Date of Award

2015-5

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN (Chair), Ruth A. Bush, PhD, MPH, Jane M. Georges, PhD, RN

Keywords

antepartum, hospital discharge, intrapartum, nursin, patient and family education, postpartum

Abstract

Pregnancy and childbirth are significant events in the lives of women and their families where the discharge decision-making process involves careful judgment in projecting the mom's ability to cope with care needs after discharge. Research examining the predictors of discharge readiness and post-discharge outcomes taking into consideration antepartum and intrapartum factors influencing readiness for discharge has not been conducted. The purpose of this study was to explore the antepartum, intrapartum, and postpartum predictors of readiness for hospital discharge and post-discharge outcomes. The Adaptation to Transitions conceptual framework consisted of conceptually-related variables was developed and guided the descriptive correlational repeated measure design study. A purposive sample of English and Spanish-speaking postpartum mothers who experiences a vaginal or cesarean birth of a healthy infant (N = 185) completed demographic, quality of discharge teaching, and readiness for hospital discharge questionnaires prior to discharge. Four weeks post-discharge, participants completed a coping difficulty questionnaire and the quality of discharge teaching questionnaire to compare pre- and post- hospital perceptions of teaching. A final model was computed with all significant predictors for readiness for hospital discharge and post-discharge coping difficulty. Infant length of stay, the delivery of education, and the difference between educational content received and the education content needed, were the significant predictor variables accounting for 42% of the variance in readiness for hospital discharge (R2=0.44, R2adj =0.42, F(8,176) = 17.5, p < 0.001). Participants with less than high school education and the difference between educational content received and needed were the two significant predictor variables accounting for 28% of the variance in post-discharge coping difficulty (R2=0.33, R2adj =0.28, F(6,60) = 5.1, p < 0.001). Nurses' skill in the delivery of education, the educational content received, and the post-discharge coping difficulty were predictive of utilization of post-discharge health care services. A statistically significant difference in the quality of discharge teaching between pre- and post- hospital discharge was also noted. The relationship between quality of discharge teaching, readiness for discharge, and post-discharge coping and utilization provides evidence of nurses' critical role in educating patients and families to facilitate a smooth transition home after childbirth.

Document Type

Dissertation

Department

Nursing

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