Person-centred discharge education following coronary artery bypass graft: A critical review

Construction and validation of an educational booklet for patients in the postoperative period of cardiac surgery: a methodological study

OBJECTIVE

to construct and validate an educational booklet for self-care of patients in the postoperative period of cardiac surgery.

METHODS

methodological study, including bibliographic survey, construction of the booklet and validation with judges and the target audience. For validation with judges, the Health Educational Content Validation Instrument was used, and with the target audience, an instrument was used with questions related to organization, writing style, appearance and motivation. To analyze the judges' answers, the content validation index was used.

RESULTS

the booklet was prepared with 14 topics. The content validation index among the eight judges was 1 and the concordance index among the ten patients was above 80%. The final version of the material was made available in printed format.

CONCLUSION

the educational booklet was developed and validated by judges and the target audience, serving as an educational support tool for self-care of patients in the postoperative period of cardiac surgery.

The impact of a self-management program on exercise adherence among patients discharged after coronary artery bypass grafts: A quasi-experimental study in Thailand

Background

Exercise adherence is essential for maintaining the physical and mental health of patients after coronary artery bypass grafts (CABG). However, adherence is often poor, particularly in the early weeks after hospital discharge, leading to adverse health outcomes. Therefore, implementing self-management programs is crucial to promote and sustain long-term exercise adherence among these patients.

Objective

This study aimed to examine the impact of self-management programs on exercise adherence in post-CABG patients.

Methods

A quasi-experimental posttest-only control group study was conducted from April to November 2022 at Surat Thani Hospital in Thailand. Forty post-CABG patients were gender and age-matched and randomly assigned to either the control group (n = 20) or the experimental group (n = 20). The experimental group participated in a six-week self-management program for exercise adherence, utilizing telephone and LINE applications, while the control group received standard care. Data were collected using validated exercise adherence rating scales and a self-management questionnaire. Descriptive statistics and independent t-tests were employed for data analysis.

Results

The mean exercise adherence score in the control group was 9.30 (SD = 4.91), whereas it was 21.30 (SD = 3.20) in the experimental group. The experimental group, which received the self-management program, exhibited significantly higher exercise adherence scores compared to the control group (t = 9.16, df = 32.65, p <0.001).

Conclusions

This study demonstrates the effectiveness of a post-CABG self-management program in improving exercise adherence. Nurses play a crucial role in promoting and enhancing self-management during the pre-and post-discharge phases, and regular phone or LINE application contacts can have a positive impact on post-CABG patients. Policymakers should consider implementing self-management programs to encourage patients to maintain their exercise routines, leading to improved physical and mental well-being.

Levels of Surgical Patients' Education Related to Surgical Interventions Among Patients in Saudi Arabia

BACKGROUND

Patient education and counseling should simplify and clarify the condition, surgery, postoperative care, and potential complications. This study aimed to determine the levels of surgical patients' education regarding surgical interventions among patients in Saudi Arabia.

METHOD

This was an online survey study that was conducted between January and May 2023 to determine the levels of surgical patients' education regarding surgical interventions among patients in Saudi Arabia. The study population was patients who underwent surgeries (elective and emergency) living in Saudi Arabia. The questionnaire tool used in this study was developed based on an extensive literature review in the field of patients' education regarding surgical interventions. Binary logistic regression analysis was used to identify predictors of satisfaction with the callouts and the surgeon-consultant's communication quality.

