Background: Accumulating literature promotes early discharge education and transparency about hospitalization goals and discharge criteria as a key element of effective care transitions. However, little is known about the prevalence or nature of parental concerns about discharge during their child’s hospitalization. Our objective was to understand the prevalence and nature of parental concerns about discharge during their child’s hospitalization.
Methods: Both grounded theory and quantitative methods were used to identify parental concerns about taking their child home. Parents and caregivers of non-technology dependent children less than 2 years of age or between the ages of 2-17 with asthma hospitalized on an acute care unit were asked the following questions: “Do you have concerns about taking your child home?,” and if “yes” then “What are your concerns?” The interview was performed on any of day of hospitalization prior to the performance of discharge education. The interviewer noted the responses, which were then coded into distinct themes. Categorical subgroups were not established due to small sample size and answer similarity. Descriptive statistics were performed to identify the percent of parents with concerns and the most frequently cited concerns about going home.
Results: 100 parents and caregivers completed the interview. 36% of the parents had concerns about discharge. 46 concerns were recorded and grouped into 5 themes which included parental concerns about; 1) what to do if the illness recurs at home (42.2%), 2) not wanting child to need to return to the hospital (24.4%), 3) their inability or lack of understanding about how to care for their child at home (17.8%), 4) lack of understanding about what determines discharge readiness (8.9%), and 5) lack of understanding of illness prognosis (6.7%).
Conclusions: More than one-third of parents interviewed had concerns about taking their child home. 67.7% of concerns related to content usually addressed during routine discharge education (groups 1, 3, and 5). Additionally, clear parental understanding of the discharge criteria and goals may have addressed 33.3% of remaining concerns (groups 2 and 4). These findings suggest that many family concerns regarding discharge could be alleviated by early introduction of discharge criteria, hospitalization goals, and the comprehensive discharge education plan.