Perceived readiness for hospital discharge : patients with spinal cord injury versus physiotherapists

Abstract

BACKGROUND : Successful discharge from rehabilitation for patients with spinal cord injury (PWSCI) relies on a smooth transition home. Assessing readiness for hospital discharge (RHD) is important in reducing secondary health conditions and improving satisfaction and function. Perception of PWSCI on RHD may be different from their physiotherapists, leading to difficulties. OBJECTIVE : To compare the perceptions of PWSCI and physiotherapists with regard to RHD. METHOD : A comparative cross-sectional study included 50 PWSCI and their physiotherapists in Tshwane. They completed the Readiness for Hospital Discharge Scale (RHDS) and their responses to the subscales were compared. Data were analysed using descriptive and inferential statistics. Relationships between variables of interest and the general perception of RHD were determined using Pearson’s chi-square test. An independent samples t-test was used to analyse the difference in RHDS scores (including subscale scores) between PWSCI and physiotherapists. Results were significant if p < 0.05. RESULTS : The total score of the RHDS was not significantly different (t = 1.31, df = 98, p = 0.19). Patients had higher perceptions in coping ability and expected support subscales (t = 3.15, df = 85.97, p = 0.002 and t = 4.23, df = 98, p = 0.0001, respectively). Physiotherapists had higher perceptions in the knowledge subscale regarding what to do and not do at home (t = -2.05, df = 82.08, p = 0.044) and follow-up sessions (t = 2.625, df = 85.28, p = 0.010). CONCLUSION : There was no difference in perception of readiness to go home, although physiotherapists gave lower scores for emotional readiness and ability to handle demands at home and higher scores for knowledge. CLINICAL IMPLICATIONS : The use of the RHDS in the spinal cord rehabilitation units will better align the goals of rehabilitation and discharge planning to improve overall satisfaction with care and discharge outcomes. All members of a multidisciplinary team can achieve consensus and comparisons can be made on their patient’s perceived RHD.