RESULTS

A total of 1360 participants were involved in this study. Around 40.5% of the participants reported that they met the surgeon after diagnosing and recommending the issue. Almost 70.0% of research participants reported that the consultant surgeon personally explained a diagnosis or strategy to attain it and the surgical technique, method, and purpose before signing the informed consent. The majority of study participants reported that the consulting surgeon or a member of his surgical team explained the stages of reaching a diagnosis and the steps he/she will take to diagnose their condition (83.2%), discussed the diagnosis with them and how certain they are of the diagnosis (88.1%), described the surgery clearly and simply (85.5%), informed them of alternatives to surgical intervention (63.1%), and discussed the entire postoperative treatment plan (81.8%), informed them of possible postoperative complications (79.6%), used additional callout during the discussion (81.3%), and spoke to them after the surgery and before they left the hospital (69.2%). After a conversation with their doctors, 36.3% of study participants said they did not require an outside source to understand the diagnosis, operation, probable problems, treatment plan, and follow-up. Discussion "Just talk," sketching, and pictograms were the most popular callouts during patient education, with 78.3%, 22.3%, and 17.9%, respectively. Saudi participants were more likely to be satisfied with the quality of communication by the surgeon-consultant (p<0.05). At the same time, participants who live in the Southern area were less likely to be satisfied with the quality of communication by the surgeon-consultant (p<0.05).

CONCLUSION

This study highlights the crucial role of surgeons in preoperative patient education as well as the significance of surgical team participation in this process. In order to increase patient knowledge, facilitate treatment decisions, and assure informed consent, it is necessary to establish guidelines and roles to improve surgeon-patient communication, increase patient and surgeon awareness, nurture patient concern expression, and encourage non-medical patient participation.

Patient experiences of, and preferences for, surgical wound care education

The aim of this study was to describe patients' experiences of, and preferences for, surgical wound care discharge education and how these experiences predicted their ability to self-manage their surgical wounds. A telephone survey of 270 surgical patients was conducted across two hospitals two weeks after discharge. Patients preferred verbal (n = 255, 94.8%) and written surgical wound education (n = 178, 66.2%) from medical (n = 229, 85.4%) and nursing staff (n = 211, 78.7%) at discharge. The most frequent education content that patients received was information about follow-up appointments (n = 242, 89.6%) and who to contact in the community with wound care concerns (n = 233, 86.6%). Using logistic regression, patients who perceived that they participated in surgical wound care decisions were 6.5 times more likely to state that they were able to manage their wounds at home. Also, patients who agreed that medical and/or nursing staff discussed wound pain management were 3.1 times more likely to report being able to manage their surgical wounds at home. Only 40% (107/270) of patients actively participated in wound-related decision-making during discharge education. These results uncovered patient preferences, which could be used to optimise discharge education practices. Embedding patient participation into clinical workflows may enhance patients' self-management practices once home.

Effectiveness of discharge education for patients undergoing general surgery: A systematic review and meta-analysis

BACKGROUND

There is some evidence to suggest that discharge education may reduce the risk of postoperative complications, however, a critical evaluation of the body of evidence is needed.

OBJECTIVE

To assess the effect of discharge education interventions versus standard education given to general surgery patients prior to, or up to 30-days of hospital discharge on clinical and patient-reported outcomes.

DESIGN

Systematic review and meta-analysis. Clinical outcomes were 30-day surgical site infection incidence and re-admission up to 28 days. Patient-reported outcomes included patient knowledge, self-confidence, satisfaction, and quality of life.

SETTING

Participants were recruited from hospitals.

PARTICIPANTS

Adult general surgical patients.

METHODS

MEDLINE (Pubmed), CINAHL (EBSCO), EMBASE (Elsevier) and the Cochrane Library were searched in February 2022. Randomised controlled trials and non-randomised studies of interventions published between 2010 and 2022, with adults undergoing general surgical procedures receiving discharge education on surgical recovery, including wound management, were eligible for inclusion. Quality appraisal was undertaken using the Cochrane Risk of Bias 2 and the Risk of Bias Assessment Tool for Nonrandomised Studies. The Grading of Assessment, Development, Recommendations, and Evaluation was used to assess the certainty of the body of evidence based on the outcomes of interest.

RESULTS

Ten eligible studies (eight randomised control trials and two non-randomised studies of interventions) with 965 patients were included. Six randomised control trials assessed the effect of discharge education interventions on 28-day readmission (Odds ratio 0.88, 95 % confidence interval 0.56-1.38). Two randomised control trials assessed the effect of discharge education interventions on surgical site infection incidence (Odds ratio = 0.84, 95 % confidence interval 0.39-1.82). The results of the non-randomised studies of interventions were not pooled due to heterogeneity in outcome measures. The risk of bias was either moderate or high for all outcomes, and the body of evidence using GRADE was judged as very low for all outcomes studied.

