Effect of Discharge Education on Discharge Readiness and Satisfaction

Today, the increase in the cost of health services, the development of technology and the shortening of the hospitalization period day by day due to the reasons for preventing complications such as hospital infections have increased the importance of discharge planning. Optimum maintenance of home care of patients who underwent surgery after discharge is possible with an effective discharge education given to the patient and their relatives and the preparation of the patients. In this study, it was aimed to examine the effect of the discharge training given to the patients who underwent Lumbar Disc Herniation Surgery with the method of feedback on their readiness for discharge and their satisfaction with the discharge training.

Among the patient groups who were given and not trained by the teach-back method; H01. There is no difference between the scores of readiness for discharge. H02. There is no difference between discharge training satisfaction scores. H11: There is a difference between the scores of being ready for discharge. H12: There is a difference between discharge training satisfaction scores.

While the discharge plan and education of the surgical patient constitute an important part of nursing care, it is also an indispensable element in improving the patient's quality of life. Early discharge training after lumbar disc herniation surgery relieves the patient's anxiety and facilitates compliance with the treatment. Patients' readiness for discharge includes adequate recovery for safe discharge, physical stability, functional ability, ability to manage self-care at home, and coping skills. The primary aim of this study is to examine the effect of discharge training given by the Teach Back Method on patients with lumbar disc herniation surgery on their readiness for discharge. The second aim of the study is to determine the satisfaction of the patients in the group using the Teach Back Method at discharge training.

Method Study design and setting: This randomized controlled trial will conduct at the Neurosurgery Service of Famagusta State Hospital and the Neurosurgery Clinic of the Nicosia Doctor Burhan Nalbantoglu State Hospital.

Sampling: The sample size of the study, the significance level of the hypothesis and the effect size were taken into account and the statistical power calculation related to the analyzes was made on the G Power 3.1.9.4 computer program. In the calculation made, the number of units in the sample was calculated as at least 68 people, 34 in each group, under the assump tions of 95% confidence interval, 80% power, and effect size 0.50.

Randomization: Allocation software was used to allocate the participants into two groups with equal numbers. Patients who meet the inclusion criteria of the study will be interviewed in the patient room by the researcher at the time of their admission to the hospital, and written and verbal consents will be obtained from the patients. Patients will then be included in the control or intervention group according to the randomization table.

Intervention: For the patients in the control group, the Personal Data Collection Form and the Readiness to Discharge Scale and Knowledge test will be filled. The discharge training of the patients in the control group will be given by the health professionals responsible for their care and treatment according to their clinical routines. The patients in the intervention group, on the other hand, will be trained with the teach-back method after completing the Personal Data Collection Form, Knowledge Test, and the "Ready to Discharge Scale". In these trainings, "Discharge Training Booklet", which will be prepared by the researcher, will be used as training material. This booklet will include information about discharge after Lumbar Disc Herniation Surgery. Expert opinion will be taken for the booklet. On the day of discharge, the patients in both groups will be given the 'Ready to Discharge Scale' and the 'Discharge Training Satisfaction Scale' and Knowledge Test.

Data Collection Tools The data collection tools to be used in the research consist of four parts. In the first part, "Descriptive information form" which includes information about patients and the disease, "Discharge Training Satisfaction Scale" in the second part, "Ready to Discharge Scale" in the third part lastly there is a knowledge test prepared to evaluate the effectiveness of the discharge training given in the fourth part.

Descriptive information form: This form of patients; It is a data collection tool that includes socio-demographic characteristics such as date of birth, gender, marital status, education level, and items related to the patient's disease.

Discharge Training Satisfaction Scale: The scale was developed by Meşe and Köşgeroğlu in 2021. It consists of 21 items. The Cronbach α reliability coefficient for the overall scale was found to be 0.91. The scale was designed as a 5-point Likert scale. The scores that can be obtained from the scale range from 21 to 105. The scale has no cut off.

Scale of Readiness to Discharge: The short form (Readiness for Hospital Discharge Scale/Short Form) developed by Weiss and et al. in 2014 was used. The scale consists of eight items and four dimensions, and items in the scale are evaluated on a scale ranging from 0 to 10, and higher scores indicate greater readiness.

Discharge training knowledge test: In line with the literature, a knowledge test consisting of 20-25 questions will be prepared for the content of the discharge training. In this knowledge test, there will be questions containing correct and incorrect answers, and patients will be expected to tick True, False and No idea. Expert opinion will be taken about the knowledge test.

Statistical analysis Collected data will analyse using the Statistical Package for Social Sciences (SPSS) version 24.0 (IBM, Armonk, NY, USA). Descriptive characteristics of the participants will be presented by the frequency of the responses. Descriptive statistics, including mean, standard deviation, and minimum and maximum values, will be used to present the scores obtained from the scales and the knowledge questionnaire. The Kolmogorov-Smirnov test will be used to examine the suitability of the data for normal distribution. Pearson's chi-squared test and Fisher's exact test will be used to compare descriptive characteristics. If it fits the normal distribution, parametric tests will be used. If it does not fit the normal distribution, nonparametric tests will be used.

Eligibility Criteria:
Inclusion Criteria:

over 18 years old Having undergone Lumbar Disc Herniation surgery, Patients who have the capacity to read and understand research guidelines

Exclusion Criteria:

Those who do not agree to participate in the research, Patients undergoing emergency surgery