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Using short message services for patient discharge instructions in the emergency department: A descriptive correlational study - 13/03/25

Doi : 10.1016/j.ajem.2025.01.058 
Chien-Hsin Lu, M.D. a, Yuh-Shin Kuo, M.D. a, Jing-Shia Tang, Ph.D. b, c, , Chih-Hao Lin, M.D. a, ⁎⁎
a Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Shengli Rd., North District, Tainan City 70403, Taiwan 
b Department of Nursing, Chung Hwa University of Medical Technology, No.89, Wenhua 1st St., Rende Dist., Tainan City 71703, Taiwan 
c International Doctoral Program in Nursing, College of Medicine, National Cheng Kung University, No.138, Shengli Rd., North District, Tainan City 70403, Taiwan 

Corresponding author at: Department of Nursing, Chung Hwa University of Medical Technology, No.89, Wenhua 1st St., Rende Dist., Tainan City 71703, Taiwan.Department of NursingChung Hwa University of Medical TechnologyNo.89, Wenhua 1st St., Rende DistTainan City71703Taiwan⁎⁎Corresponding author at: Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Shengli Rd., North Dist., Tainan City 70403, Taiwan.Department of Emergency MedicineNational Cheng Kung University HospitalNo. 138, Shengli Rd., North Dist.Tainan City70403Taiwan

Abstract

Background

Healthcare discharge instructions are important for patients who are discharged from the emergency department (ED).

Objective

This study aimed to evaluate the use of short message services (SMSs) for patient instruction on healthcare knowledge, care confidence, anxiety, and satisfaction in ED-discharged patients.

Methods

A descriptive correlational study using an online questionnaire survey was conducted for ED-discharged patients with fever or symptoms of airway infection from August 1, 2021, to July 31, 2022. We utilized a questionnaire to evaluate the domains of healthcare knowledge, care confidence, anxiety, and satisfaction. Pearson correlations between variables were calculated. Independent samples t-tests and one-way ANOVA with post hoc tests were used to estimate least squares means for different age, sex, or education groups, and the mean differences in response scores were tested. Statistical significance was set at P < .05.

Results

A total of 618 validated questionnaires were included in the analysis. In the fever group (n = 238), anxiety was negatively correlated with care confidence and satisfaction (r = −0.213, P < .001; r = −0.189, P = .003, respectively). Knowledge was positively correlated with care confidence and satisfaction (r = 0.217, P < .001; r = 0.192, P = .002, respectively). Patients with higher education levels, compared with those with lower education levels, had greater knowledge (6.8 ± 0.4 vs. 6.5 ± 1.0, t = −3.323, P = .001), care confidence (27.8 ± 3.3 vs. 26.5 ± 4.2, t = −2.661, P = .008), and satisfaction (25.7 ± 2.9 vs. 24.3 ± 3.3, t = −3.558, P < .001). In the airway infection group (n = 380), anxiety was negatively correlated with care confidence (r = −0.209, P < .001) and satisfaction (r = −0.245, P = .003). Knowledge and care confidence were positively correlated with satisfaction (r = 0.193, P < .001; r = 0.649, P < .001, respectively). Compared with males, females had greater knowledge (9.6 ± 1.1 vs. 9.2 ± 1.3, t = 2.597, P = .010) and anxiety (10.0 ± 4.7 vs. 9.0 ± 4.3, t = 2.053, P = .041). Patients with higher education levels had greater knowledge (9.6 ± 0.9 vs. 9.2 ± 1.4, t = −3.473, P = .001), care confidence (28.1 ± 2.9 vs. 27.1 ± 3.4, t = −3.350, P = .001), and satisfaction (25.6 ± 3.2 vs. 24.4 ± 3.1, t = −3.751, P < .001).

Conclusions

Patient who received SMS-based health discharge instructions improved knowledge, care confidence, and satisfaction after ED visits. Future research should explore the application of the system across a broader range of emergency medical conditions.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Digital, Short message service, Discharge instruction, Patient education, Emergency department

Abbreviations : ED, SMS, COVID-19, ANOVA, CI, SD, I-CVI, S-CVI


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