CONCLUSIONS

The impact of discharge education on the clinical and patient-reported outcomes of patients undergoing general surgery cannot be determined due to the uncertainty of the evidence base. Despite the increased use of web-based interventions to deliver discharge education to general surgery patients, larger samples in more rigorous multicentre randomised control trials with parallel process evaluations are needed to better understand the effect of discharge education on clinical and patient-reported outcomes.

REGISTRATION

PROSPERO CRD42021285392.

TWEETABLE ABSTRACT

Discharge education may reduce the likelihood of surgical site infection and hospital readmission but the body of evidence is inconclusive.

Discharge Readiness and Associated Factors Among Postpartum Women in Tamale, Ghana

Ghana experiences a relatively high maternal mortality ratio, with the majority of maternal deaths occurring in the postpartum period. Discharge readiness is a reliable indicator of maternal health outcomes and involves a postpartum woman's perception of preparedness to leave the hospital following delivery. We measured the discharge readiness of postpartum women in Ghana through an institutional-based cross-sectional study involving 151 participants. Participants completed an interviewer-administered survey, and data analyses included linear regression models. The study sample demonstrated relatively high discharge readiness, with a mean score of 177.57 on a scale from 0.00 to 220.00. Higher gravidity was positively associated with discharge readiness score, while longer length of hospital stay and receiving educational handouts were negatively associated with discharge readiness score. Clinical interventions addressing the factors found to be associated with discharge readiness have significant potential to improve postpartum care and maternal outcomes in Ghana.

Patient perceptions of care quality and discharge information following same-day cardiac catheterization laboratory procedures: A mixed-methods study

AIMS

To examine patients' perceptions of care quality following a same-day procedure in the cardiac catheterization laboratory and understand the extent to which they were prepared for discharge.

DESIGN

Single-centre, mixed-methods study.

METHODS

Postdischarge, online survey of patients who underwent a same-day procedure in the cardiac catheterization laboratory (n = 150) and one-on-one interviews with 13 of these patients.

RESULTS

Survey responses were positive with mean scores between 4.39-4.83 out of five and 63.3% of respondents (n = 95) extremely likely to recommend the service to others. Interview data analysis identified three themes: the care experience, information and education for safe discharge, and follow-up needs. Participants spoke highly of their interactions with clinicians and were satisfied with their care experience. Mode and content of information delivered varied, with some participants lacking guidance about postdischarge health management and clarity about follow-up plans.

PATIENT OR PUBLIC CONTRIBUTION

Participants were patients.

Controlled pilot test of a translated cardiac rehabilitation education curriculum in percutaneous coronary intervention patients in a middle-income country delivered using WeChat: acceptability, engagement, satisfaction and preliminary outcomes

In China, despite the rapid increase in percutaneous coronary interventions (PCIs), cardiac rehabilitation (CR) is just burgeoning, leaving a need for comprehensive evidence-based education curricula. This pilot study assessed the acceptability of Simplified Chinese CR education delivered via booklets and videos on WeChat asynchronously and the impact on improving knowledge, risk factors, health behaviors and quality of life. In this pre-post, controlled, observational study, interested PCI patients received the 12-week intervention or usual care and WeChat without education. Participants completed validated surveys, including the Coronary Artery Disease Education-Questionnaire and Self-Management Scale. Acceptability (14 Likert-type items), engagement (minutes per week) and satisfaction were assessed in intervention participants. Ninety-six patients consented to participate (n = 49 intervention), of which 66 (68.8%) completed the follow-up assessments. Twenty-seven (77.1%) retained intervention participants engaged with the materials, rating content as highly acceptable (all means ≥4/5) and satisfactory (2.19 ± 0.48/3); those engaging more with the intervention were significantly more satisfied (P = 0.03). While participants in both groups achieved some improvements, only intervention participants had significant increases in disease-related knowledge, reductions in body mass index and triglycerides, as well as improvements in diet (all P < 0.05). In this first study validating the recently translated CR patient education intervention, acceptability and benefits have been supported.

