Development of a web-based discharge education intervention to improve the postdischarge recovery of general surgical patients

J Nurs Scholarsh. 2022 Mar;54(2):143-151. doi: 10.1111/jnu.12717. Epub 2021 Nov 5.

Abstract

Background: Postoperative complications contribute to unplanned hospital readmissions, reoperations, and increased mortality for surgical patients. Discharge education for general surgical patients is often inadequate, and challenged by organizational, clinician and patient factors.

Purpose: This research describes the development of the web-based discharge education intervention to improve patients' knowledge, skills, and confidence in self-managing their recovery after general surgery.

Methods: The intervention was informed by the UK Medical Research Council guidance for developing and evaluating complex interventions and Knowledge-to-Action framework, consisting of four iterative stages. Stakeholder engagement was undertaken throughout the development process and a logic model was utilized to map the working mechanism of the intervention. The concept of patient activation and Knowles adult learning theory underpinned the development process.

Results: The literature review and stakeholders' engagement in qualitative interviews and a series of meetings resulted in a web-based discharge education program with three different components: (1) post general surgery warning signs; (2) post general surgery everyday care instructions; and (3) animation video on wound potential wound complications.

Conclusion: The web-based discharge education was developed according to the needs and preferences of healthcare providers and general surgical patients. Despite the rigorous and systematic approach used to develop the intervention, its effectiveness requires testing.

Clinical relevance: This comprehensive iterative approach serves as a guide for others planning web-based interventions designed for surgical patients and the research approach used may inform those developing web-based interventions for other patient groups.

Keywords: discharge education; general surgery; logic model; patient activation; patient education; patient engagement; web-based intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aftercare
  • Health Personnel / education
  • Humans
  • Internet-Based Intervention*
  • Patient Discharge*
  • Patient Readmission