Paper
Thursday, 20 July 2006
This presentation is part of : Developing Measurement Scales and Inventories
Readiness for Hospital Discharge Scale: Psychometric Properties
Linda B. Piacentine, MS, RN, ACNP and Marianne Weiss, RN, DNSc. College of Nursing, Marquette University, Milwaukee, WI, USA
Learning Objective #1: describe the psychometric properties of the Readiness for Hospital Discharge Scale (RHDS)tool.
Learning Objective #2: discuss the usefulness of the RHDS in clinical practice as a tool for predicting discharge readiness, post-discharge coping difficulty, and utilization of post-discharge services.
Background and Significance:  Patient perception of readiness for discharge has rarely been measured in studies of hospital discharge and transition to home. Developing a tool to measure readiness for discharge is essential to assisting with discharge planning.  Identifying predictors and outcomes of readiness or lack of readiness is critical to determining appropriate timing of discharge and subsequent post-discharge coping. 
Purpose: The purpose of the study was to assess the psychometrics properties of the Readiness for Hospital Discharge Scale (RHDS), a 23-item instrument measuring patients’ perception of readiness for discharge.
Sample: Data were obtained from 121 adult medical-surgical patients, 122 postpartum mothers, and 113 parents of hospitalized children. Subjects were English-speaking, at least 18 years old, and anticipating discharge to home.  A 3-week post-discharge telephone survey was completed.
Methods:  Meleis’ Transitions Theory provided the framework for the identification of study variables.  RHDS data were collected prior to hospital discharge and at 3 weeks post-discharge.  A Quality of Discharge Teaching Scale, Post-Discharge Coping Difficulty Scale, and measures of care coordination and utilization of post-discharge services were used for validity testing.
Results: Confirmatory factor analysis, contrasted group comparisons, and predictive validity testing supported the 4-factor structure and validity of the instrument. Following deletion of 2 poorly performing items, Cronbach’s alpha for the revised 21 item scale was 0. 90. 
Conclusions & Implications: The RHDS shows promise for discharge outcome measurement and identification of patients at risk for post-discharge coping difficulty and unplanned utilization of services. The RHDS can be a useful tool for measurement of readiness for discharge for clinical and research purposes.

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