Learning Needs and Educational Strategies for Adult Patients in the Preoperative Period of Myocardial Revascularization: Scoping Review

Objective: To identify and map learning needs and educational strategies for adult patients in the preoperative period of myocardial revascularization. Materials and method: Scoping review conducted between March and April 2021 in national and international databases to identify records published in scientific journals and gray literature, without period. Results: The selected sample consisted of 35 records, composed mostly of articles (32; 91.42 %) published from 1990 to 2021. The learning needs of patients before surgery were categorized into cardiovascular system and coronary artery disease; procedures and routines before, during, and after surgery. In addition, several educational strategies implemented in the studies were identified. Conclusions: The learning needs identified can contribute to planning and implementing patient-centered educational strategies before surgery.

Continuity of Nursing Care in Patients with Coronary Artery Disease: A Systematic Review

Coronary artery disease is the leading cause of death worldwide and patient continuity of care is essential. Health professionals can help in the transition stage by providing resources to achieve pharmacological treatment adherence, as well as social and emotional support. The objective was to analyse the effects of nursing interventions based on continuity of care in patients with coronary artery disease after hospital discharge. A systematic review of randomised controlled trials and quasi-experimental studies was carried out. Cochrane, CINAHL, Health & medical collection, Medline, and Scopus databases were consulted in January 2022. PRISMA guidelines were followed with no time limits. In total, 16 articles were included with a total of 2950 patients. Nurse-led continuity of care programs improved the monitoring and control of the disease. Positive effects were found in the quality of life of patients, and in mental health, self-efficacy, and self-care capacity dimensions. Clinical parameters such as blood pressure and lipid levels decreased. The continuity of care provided by nurses had a positive influence on the quality of life of patients with coronary artery disease. Nurse-led care focused on the needs and resources, including continuity of care, plays a key role.

A quality improvement initiative for patient knowledge comprehension during the discharge procedure using a novel computer-generated patient-tailored discharge document in cardiology

Objective

The duration of hospital admissions has shortened significantly. This challenges healthcare professionals to provide the necessary information and instructions in a limited time. Patient-tailored discharge information may improve the patient's understanding of the discharge information but may also be time-consuming. The objective of this descriptive quality improvement study was to evaluate patient comprehension of discharge information using a novel computer-generated patient-tailored discharge document.

Methods

A prospective pre-post study comparing patient-tailored discharge information with conventional discharge information, for patients undergoing an electrophysiological procedure during two periods of six weeks between January and March 2016.

Group I received conventional discharge information (n  =  55). Group II received a computer-generated, patient-tailored discharge document (n  =  57). Their comprehension of the discharge information was evaluated using a peer-reviewed questionnaire distributed among patients, comparing groups I and II using Likert scales. Nurses and nurse practitioners evaluated the use of personalized discharge information by means of a short survey.

Results

In terms of discharge information, comprehensibility was equivalent; however, an increase in comprehension was observed in patients seeking a telephone consultation with the cardiology department within one-week post-discharge. A reduction in discharge preparation time and an increased uniformity of discharge information were reported by nurses. Nurse practitioners found the web tool easy to use and time-saving.

Conclusions

In this study, computer-generated patient-tailored discharge information was equivalent to conventional discharge information. A more positive trend was seen for patients who initiated teleconsultation with the hospital within one-week post-discharge. This suggests that for this subgroup the patient-tailored discharge web tool might lead to an improvement in care. However, more research with a larger number of participants is needed to confirm this trend.

"Walking in the patient's shoes": An innovative training method using storytelling to promote knowledge transfer of patient-centered care in hospital: A quasi-experimental study

OBJECTIVE

To evaluate an onsite patient-centered care (PCC) training program for nurses using a digital patient-storytelling approach.

BACKGROUND

PCC is a dominant model for improving the quality of care. Effective strategies for providing PCC training to nurses can yield numerous benefits.

