Clinical trial NCT04253665: Nursing Discharge Teaching for Multimorbid Inpatients
Official title: Nursing Discharge Teaching for Multimorbid Inpatients to Self-manage Their Health at Home: a Pilot Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Chronic Disease
Keywords: Discharge teaching
Nursing
Multimorbidity
Lead sponsor: University of Lausanne
Sponsor class: OTHER
First posted: 2020-02-05
Enrollment: 225
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 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.
Primary purpose: SUPPORTIVE_CARE

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.

Detailed description: Seniors returning home from hospital have to manage several chronic conditions in addition to their daily tasks. The teaching provided by nurses during hospitalization is essential care to prepare them to manage their health at home. Nevertheless, there is often a gap between professionals' belief that the teaching they have provided to patients has met their needs, and patients' perceptions of the relevance of the teaching content to their home situation. The time available to conduct this teaching is also short during the hospital stay and there is limited knowledge about how to adapt this teaching for patients who must manage multiple chronic conditions at the same time. Thus, there is a real need to develop and test a new teaching nursing intervention to prepare for the return home that takes into account the unique and complex needs and characteristics of patients with multiple chronic conditions. Tailoring teaching to seniors' life situation and level of activation (i.e., knowledge, skills and confidence in managing their health) would best meet the needs of these patients for managing their health at home. An intervention that takes these characteristics into account has been developed and will be tested in this study.

Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

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

Primary outcomes:
measure: Change in Patient Activation Measure (PAM)
timeFrame: change from hospital admission to the day of discharge and 7-10 days after discharge
Secondary outcomes:
measure: Change in Health Confidence Score (HCS)
timeFrame: change from hospital admission to the day of discharge and 7-10 days after discharge
measure: Readiness for Hospital Discharge Scale-Short Form (RHDS-SF)
timeFrame: At the end of the hospital stay, an average of 7-10 days after admission
measure: Readmission rate and time to readmission
timeFrame: 7-10 days after discharge
measure: Discharge Care Experiences Survey (DICARES)
timeFrame: 7-10 days after discharge
Other outcomes:
Locations:
city: Lausanne
country: Switzerland
facility: Lausanne University Hospital (CHUV)
city: Morges
country: Switzerland
facility: EHC (Hôpital de Morges)
city: Yverdon-les-Bains
country: Switzerland
facility: eHnv (Etablissements hospitaliers du nord vaudois)
Study officials:
affiliation: Institute of Higher Education and Research in Healthcare, University of Lausanne
name: Cedric Mabire, Dr. Sc.
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.