An investigation of postpartum mothers’ readiness for hospital discharge and the affecting factors

Abstract

Introduction: Postpartum period which contains important changes in the woman's and newborn's life, WHO recommends monitoring the mother and newborn in health care system, encouraging breastfeeding, monitoring the newborn's development, and supporting and empowering parents about newborn care. Purpose: The purpose of this study is to identify postpartum mothers' readiness for hospital discharge and the affecting factors. Method and material: The study was conducted with 190 mothers who gave birth between May and July, 2014 in a Maternity and Children Hospital located in Mersin. The data were collected through the Identification Form developed by the researcher in line with the related literature and Readiness for Hospital Discharge Scale-Postpartum Mother Form (RHDS-PMF). Results: Of all the participants, 84.7% were ready for discharge, 69.4% received information from midwives or nurses about their own care, and 68.7% received information about the baby's care. Mean scores for the participants' Readiness for Hospital Discharge Scale was found 50.4712.16 for Personal State, 45.0812.33 for Knowledge, 21.075.68 for Ability, 28.13 8.91 for Expected Support and 144.7630.15 for total score. The scores were found to be significantly higher for mothers who reported to be ready for discharge, who stated to have received information about their own care and the baby's care, who were multiparous, and who would receive support for their care and the baby's care after hospital discharge (p<0.05). Conclusion: Majority of the participants in this study were found to be ready for hospital discharge and factors affecting readiness for hospital discharge were identifed as informing mothers about their care and the baby's care after delivery, mothers' being multiparous, and receiving support about their care and the baby's care after hospital discharge.

Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature

“…Research documents offered loose defnitions of discharge preparation, most of which emphasised the ‘provision of education, information or instructions’ to mothers about taking care of the newborn and their own health after birth [ 14 , 15 , 25 – 30 ]. Some specifically referred to preparation for the ‘transition home’ or to adapt to ‘changes’ in the woman’s and newborn’s lives [ 12 , 26 , 27 , 31 , 32 ]. More recent research articles mentioned empowering parents or helping them take control and make their own decisions as an important step in discharge preparation [ 30 , 31 ].…”

“…Some specifically referred to preparation for the ‘transition home’ or to adapt to ‘changes’ in the woman’s and newborn’s lives [ 12 , 26 , 27 , 31 , 32 ]. More recent research articles mentioned empowering parents or helping them take control and make their own decisions as an important step in discharge preparation [ 30 , 31 ].…”

“…Defnitions in research documents recognised that the decision to discharge was ‘complex’ and varied depending on the confidence of the mother to take care of the baby at home, support and stability at home, access to follow up care, social vulnerabilities and psychological adaptation [ 30 , 35 , 36 ]. In three research documents defnitions mentioned ‘joint assessment ‘or ‘agreement’ between the mother, family and health professionals that both the mother and infant were ready for discharge [ 9 , 10 , 31 ].…”

“…Thirteen policy documents reported discharge readiness criteria [ 24 , 33 , 34 , 37 – 46 ]. Seventeen research documents reported readiness criteria, and these included nine research studies [ 11 , 12 , 25 , 31 , 32 , 35 , 47 – 49 ], three review articles [ 36 , 50 , 51 ], two commentaries [ 52 , 53 ], a thesis [ 54 ], a medical news article [ 55 ] and an unpublished evaluation report [ 56 ]. Policy documents were from the United States ( n = 3), Canada ( n = 2), India ( n = 2), England ( n = 1) and five of the policy documents had a global focus.…”

“…maternal serologies, infant metabolic screening, infant hearing screening, infant APGAR test) 8 [47%] [ 36 , 47 , 50 – 53 , 55 , 56 ] 7 [54%] [ 24 , 33 , 34 , 37 , 38 , 42 , 44 ] Treatment (e.g. newborn immunisations, infant HepB vaccine, ARVs for mother and baby if HIV+) 6 [35%] [ 32 , 35 , 36 , 51 , 52 , 56 ] 8 [62%] [ 24 , 33 , 34 , 37 , 38 , 42 – 44 ] Knowledge, ability and confidence regarding self-care and infant care 13 [76%] [ 11 , 12 , 25 , 31 , 35 , 36 , 47 – 53 ] 11 [85%] [ 24 , 33 , 34 , 37 – 40 , 42 – 45 ] Education (information provided to mother on various topics e.g. breastfeeding, care of newborn, car seat safety, family planning, hygiene practices) 3 [18%] [ 36 , 47 , 52 ] 10 [77%] [ …”