Learning Objective #1: Examine the effectiveness of discharge plan models regarding quality of life

Learning Objective #2: Examine the effectiveness of discharge plan models regarding patients’ satisfaction with hospitalization

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Introduction: Patients discharged to the community need to adopt self-care behaviors in order to cope with disease conditions. Counseling in lifestyle changes can affect subsequent quality of life. Purpose: To examine the effectiveness of discharge plan models regarding patients' satisfaction with hospitalization, and quality of life. Methodology: A prospective intervention study with follow up of patients discharged from internal medicine wards assigned to three groups: a control (patients who received the counseling generally delivered), an individual counseling (patients who received counseling with a structured program delivered by specially trained nurses), and a group counseling (patients received counseling within structured groups from a nurse and dietician). Data was collected during telephone interviews conducted a week and a month after patient discharge regarding the comprehension and implementation of counseling, satisfaction with hospitalization, subjective health and quality of life (SF-36). Findings: Individual or group counseling contributed to greater satisfaction with hospitalization and nursing care. Patients who had received individual counseling reported (one week after discharge) better quality of life, physical functioning (p<0.05), social functioning (p<0.001), physical symptoms (p<0.001), mental health (p<0.05), vitality and perception of health (p<0.015). No differences were found between the two groups regarding quality of life with the exception of emotional role functioning, with patients who had received individual counseling reporting greater anxiety with respect to return to normal functioning. No differences were found between patients in the control group and those who had received individual counseling on the Physical and Mental Component Summaries. The only difference observed in the Functional Limitations Index regarding emotional role functioning, with patients who had received individual counseling reporting greater limitations. Conclusion: Structured discharge plans help patients adjust to life in the community. They thereby provide patients with the skills to cope and improve quality of life as well as return to normal activity.