Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Instruments
2.2.1. Nurses’ Discharge Planning Ability Scale
2.2.2. SDM-C Japanese (Care Staff) (Supplementary File S1)
2.2.3. Japanese Version of Patient Reported Experience Measures (Bed Based) Modified for Care Providers (Supplementary File S2)
2.2.4. Demographic Data
2.3. Participants and Setting
2.4. Ethical Considerations
2.5. Rules of Analysis
2.6. Statistical Analyses
3. Results
3.1. Participants’ Characteristics
3.2. Response Results for Japanese Version of PREM Modified for Care Providers (Bed Based)
3.3. Descriptive Statistics of NDPAS by Factor
3.4. The Results of the Descriptive Statistics of the Japanese Version of the PREM (Bed Based) Modified for Care Providers
3.5. Construct Validity of Japanese Version of PREM Modified for Care Providers (Bed Based)
3.6. Verification of Correlation between NDPAS, PREM (Bed Based), and SDM-C Japanese (Care Staff)
3.7. Exploring the Relationship between the Conceptual Factors of the NDPAS, the Japanese Version of the PREM Modified for Care Providers (Bed Based), and the SDM-C Japanese (Care Staff)
4. Discussion
4.1. What Are the Relationships between the Conceptual Factors of Discharge Support with the Consideration of Individuality in Japan, Patient-Centered Intermediate Care, and Shared Decision Making?
4.2. Developing Patient-Centered Intermediate Care in Japan
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Category | Response Choices | n | Percentage |
---|---|---|---|
Age group | 20s | 78 | 27.3 |
30s | 32 | 11.2 | |
40s | 106 | 37.1 | |
50s | 68 | 23.8 | |
No response | 2 | 0.7 | |
Gender | Female | 274 | 95.8 |
Male | 10 | 3.5 | |
No response | 2 | 0.7 | |
Final level of education completed | <5 years | 43 | 15.0 |
≥5 years, <10 years | 53 | 18.5 | |
≥10 years, <15 years | 54 | 18.9 | |
≥15 years, <20 years | 53 | 18.5 | |
≥20 years, <25 years | 50 | 17.5 | |
≥25 years, <30 years | 25 | 8.7 | |
No response | 8 | 2.8 |
Items | Response Choices | n | % |
---|---|---|---|
Care provider PREM item 1 Was the patient admitted within a reasonable amount of time? | Yes | 270 | 94.4 |
No | 16 | 5.6 | |
Care provider PREM item 2 Did you collect all the necessary data about the patient’s condition or disease from the referring physician? | Yes | 183 | 64.0 |
No/I do not know | 103 | 36.0 | |
Care provider PREM item 3 Did you clearly state the patient’s care objectives? | Yes | 228 | 79.7 |
No/I do not know | 58 | 20.3 | |
Care provider PREM item 4 Did you think about the home care objectives by discussing them with the patient? | Always | 150 | 50.4 |
Sometimes | 115 | 40.2 | |
No | 21 | 7.3 | |
Care provider PREM item 5 Was the room and spaces shared by the patient clean? | Very clean | 99 | 34.6 |
Somewhat clean | 181 | 63.3 | |
Not very clean | 6 | 2.1 | |
Care provider PREM item 6 While using the service, did the patient experience fear and other unpleasant things from other users or visitors? | No | 244 | 85.3 |
Yes | 42 | 14.7 | |
Care provider PREM item 7 Did you respond thoroughly to the patient’s questions? | Yes | 172 | 60.1 |
Sometimes | 82 | 28.7 | |
The patient had no questions | 31 | 10.8 | |
No | 1 | 0.3 | |
Care provider PREM item 8 Did you feel that the patient trusted you? | Yes | 92 | 32.2 |
Somewhat | 171 | 59.8 | |
No | 23 | 8.0 | |
Care provider PREM item 9 Was the patient involved in care- and treatment-related decision-making to their satisfaction? | Yes | 242 | 84.6 |
No | 44 | 15.4 | |
Care provider PREM item 10 Was the patient involved in decision-making as to when to move back home? | Sufficiently | 113 | 39.5 |
Somewhat | 138 | 48.3 | |
Involvement was not necessary | 24 | 8.4 | |
Involvement was not possible | 11 | 3.8 | |
Care provider PREM item 11 In planning home care, did you take the patient’s or family’s home situation into account? | Sufficiently | 129 | 45.1 |
Somewhat | 136 | 47.6 | |
Taking it into account was not necessary | 18 | 6.3 | |
Could not be taken into account | 3 | 1.0 | |
