General surgical patients' perspectives of the adequacy and appropriateness of discharge planning to facilitate health decision-making at home.
OBJECTIVE
To investigate general surgical patients' perspectives of the adequacy and appropriateness of their discharge planning.


OBJECTIVE
To identify any aspects of discharge planning that could be strengthened to assist people in managing their posthospital care and maintaining continuity of care.


BACKGROUND
Appropriate discharge planning is a priority in today's healthcare environment in which patients are discharged 'quicker and sicker', sometimes without home support. Adequate and appropriate discharge planning helps promote health literacy, which has benefits for both patients and their caregivers in helping them manage postsurgical recovery at home.


METHODS
A qualitative, interpretive study was designed in which patients were interviewed at least one week after they returned home from hospital.


METHODS
Purposeful sampling was used to interview 13 general surgical patients from one of three hospitals (two public and one private) in New South Wales and Queensland, Australia. Data were collected in unstructured interviews and analysed using thematic analysis. Reflective analysis by individual research team members generated preliminary themes, which were then analysed collectively by all members of the research team to achieve consensus on patients' perspectives.


RESULTS
Themes included a 'one-size-fits-all' approach to providing discharge information; inconsistent or variable advice from different health professionals; a lack of predischarge assessment of their home and/or work conditions and the need for follow-up assessment of patient and carer needs.


CONCLUSIONS
The findings of this study illuminate the need for a more individualized approach to discharge planning, taking into account the patient's age, gender, surgical procedure and family and community support for immediate and longer-term nursing follow-up.


CONCLUSIONS
Patients would be more adequately prepared for their recovery period at home, by encouraging client-centred, interdisciplinary communication between health practitioners; adopting a flexible, approach to discharge planning which is tailored to individual needs of postsurgical patients, particularly in relation to advice and information related to recovery; and encouraging and supporting adequate health literacy for self-management.
McMurray
Anne
A
Peel Health Campus, Murdoch University, Mandurah, WA, Australia. a.mcmurray@murdoch.edu.au
Johnson
Patricia
P
Wallis
Marianne
M
Patterson
Elizabeth
E
Griffiths
Susan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration; D003657:Decision Making; D005260:Female; D006301:Health Services Needs and Demand; D006701:Home Nursing / Q000193:education / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010351:Patient Discharge / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards*; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000523:psychology; D036301:Qualitative Research; D011793:Queensland; D012648:Self Care / Q000523:psychology; D012944:Social Support; D013514:Surgical Procedures, Operative / Q000523:psychology*; D011795:Surveys and Questionnaires