Date of Award

Fall 2010

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Marianne E. Weiss

Second Advisor

John Grych

Third Advisor

Maureen O'Brien, Grzegorz Telega

Abstract

Readiness for hospital discharge is an under-investigated topic in pediatric solid organ transplant. The immediate post-operative period and first few weeks after transplant are a critical time period where patients are at high risk for transplant-related complications.

A correlation design framed by Meleis' Transitions Theory were used to determine; (1) the influences of discharge teaching and care coordination on parent readiness for hospital discharge among parents of children who have experienced solid organ transplantation; and (2) the relationship of parent readiness for hospital discharge with coping, adherence difficulty, utilization of healthcare resources, and family impact in the first three weeks following discharge from the hospital. Qualitative data were used to supplement quantitative findings.

Thirty seven parents from three pediatric transplant centers participated. Participants completed questionnaires on the day of hospital discharge and three weeks following hospital discharge. Regression analysis for quantitative data and content analysis for qualitative data were used to identify significant relationships and themes.

Results contribute to the understanding of important issues surrounding the discharge transition in a specific pediatric chronic illness population. Care coordination was associated with readiness for hospital discharge. Readiness for hospital discharge was subsequently associated with post-discharge coping difficulty, adherence difficulty with medical follow-up and family impact.

Implications for nursing practice, nursing education and nursing research are identified. Identifying parents who are not ready to go home from the hospital following their child's solid organ transplant provides an opportunity to offer additional transitional services so parents can effectively manage their child's recovery and continuing care at home. Transitions theory provides a useful framework for conceptualizing and investigating the discharge transition of parents of children experiencing solid organ transplant. Results fill the current gap in knowledge and contribute to the advancement of nursing science.

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