A spinal cord injury (SCI) is a serious, irreversible condition and a common cause of death and disability worldwide. Individuals who sustain SCI typically require inpatient hospital treatment—including surgery, pain management, and rehabilitation—during their initial recovery period. As the inpatient stay draws to a close, clinicians need to ensure that the patient is adequately prepared to leave the acute care facility and to manage their own care in home or community settings. Clinicians who treat postpartum and post-surgical patients often use the Readiness for Hospital Discharge Scale (RHDS) to assess their patients’ knowledge, support systems, and emotional coping skills. However, the RHDS has not been yet used to assess readiness for discharge among SCI patients, despite the urgent need for such a tool.
A recent study in South Africa addressed this gap by examining the reliability and validity of the RHDS for patients with SCI. Both of these measures are important for ensuring that an assessment is accurate and error-free. In the context of a health care assessment tool like the RHDS,
- Reliability refers to the tool’s consistency over time and across different settings. That is, a measure is considered reliable if a patient shows the same outcomes after completing the same assessment again at a later time and if the patient shows the same outcomes regardless of which clinician administers the test (or where).
- Validity refers to the tool’s ability to accurately reflect the measurement in question. That is, an assessment that indicates a patient is ready for discharge is considered valid if the patient actually is ready for discharge.
To determine if the RHDS is reliable and valid for patients with SCI, the research team administered the assessment to 50 SCI patients in a South African acute care facility. Using statistical and analytical computer software, the research team determined that the RHDS is:
- A reliable way to determine an SCI patient’s readiness to be discharged from the hospital. The assessment scored .904 in a common measure of reliability (scores exceeding .90 are considered to have “excellent” reliability).
- A valid way to determine an SCI patient’s readiness to be discharged from the hospital. The assessment scored .810 in a common measure of validity (scores exceeding .40 are considered to be valid).
In addition to assessing discharge readiness among postpartum and post-surgical patients, the RHDS also is a reliable and valid tool to measure the extent to which people with SCI feel ready for hospital discharge. The researchers recommend adopting the RHDS as a common pre-discharge protocol for all SCI patients.
De Lange JS, Jacobs J, Meiring N, et al. Reliability and validity of the Readiness for Hospital Discharge scale in patients with spinal cord injury. South African Journal of Physiotherapy. (May 2020).