DESIGN

A pretest-posttest design was used with a nonrandomized control group METHODS: PCC training program involved participants playing a patient role to experience their hospital journey. Nurses' perception of PCC, compassion and knowledge transfer were measured before (pretest) and after (posttest) PCC training (experimental group). Controls received PCC training only after pretest and posttest evaluations.

RESULTS

Changes in PCC perception and compassion were significantly greater in the experimental group (n = 39) than in controls (n = 49; p = .001 and .006, respectively). PCC knowledge transfer was significantly correlated with PCC perception (r = 0.55) and compassion (r = 0.63).

CONCLUSIONS

Through the PCC training program, the perceived improvements of the nurses' views on supporting patient individuality and compassion while providing care were revealed. This program is also potential for promoting PCC knowledge transfer into the daily activities of nurses. Therefore, such PCC training programs could be a good beginning in developing a patient-centered culture in healthcare systems.

Education interventions in Chinese cardiac patients on health behaviours, disease-related knowledge, and health outcomes: A systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis aimed to summarize and synthesize the available evidence in adult Chinese cardiac patients to determine the effect of education interventions on health behaviours, disease-related knowledge, self-efficacy, depressive symptoms, anxiety symptoms, health-related quality of life, morbidity, and mortality.

METHODS

Seven databases were searched from database inception until January 2020 for randomized controlled trials. Characteristics of education interventions were described and random-effects meta-analysis was performed where feasible.

RESULTS

Overall, 18 randomized controlled trials were included in this systematic review and suggested that education interventions are effective in improving patients' physical activity, dietary habits, medication behaviour, disease-related knowledge, and health-related quality of life. Meta-analysis of two studies demonstrated benefit on physical activity (standardized mean difference [SMD] 1.27, 95% confidence interval [CI] 1.06-1.48; participants = 422; I² = 0%), dietary habits (SMD 0.76, 95%CI 0.44-1.08; participants = 422; I² = 61%), and medication behaviour (mean difference [MD] 0.31, 95%CI 0.17-0.46; participants = 422; I² = 28%).

CONCLUSION

This study supports the benefits of education interventions for adult Chinese cardiac patients on health behaviours, disease-related knowledge, and health-related quality of life. Future studies should characterize their education interventions in detail to facilitate reproducibility and comparison.

PRACTICE IMPLICATIONS

This study identified the need for studies on the outcome of alcohol consumption and in Chinese immigrant populations.

Development and Psychometric Properties Evaluation of a Care Needs Questionnaire in Phase 1 Cardiac Rehabilitation for Patients with Coronary Artery Disease: CNCR-Q

Introduction: Cardiovascular diseases (CVDs) are one of the most common chronic illnesses and the leading cause of mortality worldwide. This study aimed to design and assess the psychometric properties of questionnaire to examine the care needs of patients with coronary artery disease (CAD) in phase 1 of cardiac rehabilitation (CR).

Methods: This sequential exploratory study used a mixed method with two phases. In the first phase, qualitative study was performed by analyzing the concept of Schwartz-Barcott-Kim hybrid model; and in the second phase, quantitative data were obtained and analyzed for the psychometric parameters of the designed tool.

Results: The questionnaire for care needs was based on the indicators of measurement, which was identified in the qualitative phase of the study, as a tool with 40 items. After conducting face validity qualitatively, all tool items were considered important and were retained for the next steps. After completing the steps for determining the content validity ratio (CVR) and content validity index (CVI) of 40 items, they were preserved for decision making at a later stage. The results of exploratory factor analysis revealed four factors; the factor analysis of three items was eliminated and the final version of the questionnaire CNCR-Q (Care Needs Cardiac Rehabilitation-Questionnaire) with 37 items remained.

Conclusion: The findings indicated that the questionnaire with properties, such as simple scoring, reliability and validity, is an appropriate tool for assessing care needs in Iranian patients with CAD. Moreover, the CNCR-Q is an effective instrument for assessing patient needs before discharge.

