses related the benefits of participation in nursing research. Participation in a unit-level translational research project was a successful strategy for engaging nurses in practice change to improve hospital discharge. Leading unit-based implementation of a structured discharge readiness assessment including nurse assessment and patient self-assessment encourages earlier awareness of patients' discharge needs, improved patient assessment and greater patient/family involvement in discharge preparation. Integrating discharge readiness assessments into existing discharge care promotes communication between health team members that facilitates a timely, coordinated discharge.

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

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 20days. 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: Introduction Low readiness for hospital discharge (RHD) can be followed by negative healthcare outcomes. However, no studies have investigated RHD among patients with depression. Aim This study aimed to examine patient-reported RHD and its factors among patients with depression. Method In 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. Results The 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. Discussion RHD 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 Practice Nurses should pay more attention to patients with a hospital stay longer than 20days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content.

Discharge teaching, readiness for hospital discharge and post-discharge outcomes in cataract patients: A structural equation model analysis.

To explore the interaction mechanism of cataract patients' quality of discharge teaching, discharge readiness and post-discharge outcomes using structural equation model analysis. The quality of discharge teaching and discharge readiness are two indicators used to evaluate the quality of hospital discharge services. Little research has been done on the quality of discharge teaching, discharge readiness and post-discharge outcomes in cataract patients, especially in China. Four questionnaires were administered to 192 patients, and the results were analysed using Spearman's correlation and structural equation model. The statistical analysis showed low-to-moderate correlations among the quality of discharge teaching, discharge readiness and post-discharge outcome variables; discharge readiness played an intermediary role in the interaction mechanism of the three variables. The cataract patients demonstrated satisfactory quality of discharge teaching, discharge readiness and post-discharge outcomes. Quality of discharge teaching affected post-discharge outcomes through the intermediary role of discharge readiness. Nursing managers should recognize the importance of discharge services, pay more attention to improve the quality of discharge teaching and strengthen discharge readiness to prevent the risks of post-discharge complications and readmission.

Transition From Hospital to Home Following Hematopoietic Stem Cell Transplantation: A Feasibility Study for “Rooming in”

Background: The experience of hematopoietic stem cell transplant (HSCT) on both the patients and their caregivers is complex and challenging during hospitalization and post discharge. Complex patient populations require heightened attention on discharge practices to ensure that they are prepared for home regimens. "Rooming in" is a standardized intervention implemented prior to discharge that allows patients and caregivers to assume post discharge care with the support of staff. Other complex patient populations have reported positive outcomes related to "rooming in." Aims: The purpose of this study was to assess the feasibility of a standardized "rooming in" intervention for discharge of pediatric HSCT patients. An additional aim was to describe the quality of discharge teaching, readiness for hospital discharge, and postdischarge coping difficulty in a cohort of HSCT patients using validated questionnaires. Method: Data were collected via medical chart review. A prospective cohort completed validated study questionnaires at discharge and 30 days postdischarge. Results: All caregivers of post-HSCT patients were able to complete the "rooming in" intervention. There was no statistically significant difference for length of stay between the retrospective and prospective cohorts. Caregivers enrolled on the study rated the Quality of Discharge Teaching Scale-Parent Form high (Mdn = 165). Conclusion: We conclude that "rooming in" is a feasible discharge intervention for caregivers of pediatric HSCT patients.

Using the consolidated framework for implementation research to evaluate clinical trials: An example from multisite nursing research

BackgroundThe Consolidated Framework for Implementation Research (CFIR) is a comprehensive guide for determining the factors that affect successful implementation of complex interventions embedded in real-time clinical practice. PurposeThe study aim was to understand implementation constructs in a multi-site translational research study on readiness for hospital discharge that distinguished study sites with low versus high implementation fidelity. MethodsIn this descriptive study, site Principal Investigator interviews (from 8 highest and 8 lowest fidelity sites) were framed with questions from 20 relevant CFIR constructs. Analysis used CFIR rules and rating scale (+2 to −2 per site) and memos created in NVivo 11. FindingsFrom a bimodal distribution of differences (1.5 and 5), 7 constructs distinguished high and low fidelity sites with ≥5-point difference. DiscussionCFIR provided a determinant framework for identifying elements of a study site's context that impact implementation fidelity and clinical research outcomes.

Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants.

To examine the extent to which parental readiness for hospital discharge mediates the relationship between quality of discharge teaching and parental self-efficacy in parents of preterm infants. Parental readiness for hospital discharge and self-efficacy should be considered to establish whether preterm infants and their families are prepared for the discharge. High-quality discharge teaching could facilitate a smooth discharge transition. However, little is known about how quality of discharge teaching influences parental readiness for hospital discharge and self-efficacy. This was a descriptive cross-sectional study of 202 parents with preterm infants in a tertiary hospital in Eastern China. The key variables of interest were measured using the Chinese versions of the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale-Parent Form, and Preterm Parenting and Self-Efficacy Checklist. Path analyses were conducted to test the mediation models. STROBE checklist was used to compile the study's report. Parental readiness for discharge (overall and knowledge dimension) partially mediated the relationship between the quality of discharge teaching and parental self-efficacy. The two dimensions (content received and delivery) of quality of discharge teaching positively influenced parental self-efficacy by improving parental readiness for discharge. Parental readiness for hospital discharge, especially the knowledge dimension, was an important factor in quality of discharge teaching's association with self-efficacy in parents of preterm infants. Improving the quality of discharge teaching could increase parental readiness for discharge and thus promote parental self-efficacy. Improving discharge instructions is essential to help parents of preterm infants prepare for the transition to home care. Assessing readiness and confidence at an early stage and continuing to do so throughout the hospital stay may provide additional ways for nurses to identify parents' knowledge gaps and to provide tailored interventions at more opportune times before hospital discharge.

Factors influencing readiness for hospital discharge among patients undergoing laryngectomy.

To identify factors influencing readiness for hospital discharge among Chinese patients having undergone a laryngectomy and to provide evidence for developing future processes. Laryngectomy changes the functional and psychological state of laryngeal cancer patients considerably. However, influencing factors for discharge readiness among laryngectomy patients have hardly been investigated. A descriptive, cross-sectional design was used with Meleis' transitions theory as a guiding framework. This survey-based study was performed with 212 laryngeal cancer patients undergoing laryngectomy at a regional tertiary medical centre between August 2012 and September 2013. Quality of discharge teaching and having a designated caregiver after discharge were found to influence patients' readiness for discharge. Clinical interventions such as nursing assessment on discharge readiness, assistance to coordinate postdischarge support and individualized follow-up planning should be integrated into future clinical processes in China. However, further investigations are needed to systematically align relevant results before clinical practices in Chinese settings are eventually changed.