Readiness for Hospital Discharge among Family Caregivers of Patients with Chronic Diseases

Indonesian Journal of Global Health Research Volume 6 Number 4, Agustus 2024 e-ISSN 2715-1972; p-ISSN 2714-9749 http://jurnal.globalhealthsciencegroup.com/index.php/IJGHR READINESS FOR HOSPITAL DISCHARGE AMONG FAMILY CAREGIVERS OF PATIENTS WITH CHRONIC DISEASES Salwa Ghaida Fauzia, Titis Kurniawan*, Sri Hartati Pratiwi, Mira Trisyani, Tuti Pahria Faculty of Nursing, Universitas Padjadjaran, Jl. Ir. Soekarno KM.21, Hegarmanah, Jatinangor, Sumedang, West Java 45363, Indonesia * ABSTRACT Families often act as informal caregivers for family members who suffer from chronic diseases. Intensive family involvement improved patients’ adherence in performing post-discharge treatment program, hospital readmission, clinical outcomes, and quality of life. To effectively help the patients managing their diseases, the family caregivers required not only understand but also must be ready for helping patients manage their conditions. This study aims to identify the readiness for hospital discharge among family caregivers of patients with chronic diseases. Data were collected from 121 family caregivers recruited consecutively from adult inpatients wards using the respondents’ characteristics questionnaire and Readiness for Hospital Discharge Scale for Family with Adult Patients (RHDS Fam) questionnaire (inter-item correlation = 0.90, and Cronbach alpha 0.89). Descriptive analysis was applied. The results showed that most of family were female (77.7%%), unemployed (69.4%), graduated from senior high school (57.9%), and had no chronic diseases (86.8%). Generally, family caregivers reported high readiness for hospital discharge (7.75 Out of 10). While the coping abilities identified as the readiness domain with highest average score (9.07±1.15), the personal domain identified as the lowest domain (7.07 ±0.68). Higher readiness was showed in the age group of 20-40 years, female, graduated from senior high school, employed, and are the siblings of the patients. It can be concluded that the family caregivers of chronic disease patients are ready to return home and help patients continue their post-discharge treatment program. However, interventions are needed to improve their readiness related to patient’s personal status, particularly those who are male, lower educational background, unemployed, has a relationship as parents of the patients, and has a chronic illness. Keywords: chronic patient; family readiness; hospital discharge First Received Revised Accepted 16 March 2024 23 April 2024 24 April 2024 Final Proof Received Published 15 May 2024 01 August 2024 How to cite (in APA style) Fauzia, S. G., Kurniawan, T., Pratiwi, S. H., Trisyani, M., & Pahria, T. (2024). Readiness for Hospital Discharge among Family Caregivers of Patients with Chronic Diseases. Indonesian Journal of Global Health Research, 6(4), 2059-2067. https://doi.org/10.37287/ijghr.v6i4.3306. INTRODUCTION Chronic diseases are becoming a major health concern. Globally, the prevalence of this disease significantly increasing and contributes significant morbidity and mortality (WHO, 2020). Similar issues were also found In Indonesia A national study found as the prevalence of stroke 56%, diabetes mellitus at 23%, hypertension at 32%, and obesity at 47% (Ministry of health of Republic of Indonesia [MOHRI], 2018). Not only the number, these patients also often experienced a decline in physical and mental capabilities, requiring comprehensive care including long-term management that may incurable (Gertrude et al., 2019). To manage their conditions, they frequently experienced hospitalization and rehospitalization. Research conducted in Hongkong and Australia showed a range of 13-16% of unplanned readmission occurrences (Jayakody et al., 2018; Wong et al., 2011). In a survey, re-hospitalization of patients with chronic diseases ranked first as the highest unplanned readmission rate (Bureau of Health Information, 2012). Based on data from the Indonesian Health Insurance 2059 Indonesian Journal of Global Health Research, Vol 6 No 4, August 2024 Administration (BPJS Kesehatan), there has been an increase in the incidence of readmission in Indonesia. In 2021, there were 12.5% readmission cases, 12.9% in 2022, and 13.2% in 2023. These figures indicate that out of every 100 patients hospitalized, 13 of them will return to the hospital within 30 days post-hospitalization. After hospitalization, patients were expected to continue the treatment program at home. Unfortunately, study found that this period is critical as many patients experienced difficulties in performing self-care and medication that caused them re-hospitalized or even death (Risky et al., 2021). To help these conditions, chronic patients need an intensive support (Adib, 2021). Families play a very important role as informal caregiver for their family members who are undergoing treatment for chronic diseases (Onsudina, 2017). Study by Levine (2011) found that family members are the primary source of support for patients. Additionally, Kang et al. (2016) found that intensive involvement of family caregivers motivated the patients to life more optimistic in facing life, both now and in the future. Involvement in the care of chronic patients improves their quality of life, optimizes their ability in doing activities, and minimizing the potential stress of undergoing treatment (Kusumawardani, 2023). Moreover, Rachmat et al., (2021) reported that one of the leading causes of death in chronic patients is lack of social support from their family. In enabling family caregivers and patients for effectively manage patients’ post-discharge conditions, they must be prepared in advance. Family readiness for hospital discharge therefore is a crucial indicator. A study among stroke patients found that family caregivers’ readiness is an important factor for effective stroke management at home (Tanwir et al., 2014). Another study also showed that the key of care in diabetic patients was readiness of the family caregivers as the closest supports (Osundina, 2017). Additionally, a study among cancer patients found that lack of knowledge among family caregivers was negatively impact on unplanned readmission and the patients readiness to discharge from the hospital (Chang et al., 2016; Naoki et al., 2018; Dhollander et al., 2018). There is a lack of research specifically addressing the readiness of family caregivers of chronic patients, particularly in Indonesian context. Identifying the family caregivers’ readiness for hospital discharge therefore is very important, not only to identify whether or not they ready for helping the patients after discharge from the hospital but also explore the area for improvement regarding the hospital discharge education and follow-up program. This study aims to identify the readiness for hospital discharge among family caregivers of patients with chronic diseases. METHOD A descriptive quantitative study was implemented with a cross-sectional approach. Thi (...truncated)