Patient understanding of discharge instructions in the emergency department: do different patients need different approaches?
| Autor: | Agata Dzwonek, Hasan Sheikh, Lawrence Yau, Aleksandar Brezar, Lisa A. Calder |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry Patient demographics lcsh:Medical emergencies. Critical care. Intensive care. First aid MEDLINE 030208 emergency & critical care medicine lcsh:RC86-88.9 Emergency department 03 medical and health sciences 0302 clinical medicine Psychiatric history Treatment plan Emergency Medicine Physical therapy medicine In patient Patient survey 030212 general & internal medicine Discharge instructions business Original Research |
| Zdroj: | International Journal of Emergency Medicine International Journal of Emergency Medicine, Vol 11, Iss 1, Pp 1-7 (2018) |
| ISSN: | 1865-1380 1865-1372 |
| Popis: | Background Previous studies have demonstrated that patients have poor understanding of the discharge instructions provided from the emergency department (ED). The aims of this study are to determine if patient factors, such as income and level of education, correlate with patient understanding of discharge instructions and to explore if different patient populations prefer different resources for receiving discharge instructions. Methods We conducted live observations of physicians providing discharge instructions in the ED to 100 patients followed by a patient survey to determine their understanding in four domains (diagnosis, treatment plan, follow-up instructions, and return to ED (RTED) instructions) and collect patient demographics. We enrolled patients over the age of 18 being discharged home. We excluded non-English- or French-speaking patients and those with significant psychiatric history or cognitive impairment. We performed a two-way ANOVA analysis of patient factors and patient understanding. Results We found that patients had poor understanding of discharge instructions, ranging from 24.0% having poor understanding of their follow-up plan to 64.0% for RTED instructions. Almost half (42%) of patients did not receive complete discharge instructions. Lower income was correlated with a significant decrease in patient understanding of discharge diagnosis (p = 0.01) and RTED instructions (p = 0.04). Patients who did not complete high school trended towards lower levels of understanding of their diagnosis and treatment plan (p = 0.06). Lower income patients had a preference for receiving a follow-up phone call by a nurse, while higher income patients preferred online resources. Conclusions Lower income patients and those who have not completed high school are at a higher risk of poor understanding discharge instructions. As new technological solutions emerge to aid patient understanding of discharge instructions, our study suggests they may not aid those who are at the highest risk of failing to understand their instructions. Electronic supplementary material The online version of this article (10.1186/s12245-018-0164-0) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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