Patients Satisfied With Discharge Teaching Quality, Outcomes After Cataract Surgery

Patients who received cataract surgery had discharge planning services that were satisfactory overall, which could lead to improvement of their postdischarge outcomes, according to a new study published in Ophthalmic Research.

Cataracts are one of the most common causes of blindness, with cataract surgery being one of the few ways to counteract vision loss. However, surgery still carries a risk of severe visual impairment due to postop complications. This makes discharge teaching vital so that patients can self-manage their health at home. This study aimed to describe the quality of patients’ discharge teaching, discharge readiness, and postdischarge outcomes; explore the associations in the 3 variables; and determine the difference in discharge teaching quality between inpatient status and day ward patients.

The study took place from September 2019 to December 2020 in an ophthalmology ward in western China. Patients were included if they were 19 years and older, met the diagnostic criteria for cataract and underwent phacoemulsification with intraocular lens implantation, were stable after surgery and met the discharge condition, had normal mental status and communication skills, and were voluntary participants.

The General Information Questionnaire, Quality of Discharge Teaching Scale (QDTS), Readiness for Hospital Discharge Scale (RHDS), and Post-Discharge Outcomes Scale (PDOS) were used in this study.

There were 387 patients included in the study with a median age of 69 years; 59.69% were female patients. The median age of inpatients and day ward patients were 70 and 68 years, respectively. The median length of stay was 2 days, with inpatients staying a median of 6 days and day ward patients staying a median of 1 day. A median preoperative visual acuity of 0.20 was seen.

The median (IQR) score for the QDTS was 156 (143-164), with scores for each question ranging from 0 to 10, overall score ranging from 0 to 180, and higher scores indicating higher quality of discharge. Only 3 items received a median score of less than 9 points: how much information was provided on postdischarge emotional management (5 points), how much practice with medication did the patient receive (7 points), and how much information did patients get about asking for help after returning home (8 points).

The median RHDS score was 187 (172-199), and 96.4% of patients felt they were prepared on their day of discharge. The median scores for the items were 8 or 9 except for a question asking how much the patient knew about community care. Scores ranged from 0 to 220, with higher scores indicating better discharge quality.

The median postoperative visual acuity for participants was 0.80, which indicated an increase of 0.60 compared with baseline. None of the participants reported postoperative complications, although 74 (19.1%) reported some eye discomfort in the form of swelling and pain. The median PDOS score was 78 (76-80) of an 80-point scale, with the “subjective feelings” and “compliance” subscales earning median scores of 23 (21-24) and 56 (52-56), respectively.

The researchers also found that men with a higher family income, better preoperative vision, and younger age were more likely to score higher on the discharge readiness scale. Patients without combined eye disease were also found to have better postdischarge outcomes. Inpatients were also found to have a higher QDTS score than patients in the day ward whereas the PDOS “subjective feelings” score was significantly lower in inpatients compared with patients in the day ward.

There were some limitations to this study. The study used a convenience sample from a single general hospital and it did not include children. Also, the surgical method was limited to solely phacoemulsification with intraocular lens implantation. Most patients were seniors who were not solitary and had good financial status, which could have affected the diversity of the sample population. Short-term self-report postdischarge outcomes also were the only available data involved, which could have influenced the results of the study.

The researchers concluded that patients were satisfied with discharge teaching quality, were well prepared for discharge, and had good postoperative outcomes.

Reference

Qiu C, Feng X, Zeng J, Jiang Y. Relationships between cataract surgery patient-perceived discharge teaching quality, discharge readiness, and post-discharge outcomes: a cross-sectional study based on regression modeling analysis. Ophthalmic Res. Published online November 9, 2022. doi:10.1159/000527958