Understanding preparation for preterm infant discharge from parents' and healthcare providers' perspectives: Challenges and opportunities

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.

Patient education interventions for health behaviour change in adults diagnosed with coronary heart disease: A protocol for a systematic review and meta-analysis

AIM

To assess the efficacy of structured patient education on disease-related knowledge and health behaviour change outcomes in adults with coronary heart disease.

DESIGN

Systematic review and meta-analyses including meta-regression on education duration.

METHODS

Seven databases (including Medline, Pubmed (non-Medline), CINAHL, PsycINFO, Embase, Emcare and Cochrane central register of controlled trials) will be searched from inception through 2020 to identify relevant randomized controlled trials testing interventions to improve health behaviours and disease-related knowledge in adults with coronary heart disease. Risk for bias will be assessed using the Cochrane Risk for Bias tool. Data will be synthesized using random-effects meta-analyses in Comprehensive Meta-Analysis Version 3. Heterogeneity will be assessed using Cochrane's Q statistic and the I-squared statistic will be reported. Meta-regression will be used to determine the effect of intervention duration. Publication bias will be assessed using funnel plots and Egger's test and which will be adjusted by conducting the trim-and-fill test when necessary. Funding for this project began in March 2020.

DISCUSSION

We will examine knowledge and behaviour outcomes including physical activity, dietary habits, smoking and medication adherence for patients with coronary heart diseases. This review will be the most comprehensive meta-analysis of structured patient education interventions to date and the first to analyse the effect of education duration.

IMPACT

The efficacy of patient education on knowledge and behaviour outcomes for patients with coronary heart diseases has not yet been established. This systematic review will determine the efficacy of structured patient education on knowledge and behaviour outcomes and determine whether the duration of patient education influences patient outcomes and thus guide intervention design. PROSPERO registration Number: CRD42020173467.

[Discharge education, a new type of therapeutic patient education. Quality criteria and perspective of application to our context]

Patient education prior to discharge from hospital is a practice developed under the name of "discharge education" (DE) in the Anglo-Saxon countries. This new form of patient education targets acute and sometimes chronic patients and concerns all hospital specialties ; it aims to facilitate the transition "hospitalhome" and avoid early readmissions. In this article we want to outline a framework of indications and effects of DE, starting from an analysis of the international literature, and identify its quality criteria in order to forecast the conditions of its application to our context. A scoping review allowed us to examine 43 scientific studies specifically related to the description, analysis and evaluation of discharge education, as well as some recommendations. Almost half of the studies are published in Nursing Science journals. DE is an intense and short educational intervention (30 minutes to an hour) delivered mainly in acute situations. Paediatrics has the largest number of publications together with post-operative care. In most studies, DE is effective in improving clinical and psychosocial parameters, reducing early admissions, increasing skills and patient compliance. To achieve its goals, DE must be structured and include systematic follow up. Focused on the patient's needs and his learning ability, it uses a specific interactive pedagogy to which caregivers must be trained. The analysis of the international research leaves no doubt about the positive contributions of DE. It would be important for caregivers and policymakers to look at it as an opportunity to improve the quality of care and to humanize it.

The effect of a structured patient education intervention on the quality of life for coronary artery bypass grafting patients: A prospective randomised controlled study

This study aimed to determine the effectiveness of structured patient education on the quality of life for coronary artery bypass grafting patients. The research included 80 patients (40 control, 40 experimental) who underwent coronary artery bypass graft surgery at the cardiovascular surgery ward of a university hospital in Western Turkey and met the criteria to be included in the sample. The following documents were used to collect data: Patient Information Form, Knowledge Level Form and SF36 Quality of Life Scale. It was determined that the structured planned patient education for coronary artery bypass grafting patients effectively improved the patients' knowledge level and quality of life.

