Psychometric Properties of the Readiness for Hospital Discharge Scale

The purpose of the study was to assess the psychometrics properties of the Readiness for Hospital Discharge Scale (RHDS), a 23-item instrument that measures patients\u27 perception of readiness for discharge. Data were obtained from 356 respondents from two urban tertiary medical centers (adult and children\u27s) in the midwestern United States who were participants in a larger study of predictors and outcomes of readiness for hospital discharge. Confirmatory factor analysis, contrasted group comparisons, and predictive validity testing supported the 4-factor structure and construct validity of the instrument. Following deletion of two poorly performing items, Cronbach\u27s alpha for the revised 21item scale was 0.90. The RHDS can be a useful tool for measurement of readiness for discharge for clinical and research purposes

Frequency of Lost Dogs and Cats in the United States and the Methods Used to Locate Them

Dogs and cats are a common member of the family in homes across the US. No population-based data exist on the frequency of pets getting lost from the home and lost pets can be a source of human and animal suffering. Our primary objective was to determine the percentage of owned dogs and cats that were lost, and of these, what percentages of pets were recovered. We examined the recovery success for dogs compared to cats and the methods used as well as the relationship between lost or found pets and pet and owner demographics. While 15% of dog and cat owners lost their pets, dogs had higher recovery rates (93%) than cats (75%) as well as being returned using different search methods

Coping Difficulties After Hospitalization

Coping difficulties of 113 adults 3 weeks after hospital discharge were identified using the Post-Discharge Coping Difficulty Scale and a brief focused telephone interview (11-item guide). Overall, low difficulty scores were reported (M = 23.9, SD = 18.2, range = 0 to 100). Qualitative data reveal specific coping difficulties in the categories of stressors, specific difficulties, caring for self, managing the condition, family, advice needed, contact with the health care system, and what they wished they knew before discharge. A core theme of biographical reconstruction emerged

Validation of Patient and Nurse Short Forms of the Readiness for Hospital Discharge Scale and Their Relationship to Return to the Hospital

Objective: To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits. Data Sources/Study Setting: A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Study Design Prospective longitudinal design, multinomial logistic regression analysis. Data Collection/Extraction Methods: Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted. Principal Findings: Nurse assessment of low discharge readiness was associated with a six- to nine-fold increase in readmission risk. Patient self-assessment was not associated with readmission; neither was associated with ED visits. Conclusions: Nurse discharge readiness assessment should be added to existing strategies for identifying readmission risk

Teaching students to teach patients: A theory-guided approach

Nurses in every setting provide patient teaching on a routine basis, often several times a day. Patient teaching skills are essential competencies to be developed during pre-licensure nursing education. While students learn what to teach for specific conditions, they often lack competence in how to teach in ways that individualize and optimize patient learning. The ultimate goal of patient teaching is to arm patients with the knowledge and skills, and the desire and confidence in their ability to reach their targeted health outcomes. We describe the creation of a theoretical framework to guide development of patient teaching skills. The framework, rooted in the contemporary health care values of patient-centered care, is a synthesis of four evidence-based approaches to patient teaching: patient engagement, motivational interviewing, adult learning theory, and teach-back method. Specific patient teaching skills, derived from each of the approaches, are applied within the context of discharge teaching, an important nursing practice linked to patient outcomes. This exemplar emphasizes the use of critical teaching process skills and targeted informational content. An online student learning module based on the theoretical framework and combined with simulation experiences provides the nurse educator with one strategy for use with nursing students. The theoretical framework has applicability for skill development during pre-licensure education and skill refinement for nurses in clinical practice

Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 20102012

Weight loss and physical activity achieved through the Diabetes Prevention Program (DPP) have been shown to reduce type 2 diabetes risk among individuals with prediabetes. The New York State Young Men's Christian Association (YMCA) delivered the 16-week evidence-based model at 14 YMCAs. A mixed methods process and outcomes evaluation was conducted

A Model for Hospital Discharge Preparation: From Case Management to Care Transition

There has been a proliferation of initiatives to improve discharge processes and outcomes for the transition from hospital to home and community-based care. Operationalization of these processes has varied widely as hospitals have customized discharge care into innovative roles and functions. This article presents a model for conceptualizing the components of hospital discharge preparation to ensure attention to the full range of processes needed for a comprehensive strategy for hospital discharge

A volta do Estado: aprendendo com os BIC? O Estado de transformação: volta, renovação, ou redescoberta?

A crise financeira global expôs a  fraqueza  da teoria econômica dominante e de políticas desregulatórias, maculou o modelo de laissez-faire do capitalismo, e precipitou uma reavaliação generalizada do papel do estado no controle do mercado. Enquanto a experiência dos BICs que oferece um poderoso modelo de ativismo do estado que transcende o Consenso de Washington, está em boa companhia. Um exame das experiências do passado e do futuro do Nordeste da Ásia (NEA) e dos Estados Unidos contesta, por um lado, vários mitos relativos ao pretenso desaparecimento do estado desenvolvimentista, e por outro, a chegada de um estado neoliberal. Enquanto o NEA oferece um modelo bem estudado do avanço industrial (catch-up) orientado pelo estado, que o neoliberalismo teria relegado ao lixo da história, os Estados Unidos fornecem um modelo substituto de supremacia tecnológica patrocinado pelo estado, que poucos desejam reconhecer