Care provider PREM item 12 Did you sufficiently disclose information related to the patient’s care to the patient’s family and close friends? | Sufficiently | 131 | 45.8 |
Somewhat | 127 | 44.4 | |
Patient disagreed to disclosure/Disclosure was unnecessary | 16 | 5.6 | |
No | 12 | 4.2 | |
Care provider PREM item 13 Did you discuss with the patient the assistive tools and medical devices for care at home? | Yes | 170 | 59.4 |
Discussion was not necessary | 89 | 31.1 | |
Discussion was not possible | 27 | 9.4 | |
Care provider PREM item 14 Did you discuss sufficiently with the patient the necessity of receiving care or support after discharge? | Yes | 197 | 68.9 |
Discussion was not necessary | 63 | 22.0 | |
Discussion was not possible | 26 | 9.1 | |
Care provider PREM item 15 Overall, did you provide the patient with care and respect during hospital stay? | Yes | 257 | 89.9 |
Sometimes | 27 | 9.4 | |
No | 2 | 0.7 |
Factor | NDPAS Items | Mean | Median | SD | Variance | Minimum | Maximum |
---|---|---|---|---|---|---|---|
Ability to estimate post discharge care balance (6 items) |
| 18.371 | 18.75 | 2.952 | 8.712 | 9.375 | 25.000 |
Ability to build consensus with the patient/family (7 items) |
| 21.514 | 21.875 | 3.477 | 12.087 | 10.417 | 29.167 |
Ability to coordinate post discharge care balance (6 items) |
| 17.858 | 18.750 | 3.336 | 11.129 | 5.208 | 25.000 |
Ability to prepare for the transition of place of care (5 items) |
| 14.212 | 15.625 | 3.368 | 11.344 | 0 | 20.833 |
Items | Median | Minimum Value | Maximum Value | Dispersion | Mean | Standard Deviation | Mode |
---|---|---|---|---|---|---|---|
Care provider PREM item 1 | 1.000 | 0 | 1.000 | 0.053 | 0.944 | 0.230 | 6.67 |
Care provider PREM item 2 | 1.000 | 0 | 1.000 | 0.231 | 0.640 | 0.481 | 6.67 |
Care provider PREM item 3 | 1.000 | 0 | 1.000 | 0.162 | 0.797 | 0.403 | 6.67 |
Care provider PREM item 4 | 1.000 | 0 | 1.000 | 0.099 | 0.726 | 0.315 | 6.67 |
Care provider PREM item 5 | 0.500 | 0 | 1.000 | 0.066 | 0.663 | 0.256 | 3.33 |
Care provider PREM item 6 | 1.000 | 0 | 1.000 | 0.126 | 0.853 | 0.355 | 6.67 |
Care provider PREM item 7 | 1.000 | 0 | 1.000 | 0.054 | 0.829 | 0.233 | 6.67 |
Care provider PREM item 8 | 0.500 | 0 | 1.000 | 0.086 | 0.621 | 0.294 | 3.33 |
Care provider PREM item 9 | 1.000 | 0 | 1.000 | 0.131 | 0.846 | 0.361 | 6.67 |
Care provider PREM item 10 | 0.670 | 0 | 1.000 | 0.064 | 0.746 | 0.254 | 4.47 |
Care provider PREM item 11 | 0.670 | 0 | 1.000 | 0.047 | 0.790 | 0.216 | 4.47 |
Care provider PREM item 12 | 0.670 | 0 | 1.000 | 0.065 | 0.774 | 0.254 | 6.67 |
Care provider PREM item 13 | 1.000 | 0 | 1.000 | 0.110 | 0.750 | 0.332 | 6.67 |
Care provider PREM item 14 | 1.000 | 0 | 1.000 | 0.106 | 0.799 | 0.325 | 6.67 |
Care provider PREM item 15 | 1.000 | 0 | 1.000 | 0.028 | 0.946 | 0.167 | 6.67 |
Japanese Version of PREM Modified for Care Providers (Bed Based) Patient Centeredness | Japanese Version of PREM Modified for Care Providers (Bed Based) Management of Beds | SDM-C Japanese (Care Staff) | |
---|---|---|---|
NDPAS Ability to build consensus with the patient/family | r = 0.524 ** | r = 0.160 ** | r = 0.548 ** |
NDPAS Ability to estimate post discharge care balance | r = 0.518 ** | r = 0.101 | r = 0.543 ** |
NDPAS Ability to coordinate post discharge care balance | r = 0.486 ** | r = 0.173 ** | r = 0.490 ** |
NDPAS Ability to prepare for the transition of place of care | r = 0.455 ** | r = 0.077 | r = 0.452 ** |
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Goto, Y.; Miura, H. Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study. Hospitals 2024, 1, 32-49. https://doi.org/10.3390/hospitals1010004
Goto Y, Miura H. Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study. Hospitals. 2024; 1(1):32-49. https://doi.org/10.3390/hospitals1010004
Chicago/Turabian StyleGoto, Yuko, and Hisayuki Miura. 2024. "Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study" Hospitals 1, no. 1: 32-49. https://doi.org/10.3390/hospitals1010004