Intervention Review

Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home

  1. Anne Johnson1,*,
  2. Jayne Sandford1,
  3. Jessica Tyndall2

Editorial Group: Cochrane Consumers and Communication Group

Published Online: 20 OCT 2003

Assessed as up-to-date: 9 SEP 2005

DOI: 10.1002/14651858.CD003716


How to Cite

Johnson A, Sandford J, Tyndall J. Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003716. DOI: 10.1002/14651858.CD003716.

Author Information

  1. 1

    Flinders University, Department of Public Health, School of Medicine, Adelaide, South Australia, Australia

  2. 2

    Flinders University, Gus Fraenkel Medical Library, Adelaide, SA, Australia

*Anne Johnson, Department of Public Health, School of Medicine, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia. anne.johnson@flinders.edu.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 OCT 2003

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

It is becoming commonplace for patients to be discharged earlier from acute hospital settings to their own homes and be required to manage various aspects of their own care. This has increased the need for detailed information to be given to patients and/or significant others to enable them to effectively manage care at home. It has been suggested that providing written health information can assist in this self management.

Objectives

To determine the effectiveness of providing written health information in addition to verbal information for patients and/or significant others being discharged from acute hospital settings to home.

Search methods

Computerised searches from 1990 to September 2005 in the Cochrane Consumers and Communication Review Group Specialised Register and Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), EMBASE, CINAHL, PsycINFO, ERIC, OVID (including Ageline, EBM Reviews, DARE, Best Evidence, Pre-MEDLINE and PsycARTICLES), Sociological abstracts, Austhealth and bibliographies in articles that met inclusion criteria.

Selection criteria

Articles were selected if they were randomised control trials or controlled clinical trials; included patients discharged from acute hospital settings to home; the patient and/or significant others received written health information and verbal information in the intervention group, and verbal information only in the control group; and the intervention (written health information and verbal information) was provided at discharge.

Data collection and analysis

Two review authors independently screened abstracts to determine relevance. Relevant full paper copies were then reviewed against the inclusion criteria. The findings were extracted by one author and confirmed by the other author. The two trials that met the inclusion criteria were too disparate to warrant meta-analysis.

Main results

The participants in the two trials were parents of children who were discharged from children's hospitals, one in the United States (n = 197) the other in Canada (n = 123). Provision of verbal and written health information significantly increased knowledge and satisfaction scores.

Authors' conclusions

This review recommends the use of both verbal and written health information when communicating about care issues with patients and/or significant others on discharge from hospital to home. The combination of verbal and written health information enables the provision of standardised care information to patients and/or significant others, which appears to improve knowledge and satisfaction. Many of our objectives could not be addressed in this review due to lack of trials which met the review's inclusion criteria. There is therefore scope for future research to investigate the effects of providing verbal and written health information on readmission rates, recovery time, complication rates, costs of health care, consumers' confidence level, stress and anxiety and adherence to recommended treatment and staff training in the delivery of verbal and written information. In addition there are other factors which impact on the effectiveness of information provided that were not considered in this review but are worthy of a separate systematic review, such as the impact of patient and/or significant others being involved in the development of the written information and cultural issues around development and provision of information. Due to concerns about literacy levels for some population groups, other systematic reviews should also focus on other modes of delivery of information besides the written format.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Written and verbal information, compared to verbal information only, for people being discharged from hospital

When children are discharged from hospital, parents' understanding of how to continue care at home is better if they receive both written and verbal information.

