J Nurs Manag. 2026;2026(1):e5080347. doi: 10.1155/jonm/5080347.
ABSTRACT
BACKGROUND: Following percutaneous coronary intervention (PCI), patients with coronary heart disease (CHD) face multiple disease- and treatment-related self-management demands after discharge. Accurate assessment of discharge readiness is essential for identifying areas in which patients may require additional discharge education and transitional care support. The widely used Readiness for Hospital Discharge Scale (RHDS) assesses overall discharge readiness across four domains: personal status, knowledge, coping ability and expected support. As a generic instrument, however, its broadly framed items may not adequately capture PCI-specific aspects of readiness, including treatment adherence, puncture-site healing, recognition of warning symptoms and preparedness for cardiac rehabilitation.
OBJECTIVE: To develop and initially validate a nurse-assessed Discharge Readiness Scale for Patients with CHD Following PCI (DRS-CHD-PCI).
METHODS: A multistage instrument development and validation study was conducted. Candidate items were generated using transition theory, a targeted review of relevant literature, clinical guidelines and existing discharge-readiness instruments, and semistructured interviews with patients with CHD following PCI and with healthcare professionals. Items were refined through two rounds of Delphi expert consultations and a pilot test with 20 patients. During psychometric validation, nurses assessed 444 patients on the planned discharge day; assessments took approximately 10-15 min. The sample was randomly split into two subsamples for exploratory and confirmatory factor analyses. Psychometric evaluation included item analysis, content validity, structural validity, convergent and discriminant validity, internal consistency and split-half reliability.
RESULTS: The final scale comprised 17 items across five dimensions. Exploratory factor analysis supported a five-factor structure that explained 75.84% of the total variance. Both the first- and second-order confirmatory factor analysis models showed acceptable fit. Cronbach's α was 0.945 for the total scale and ranged from 0.813 to 0.894 across the five dimensions.
CONCLUSIONS: The DRS-CHD-PCI is a 17-item, five-dimensional scale with initial evidence supporting its content validity, structural validity and internal consistency. Further multicentre longitudinal studies are needed to evaluate its predictive validity and clinical utility and to determine how its scores can be meaningfully interpreted in clinical practice.
IMPLICATIONS FOR NURSING MANAGEMENT: The DRS-CHD-PCI may assist nursing managers and cardiovascular nursing teams by providing a structured, assessment of discharge readiness before discharge and informing nurse-led transitional care planning following PCI. Lower total or dimension scores may highlight areas in which patients require further clinical assessment, additional education, or follow-up.
PMID:42895068 | DOI:10.1155/jonm/5080347