Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home.
BACKGROUND
It is becoming commonplace for patients to be discharged earlier from acute hospital settings to their own homes and be required to manage various aspects of their own care. This has increased the need for detailed information to be given to patients and/or significant others to enable them to effectively manage care at home. It has been suggested that providing written health information can assist in this self management.


OBJECTIVE
To determine the effectiveness of providing written health information in addition to verbal information for patients and/or significant others being discharged from acute hospital settings to home.


METHODS
Computerised searches from 1990 to June 2002 of the Cochrane Consumers and Communication Review Group Specialised Register and Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), EMBASE, CINAHL, PsycINFO, ERIC, OVID (including Ageline, EBM Reviews, DARE, Best Evidence, Pre-MEDLINE and PsycARTICLES), Sociological abstracts, Austhealth and bibliographies in articles that met inclusion criteria.


METHODS
Articles were selected if they were randomised control trials or controlled clinical trials; included patients discharged from acute hospital settings to home; the patient and/or significant others received written health information and verbal information in the intervention group, and verbal information only in the control group; and the intervention (written health information and verbal information) was provided at discharge.


METHODS
Two reviewers independently screened abstracts to determine relevance. Relevant full paper copies were then reviewed against the inclusion criteria. The findings were extracted by one reviewer and confirmed by the other reviewer. The two trials that met the inclusion criteria were too disparate to warrant meta-analysis.


RESULTS
The participants in the two trials were parents of children who were discharged from children's hospitals, one in the United States (n=197) the other in Canada (n=123). Provision of verbal and written health information significantly increased knowledge and satisfaction scores.


CONCLUSIONS
This review recommends the use of both verbal and written health information when communicating about care issues with patients and/or significant others on discharge from hospital to home. The combination of verbal and written health information enables the provision of standardised care information to patients and/or significant others, which appears to improve knowledge and satisfaction. Many of our objectives could not be addressed in this review due to lack of trials which met the review's inclusion criteria. There is therefore scope for future research to investigate the effects of providing verbal and written health information on readmission rates, recovery time, complication rates, costs of health care, consumers' confidence level, stress and anxiety and adherence to recommended treatment and staff training in the delivery of verbal and written information. In addition there are other factors which impact on the effectiveness of information provided that were not considered in this review but are worthy of a separate systematic review, such as the impact of the patient and/or significant others being involved in the development of the written information, and cultural issues around development and provision of information. Due to concerns about literacy levels for some population groups, other systematic reviews should also focus on other modes of delivery of information besides the written format.
Department of Public Health, Flinders University of South Australia, Flinders Drive, Bedford Park, South Australia, Australia, 5042.
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Johnson
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Sandford
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Tyndall
D000359:Aftercare / Q000379:methods*; D003142:Communication; D006801:Humans; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care