University of Twente Student Theses
Patient preference regarding timing of discharge after elective percutaneous coronary intervention : a best-worst scaling.
Herk, L.A. van (2016) Patient preference regarding timing of discharge after elective percutaneous coronary intervention : a best-worst scaling.
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| Abstract: | Background:With the continuous improvement of stent techniques and antiplatelet drugs, same-day discharge is both feasible and safe in selected patients undergoing elective percutaneous coronary intervention. While the majority of the patients go home happily after the procedure, other patients feel hesitant about early discharge. Objectives: The primary objective of this study was to explain patient preference regarding the timing of discharge after elective percutaneous coronary intervention by using a best-worst scaling approach. Secondary objective was to explore a potential association between preference and anxiety measured by the generalized anxiety disorder 7-item scale.Additionally, potential associations with sociodemographic-, clinical-, and procedural-characteristics and preference were explored. Methods:Through literature review andexpert consultation, thirteen objects were identifiedthat could possibly influence preference for timing of discharge. A patient sample who underwent coronary angiography and/or percutaneous coronary intervention (n=118) at Thorax Centrum Twente, the Netherlands, participated in the study. Conditional logit models were fitted to estimate the relative importance of each belief in influencing patients’ preference. Univariate analysis was performed to identify a potential association between preference and anxiety and other sociodemographic-, clinical-, and procedural-characteristics. Results: The majority of patients prefer same-day discharge (n=78; 66.1%). Patients considered feeling more at ease, feeling calmer, and the presence of family and friends to be the most important reasons fortheir preferred timing of discharge. Least important reasons for patient preference were presence of fellow-patients, and performing daily activities. Subgroup analysis showed that the estimated object importance was different across the same-day discharge and overnight-hospital stay preference groups. No statistically significant association was found between anxiety and preference, however, preference was found a statistically significant association between procedure type and preference for timing of discharge. Conclusion: Although same-day discharge after elective percutaneous coronary intervention is feasible and safe, this study shows that some patients prefer overnight-hospital stay. This study implies that patients are discharged home the same day despite their preference for overnight-hospital stay. In order to provide patient centered care, healthcare professionals should not only consider a medical discharge checklist but also patient preference for timing of discharge. In addition, healthcare professionals should ascertain reasons for patients to be hesitant against same-day discharge, so that barriers for same-day discharge could be overcome. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/70735 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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