Cross-Cultural Adaptation and Psychometrics Evaluation of the Arabic Version of the Patient-Readiness for Hospital Discharge Scale.

BACKGROUND AND PURPOSE: The Patient Readiness for Hospital Discharge Scale (PT-RHDS) is an outcome measure of discharge care processes. The purpose of the study was to test a cross-cultural adaptation from English into Arabic. METHODS: The Rand Corporation cross-cultural adaptation method and psychometric analysis of data from 1844 adult surgical inpatients in two Saudi Arabia hospitals. RESULTS: Reliability of the Arabic version (α = .75) was adequate. Confirmatory factor analysis supported construct validity. No differences in PT-RHDS scores were detected in comparisons for marital status, sex, age, or length of stay. The Arabic PT-RHDS did not predict readmissions. CONCLUSIONS: The psychometric properties of the Arabic PT- RHDS provide preliminary evidence for its use in assessing surgical patients' perception of readiness for discharge in Arabic-speaking countries.

An evaluation of the implementation of maternal obesity pathways of care: a mixed methods study with data integration.

OBJECTIVES: Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives. STUDY DESIGN: A simultaneous mixed methods model with data integration was used. Three component studies were given equal priority. 1: Semi-structured qualitative interviews explored obese pregnant women's experiences of being on the pathways. 2: A quantitative and qualitative postal survey explored healthcare professionals' experiences of delivering the pathways. 3: A case note audit quantitatively assessed pathway compliance. Data were integrated using following a thread and convergence coding matrix methods to search for agreement and disagreement between studies. RESULTS: Study 1: Four themes were identified: women's overall (positive and negative) views of the pathways; knowledge and understanding of the pathways; views on clinical and weight management advice and support; and views on the information leaflet. Key results included positive views of receiving additional clinical care, negative experiences of risk communication, and weight management support was considered a priority. Study 2: Healthcare professionals felt the pathways were worthwhile, facilitated good practice, and increased confidence. Training was consistently identified as being required. Healthcare professionals predominantly focussed on women's response to sensitive obesity communication. Study 3: There was good compliance with antenatal clinical interventions. However, there was poor compliance with public health and postnatal interventions. There were some strong areas of agreement between component studies which can inform future development of the pathways. However, disagreement between studies included a lack of shared priorities between healthcare professionals and women, different perspectives on communication issues, and different perspectives on women's prioritisation of weight management. CONCLUSION: The differences between healthcare professionals' and women's priorities and perspectives are important factors to consider when developing care pathways. Shared perspectives could help facilitate more effective implementation of the pathway interventions that have poor compliance.