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| Name | Class |
|---|---|
| Queen Mary Hospital, Hong Kong | OTHER |
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The goal of this cluster randomized controlled trial is to evaluate whether a nurse-led primary health care (PHC) discharge intervention can improve patient activation and primary health care-related outcomes among hospitalized adult patients after discharge.
Chronic diseases account for approximately 74% of global deaths and remain the leading cause of morbidity and mortality worldwide and in Hong Kong, particularly ischemic heart disease, cerebrovascular disease, and diabetes-related complications. The growing burden of ageing populations and non-communicable diseases highlights the need to shift healthcare systems from secondary and tertiary care toward prevention-oriented primary health care (PHC).
PHC serves as the first point of contact in a continuous healthcare process and is essential to a sustainable healthcare system. In response, Hong Kong is implementing a PHC reform through the establishment of District Health Centres to enhance population health and reduce pressure on public hospitals. Nurses, as the largest healthcare workforce, play a critical role in PHC delivery; however, nursing training in Hong Kong remains predominantly hospital-focused. Strengthening hospital nurses' roles in PHC-oriented discharge education may improve care continuity, patient self-management, and long-term health outcomes while reducing hospital readmissions and healthcare costs.
The aims of study are as follows:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental |
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| Control Group | Active Comparator | usual hospital discharge practice |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Primary healthcare discharge education | Behavioral | The primary healthcare discharge education begins by identifying priorities to address related to patients' life situations (using the Instrument for Patient Capacity Assessment) and determining the patient's current level of activation (using the Patient Activation Measure). A discharge education guide developed by the research team helps to individualize the teaching according to the patient's priorities and activation level. |
| Measure | Description | Time Frame |
|---|---|---|
| The primary outcome is the change in the Patient Activation Measure (PAM) between baseline and 3-month follow-up. | The PAM is a 13-item self-report questionnaire to measure patient activation level [18]. Patients can go through four levels of activation: (1) disengaged and overwhelmed, (2) becoming aware but still struggling, (3) taking action, and (4) maintaining behaviors and pushing further [18].PAM raw score can be calculated by adding all of the responses to the 13 questions [18]. This score is then converted into an activation score ranging from 0 = no activation to 100 = high activation using a scoresheet provided by Insignia Health. | From baseline to 3-month follow up. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Siu Long Chau, PhD | Contact | +852 6700 9987 | cslmatt@hku.hk |
| Name | Affiliation | Role |
|---|---|---|
| Siu Long Chau, PhD | HKU | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 18/F, Metro South Tower 1, 39 Wong Chuk Hang Road, Wong Chuk Hang, Hong Kong | Hong Kong | Hong Kong | 000000 | Hong Kong |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
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| specially-designed health education leaflet | Behavioral |
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| Patient discharge package | Behavioral | Subjects in the intervention group will receive the following items with instructions for use upon hospital discharge:
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| usual hospital discharge practice | Behavioral | The control group will receive the usual hospital discharge practice upon discharge. |
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