Brief scale measuring patient preparedness for hospital discharge to home: Psychometric properties

• Published in: Journal of hospital medicine Vol. 3; no. 6; pp. 446 - 454
• Main Authors: Graumlich, James F., Novotny, Nancy L., Aldag, Jean C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.11.2008
• Subjects: Adult; Aged; Aged, 80 and over; Cohort Studies; continuity of patient care; Female; Follow-Up Studies; health care surveys; Health Care Surveys - methods; Health Care Surveys - standards; Humans; Male; Middle Aged; patient discharge; Patient Discharge - standards; Patient Education as Topic - methods; Patient Education as Topic - standards; Patient Satisfaction; patient-centered care; Prospective Studies; Psychometrics; Weights and Measures - standards
• ISSN: 1553-5592; 1553-5606
• DOI: 10.1002/jhm.316

BACKGROUND: Adverse events occur when patients transition from the hospital to outpatient care. For quality improvement and research purposes, clinicians need appropriate, reliable, and valid survey instruments to measure and improve the discharge processes. OBJECTIVE: The object was to describe psychometric properties of the Brief PREPARED (B‐PREPARED) instrument to measure preparedness for hospital discharge from the patient's perspective. METHODS: The study was a prospective cohort of 460 patient or proxy telephone interviews following hospital discharge home. We administered the Satisfaction with Information about Medicines Scale and the PREPARED instrument 1 week after discharge. PREPARED measured patients' perceptions of quality and outcome of the discharge‐planning processes. Four weeks after discharge, interviewers elicited emergency department visits. The main outcome was the B‐PREPARED scale value: the sum of scores from 11 items. Internal consistency, construct, and predictive validity were assessed. RESULTS: The mean B‐PREPARED scale value was 17.3 ± 4.2 (SD) with a range of 3 to 22. High scores reflected high preparedness. Principal component analysis identified 3 domains: self‐care information, equipment/services, and confidence. The B‐PREPARED had acceptable internal consistency (Cronbach's alpha 0.76) and construct validity. The B‐PREPARED correlated with medication information satisfaction (P < 0.001). Higher median B‐PREPARED scores appropriately discriminated patients with no worry about managing at home from worriers (P < 0.001) and predicted patients without emergency department visits after discharge from those who had visits (P = 0.011). CONCLUSIONS: The B‐PREPARED scale measured patients' perceptions of their preparedness for hospital discharge home with acceptable internal consistency and construct and predictive validity. Brevity may potentiate use by patients and proxies. Clinicians and researchers may use B‐PREPARED to evaluate discharge interventions. Journal of Hospital Medicine 2008;3(6):446–454. © 2008 Society of Hospital Medicine.