Patient Discharge Clinical Trial
Official title:
Self-Management Guided Discharge Teaching for Parents of Hospitalized Children: A Pilot Study
The purpose of this study is to pilot test the 'Family Self- Management Discharge Preparation Intervention [FSM-DPI]' that focuses on content and delivery methods to support an effective family transition to home self-management after a child's hospitalization.
The specific aims of the study are:
1. To estimate the effect of an intervention designed to improve family self-management
after discharge of a hospitalized child on:
1. Family self-management process (e.g., knowledge, self-regulation, and social
facilitation)
2. Proximal family self-management behavioral outcomes, (e.g., post-discharge
parental coping difficulty and family impact), and unplanned use of post-discharge
services (calls to family/friends, health care providers, hospital; unscheduled
office visits, urgent care/ED visits, readmission).
2. To describe nurse assessment and patient responses to the FSM-DPI.
3. To compare nurse satisfaction with discharge teaching process when nurses perform
discharge teaching using the FSM-DPI vs. the standard discharge teaching approach.
A novel discharge preparation intervention delivered by nurses to parents of hospitalized
children who are being discharged home was developed based on previous research conducted by
the investigators. The intervention is grounded in the individual and family self-management
Theory. To test the impact of the intervention on discharge preparation process and parent
outcomes, the investigators will conduct a pilot trial implementation using trained staff
nurses to deliver the intervention. To measure the effects of the intervention a difference-
in-differences approach with be used with selection of 200 parents with 50 in each of 4
groups: Baseline control 1 (parents assigned for usual care to study nurses before training
on the use of the intervention); Baseline control group 2 ( parent assigned for usual care
to other than study nurses); Implementation group ( parents assigned to study nurses who
will receive the intervention); Concurrent control group ( parent assigned to other than
study nurses). The study will be conducted on two nursing units and half of the sample will
be selected from each unit using a random selection procedure.
Data to be collected from all parents (baseline control, implementation, concurrent control)
on the day of hospital discharge include: Parent enrollment sheet for collection of parent
demographics; Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale,
Care Transition Measure. In addition the CHW Synergy form will be copied from the child's
medical record to provide information on child characteristics of the hospitalization. At 3
weeks post-discharge, parents will be contacted by telephone to obtain outcome data using
the Post-Coping Difficulty Scale and the PedsQLâ„¢. Parents will also be asked questions about
post-discharge utilization of health services.
Nurses will record process measures related to the delivery of the intervention. In addition
the nurse of parents in implementation and control groups will complete assessments of
patient readiness for discharge using the Readiness for Hospital Discharge Scale and will
rate their experience with the discharge process on a survey developed by the research team.
Analysis will provide information about the utility of the FSM-DPI and preliminary data on
which to base revisions and enhancements to the intervention and for development of a larger
implementation trial.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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