Aims and objectives To examine the extent to which parental readiness for hospital discharge mediates the relationship between quality of discharge teaching and parental self‐efficacy in parents of preterm infants. Background Parental readiness for hospital discharge and self‐efficacy should be considered to establish whether preterm infants and their families are prepared for the discharge. High‐quality discharge teaching could facilitate a smooth discharge transition. However, little is known about how quality of discharge teaching influences parental readiness for hospital discharge and self‐efficacy. Design This was a descriptive cross‐sectional study of 202 parents with preterm infants in a tertiary hospital in Eastern China. Methods The key variables of interest were measured using the Chinese versions of the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale‐Parent Form, and Preterm Parenting and Self‐Efficacy Checklist. Path analyses were conducted to test the mediation models. STROBE checklist was used to compile the study's report. Results Parental readiness for discharge (overall and knowledge dimension) partially mediated the relationship between the quality of discharge teaching and parental self‐efficacy. The two dimensions (content received and delivery) of quality of discharge teaching positively influenced parental self‐efficacy by improving parental readiness for discharge. Conclusions Parental readiness for hospital discharge, especially the knowledge dimension, was an important factor in quality of discharge teaching's association with self‐efficacy in parents of preterm infants. Improving the quality of discharge teaching could increase parental readiness for discharge and thus promote parental self‐efficacy. Relevance to clinical practice Improving discharge instructions is essential to help parents of preterm infants prepare for the transition to home care. Assessing readiness and confidence at an early stage and continuing to do so throughout the hospital stay may provide additional ways for nurses to identify parents’ knowledge gaps and to provide tailored interventions at more opportune times before hospital discharge.
Aim To describe the facilitating/inhibiting factors of preparation for preterm infant discharge and recommendations for increasing discharge readiness from parents’ and healthcare providers’ perspectives based on Meleis's Transitions Theory. Design A qualitative cross‐sectional descriptive design. Methods We selected a purposive sample of 17 parents (9 fathers and 8 mothers) and 13 healthcare providers (10 nurses and 3 clinicians) from the neonatal intensive care unit of a tertiary hospital in Eastern China. Data were collected between May ‐July 2018. Data from audio‐recorded semi‐structured individual interviews were coded with content analysis both inductively and deductively. Results The analyses yielded four themes: personal conditions, community conditions, nursing therapeutics, and patterns of response. Parents and healthcare providers had unique opinions about the themes. Conclusion Meleis's Transitions Theory seems to be an applicable and practicable framework for understanding the discharge preparation of parents with preterm infants and may be used to help healthcare providers to develop appropriate interventions on discharge preparation practice. Impact To address the lack of discharge readiness of preterm infants in China and countries with a similar clinical context, healthcare providers should help parents play a more active role to promote their engagement in discharge preparation. In a wider global community, healthcare providers should consider parents’ personal conditions and their practical needs in performing discharge preparation.
Background Delay in care seeking is one of the causes for neonatal death. Mothers’ knowledge of neonatal danger signs is imperative to promote early recognition of neonatal illness and reduce the delay in care seeking. Currently, no study has been conducted on the knowledge about neonatal danger signs in China, especially in economically less developed areas. This study aimed to examine the knowledge of neonatal danger signs and risk factors of poor knowledge among mothers in a rural county of southwest of China. Methods A cross-sectional study was conducted in Wenshan, a rural county of southwest of China. A total of 112 respondents were included from November 2020 to February 2021 among women who had babies aged 0–12 months and brought their babies to health care centers for immunization within the study period. A questionnaire with 18-item key neonatal danger signs was used to measure their knowledge about these signs. Mothers who scored above average were considered to have relatively good knowledge whereas those who scored below average were considered to have relatively poor knowledge. Independent predictors of mothers’ knowledge were identified by multivariable logistic regression analysis. Results The mean knowledge score of neonatal danger signs of mothers was 18.1 (SD = 8.6). Fifty-eight percentage of mothers (65/112) had poor knowledge of neonatal danger signs. Danger signs of “bluish or pale skin”, “chest indrawing”, and “convulsion” were mostly recognized, whereas danger signs of “not able to feed since birth, or stopped feeding well”, “excessive crying” and “eyes draining pus” were recognized poorly. Less than four antenatal visits [AOR = 4.348], younger than 25 years old [AOR = 3.839], ethnic minority [AOR = 3.956] and family financial difficulty [AOR = 4.944] were significant indicators of relatively poor knowledge. Conclusions Mothers’ knowledge about neonatal danger signs in rural China is poor even though the coverage of maternal and child health care services are expanded. Existing efforts should be enhanced for antenatal care visits, avoiding early marriage as well as early childbearing. More attention should be paid to low-income ethnic minority mothers. Educating and training should be strengthened for danger signs, especially those who are predicted to have insufficient knowledge.
Background Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties. Methods A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability. Results The “float or PRN” and “manager” words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach’s α = 0.68 ~ 0.93, McDonald’s omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including “Response to Error”, “Communication Openness”, and “Reporting Patient Safety Events”, when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0. Conclusion The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed.
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