Nursing Discharge Teaching for Multimorbid Inpatients

NCT04253665 | Completed DMC

• 1 other identifier: 2020_2201
• Study Type: interventional
• Target: 225
• Locations: 1 country
• Sites: 3

Brief Summary

The objective of this study is to estimate the effect size of a nursing discharge teaching intervention on multimorbid inpatients activation level, health confidence, readiness for hospital discharge, experience with discharge care and rate and time to 7-days readmission.

Conditions

Chronic Disease

Keywords

Discharge teaching; Nursing; Multimorbidity

Outcome Measures

Primary Outcomes (1)

• Change in Patient Activation Measure (PAM)

  The patient activation measure (PAM) is a 13-item self-report questionnaire to measure patient activation level. Stages of activation are distributed as follows in the PAM items: items 1-2: believing an active role is important; items 3-8: having confidence and knowledge to take action; items 9-11: taking action; and items 12-13: continuing healthy behaviors under stress. PAM raw score can be calculated by adding all of the responses to the 13 questions. This score is then converted into an activation score ranging from 0 = no activation to 100 = high activation using a calibration table. Psychometric properties of the PAM in hospitalized multimorbid patients showed a satisfying reliability (Cronbach's alpha = 0.88) and a content validity index of 0.91.

  change from hospital admission to the day of discharge and 7-10 days after discharge

Secondary Outcomes (4)

• Change in Health Confidence Score (HCS)

  change from hospital admission to the day of discharge and 7-10 days after discharge

• Readiness for Hospital Discharge Scale-Short Form (RHDS-SF)

  At the end of the hospital stay, an average of 7-10 days after admission

• Readmission rate and time to readmission

  7-10 days after discharge

• Discharge Care Experiences Survey (DICARES)

  7-10 days after discharge

Study Arms (2)

Usual care

NO INTERVENTION

Discharge teaching is usually not delivered in a systematic or consistenly way, nor by relying on a particular intervention model.

Discharge teaching

EXPERIMENTAL

Receiving tailored discharge teaching by nurses during hospital stay.

Behavioral: Nursing discharge teaching

Interventions

Nursing discharge teaching BEHAVIORAL

Nurses will provide multimorbid seniors inpatients with teaching related to self-management to prepare them to be discharged home. The teaching delivery will be tailored to patients' activation level and priorities. The intervention begins by determining the level of activation at which patients are and identifying priorities to address related to patients' life situation. A Discharge Teaching Guide will be used by nurses to deliver the teaching and includes six domains of self-management. For each domain, nurses first report whether a priority has been identified and what intervention they have proposed to address it. Then for each domain, teaching objectives are described and differ according to the level of patient activation. These six domains of self-management are found in the patient-oriented discharge summary, which is a document for the patient that summarizes what has been addressed in discharge teaching.

Discharge teaching

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• chronic diseases or more
• Being discharged home
• Able to speak, read and write in French

You may not qualify if:

• Insufficient capacity to consent assessed with the University of California San Diego Brief Assessment of Capacity to Consent (UBACC).

Sponsors & Collaborators

• University of Lausanne: lead

Study Sites (3)

Lausanne University Hospital (CHUV)

Lausanne, 1010, Switzerland

Location

EHC (Hôpital de Morges)

Morges, 1110, Switzerland

Location

eHnv (Etablissements hospitaliers du nord vaudois)

Yverdon-les-Bains, 1318, Switzerland

Location

Related Publications (2)

• Pellet J, Weiss M, Mabire C. Evaluation of a theory-informed implementation of a nursing discharge teaching intervention for older adults. J Adv Nurs. 2023 Aug;79(8):3147-3159. doi: 10.1111/jan.15666. Epub 2023 Apr 4.

  PMID: 37014070 DERIVED

• Pellet J, Weiss M, Zuniga F, Mabire C. Implementation and preliminary testing of a theory-guided nursing discharge teaching intervention for adult inpatients aged 50 and over with multimorbidity: a pragmatic feasibility study protocol. Pilot Feasibility Stud. 2021 Mar 17;7(1):71. doi: 10.1186/s40814-021-00812-4.

  PMID: 33731212 DERIVED

MeSH Terms

Conditions

Chronic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Cedric Mabire, Dr. Sc.

  Institute of Higher Education and Research in Healthcare, University of Lausanne

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr.Sc.

Model Details: 2 group pre/post-intervention comparative design: 90 control patients will be recruited before the implementation of the intervention in study units. This recruitment will last approximately two months, according to the estimated turnout of patients in these units. After this control period, 30 other patients will be recruited to receive the intervention. In this sense, participants are assigned to one group or the other, depending on the phase of the study.

Study Record Dates

• First Submitted: January 23, 2020
• First Posted: February 5, 2020
• Study Start: August 13, 2020
• Primary Completion: August 31, 2021
• Study Completion: September 30, 2021
• Last Updated: November 8, 2021

Record last verified: 2021-11

Data Sharing

• IPD Sharing: Will not share

Locations

CH (3)