Investigating the Effect of a Structured Discharge Training Program on Patient Outcomes Following Gynecologic Oncology Surgery

This study aimed to investigate the effect of a discharge training program structured according to the Roy adaptation model (RAM) on patient outcomes (quality of life, coping-adaptation, self-esteem) following gynecologic oncology surgery. This nonrandomized intervention studies consisted of two stages. In the first stage, patients were interviewed, patient needs after discharges were determined. Interview data were analyzed, and RAM-based training booklet was prepared. This booklet was prepared in line with a number of themes. In the second stage, the study was conducted with a sample of 36 control and 36 intervention patients, who were included in the discharge training program. Data was collected preoperatively, at 9^th and 13^th weeks after discharge. The mean quality of life and coping/adaptation scores of the intervention group at 13^th weeks were significantly higher than those of the control group, however, no significant difference was found between the groups in terms of mean self-esteem scores.

Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis

Coronary artery bypass graft surgery (CABG) might adversely affect the health status of the patients, producing cognitive deterioration, with depression being the most common symptom. The aim of this study is to analyse the prevalence of depression in patients before and after coronary artery bypass surgery. A systematic review and meta-analysis was carried out, involving a study of the past 10 years of the following databases: CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The total sample comprised n = 16,501 patients. The total number of items was n = 65, with n = 29 included in the meta-analysis. Based on the different measurement tools used, the prevalence of depression pre-CABG ranges from 19-37%, and post-CABG from 15-33%. There is a considerable presence of depression in this type of patient, but this varies according to the measurement tool used and the quality of the study. Systematically detecting depression prior to cardiac surgery could identify patients at potential risk.

General surgical patients' experience of hospital discharge education: A qualitative study

AIMS AND OBJECTIVES

To explore adult general surgical patients' perceptions of, and satisfaction with, discharge education provided by healthcare providers.

BACKGROUND

Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self-manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience.

DESIGN

A constructivist-interpretivist paradigm using qualitative interviews.

METHODS

Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study.

RESULTS

Four themes were uncovered: (a) The quality of discharge information influences patients' postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients' preferences with the delivery of discharge education.

CONCLUSION

Inadequate discharge education leads to patients' inability to self-manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations.

RELEVANCE TO CLINICAL PRACTICE

Understanding patients' view may inform the design of patient-centred discharge education interventions for patients to self-manage their recovery postdischarge.

Évaluation quadriennale des programmes d’ETP en Île-de-France : un moyen de pilotage régional

Introduction : Dans le cadre de la première évaluation quadriennale des programmes d’Éducation Thérapeutique du Patient (ETP) en Île-de-France, l’agence régionale de santé d’Île-de-France a marqué sa volonté de décrire et d’analyser l’offre des programmes d’ETP initialement autorisés entre 2010 et début 2011. Méthode : L’étude s’est déroulé en deux temps à partir d’une démarche méthodologique mixte selon un design explicatif afin d’approfondir et expliquer les premiers résultats quantitatifs (obtenus par un traitement statistique des résultats au moyen de pourcentages) par des données qualitatives (à partir de focus groups). Résultats : Sur les 600 programmes franciliens autorisés entre 2010 et début 2011, 515 programmes ont été reconduits avec seulement 10 % d’arrêts après 4 ans. On constate une augmentation régulière du nombre de patients inclus dans les programmes d’ETP. L’offre est centrée sur Paris et la petite couronne par le simple fait que l’AP-HP est le principal promoteur de programmes. Trois quarts des programmes sont portés par des centres hospitaliers et seulement 18 % d’entre eux sont proposés en dehors. L’étude a confirmé le caractère multi professionnel et interdisciplinaire des programmes. Le soutien et la formation des équipes à l’évaluation des programmes d’ETP apparaissent comme une nécessité pour ces dernières. Discussion : L’investissement des acteurs de l’ETP est incontestable, tant par le nombre et la variété des programmes, les files actives de patients éduqués, que par la quantité de personnels mobilisés. Néanmoins, d’ETP est encore loin d’être homogène et équitablement répartie entre pathologies, les publics bénéficiaires, les territoires et les structures de soins. Ainsi, une telle étude questionne plus largement l’intégration de l’ETP dans une stratégie d’amélioration de la qualité de la prise en charge des maladies chroniques.