When people are discharged from hospital, they and/or their carers are given information on how to manage care effectively at home. Hospital staff usually explain what is required verbally and may also give written, or even video-taped, information. The review of hospital discharge information found only studies looking at parents caring for their children. Parents had a better understanding of the care needed when given both written and verbal instructions, rather than verbal instructions alone. Further research is needed to determine if this leads to better health outcomes and faster recovery times, and on discharge information for other hospital patients.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

對照急性病人出院時,提供口頭加上書面衛教或僅口頭衛教的不同

病人提早從急性病房出院回家休養,以及打理出院回家後各方面的自主健康照護,已經是一件很平常的事了。因此這也提升了對各種疾病衛教的需求,以便讓病人以及/或其他照護者出院回家後,可以更有效地達到照顧的目的。一般認為提供書面的疾病衛教資料,對出院的病人以及家屬是有幫助的。

目標

確認除提供口頭衛教資料之外,再提供書面衛教資料給出院病人以及/或其他照護者的影響力。

搜尋策略

我們以電腦化的搜尋方式,搜尋了從1990年到2005年9月這期間的資料庫Cochrane Consumers and Communication Review Group Specialised Register and Cochrane Central Register of Controlled Trials (CENTRAL) 、也同時搜尋了MEDLINE (Ovid) 、EMBASE、CINAHL、PsycINFO、ERIC、 OVID (包含Ageline, EBM Reviews, DARE, Best Evidence, PreMEDLINE 以及 PsycARTICLES) 、Sociological的摘要, 以及搜尋在Austhealth以及bibliographies中所有符合納入條件的論文。

選擇標準

作者選擇以從急性病房出院的病人,為實驗對象的隨機對照臨床試驗,或是控制臨床試驗的論文,在實驗組中,當病人出院的時候,同時提供病人以及主要照顧者口頭及書面的衛教資料,而在對照組中,只有提供他們口頭的衛教資料。

資料收集與分析

2位評論作家分別獨立篩選一些摘要,以確認其關連性。評論相關全文副本以確認符合納入條件。由1位作者摘錄結果,而由另1位作者確認。本文所選取2個符合納入條件的臨床試驗之間差異性很大,因此無法進行統合分析,達到與研究主題有關的整合性結論。

主要結論

這2個臨床試驗的參與者都是從兒童醫院出院病童的父母,其中1個臨床試驗是在美國進行(個案有197位),另1個臨床試驗是在加拿大進行(個案有123位)。研究結果發現,同時提供口語以及書面的疾病衛教資料明顯地提升了知識以及滿意度。

作者結論

這篇評論建議,在跟病人以及/或主要照顧者做出院衛教的時候,應該要同時提供口頭以及書面的資料。同時給予口頭以及書面衛教資料,可以確保提供給出院病人或主要照顧者的資訊一致,也可以提升保健知識以及滿意度。因為缺乏符合納入條件的臨床研究,所以這篇評論有很多當初訂定的目標無法達成。這也提供機會讓未來的研究可以調查如提供出院病人口頭以及書面衛教資料後,病人再住院率、併發症的機率、出院病人復原所需的時間、健康照護所需的成本、消費者信心水準、壓力以及焦慮,還有病人是否有遵循醫護人員所建議的健康指導原則,以及提供口頭以及書面衛教資料的專業人員訓練。除此之外,還有其它沒有被這篇評論考慮到的影響因素,倒是值得另外探討,例如:病人以及/或主要照護者對書面衛教資料以及文化議題的影響。因為受限於一些族群的知識,其它系統性的評論應該也要將焦點放在提供書面衛教資訊以外的方法。

翻譯人

本摘要由成功大學附設醫院蔡佩蓉翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

當病童從醫院出院後,如果能從醫護人員那同時得到口頭以及書面的衛教資訊,父母會比較瞭解如何在家持續照護。當病人出院時,醫護人員會提供他們以及/或主要照顧者,如何有效地在家自主管理健康的資料。醫護人員通常會對他們進行口頭的衛教,有時候也會同時給予書面資料,甚至會將資料存放在錄影帶裡,讓他們可以在家觀看。這篇關於出院病人衛教的評論只著眼於父母在家照護出院病童的研究資料。當醫護人員同時給予出院病童的父母口頭以及書面衛教資料的時候,父母會比只給予口頭的衛教時更能瞭解如何居家照護。我們需要進一步的研究,來確認同時給予口頭以及書面衛教資料,是否可以讓出院的病人更健康、縮短復原的時間以及提供其他住院病人資訊。