Enhancing Postpartum Discharge Instructions

Thomas Jefferson University

Status: Completed

Conditions: Cesarean Delivery Affecting Newborn; Randomized Controlled Trial; Postpartum; Health Literacy

Treatments: Other: Standard Instructions; Other: Visual Aid

Study type: Interventional

Funder types: Other

Identifiers

NCT03592628

16D.794

Details and patient eligibility

About

Post-cesarean delivery discharge instructions are not currently at an appropriate health literacy level. Enhancing discharge instructions with a visual aid did not improve scores on comprehension quizzes, either immediately or two-weeks post-discharge. However, participants preferred to have access to visual images with discharge instructions.

Full description

Objective:

To evaluate the effect of a visual aid on improving comprehension of hospital discharge instructions for cesarean wound care.

Methods:

A randomized control trial with a 1:1 allocation ratio and an intention to treat analysis was performed at an urban, tertiary care center from June-November 2017. Fifty English-speaking patients ages 18-50 who had undergone a cesarean delivery were randomized to receive either standard or enhanced discharge instructions regarding post-cesarean incision care. Enhanced instructions included a visual aid not present in the standard instructions. Participants completed a comprehension quiz prior to hospital discharge and again 2 weeks after discharge as well as the REALM literacy assessment prior to discharge.

Enrollment: 50 patients

Sex: Female

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Able to consent
• Identified as English speaking
• Had a cesarean delivery during the index hospitalization for delivery of their living newborn

Exclusion criteria

• Non-English speaking
• Declined to participate
• Required a translator for communication
• Intellectual disability (as self-identified or as determined by healthcare provider)
• Currently incarcerated

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups, including a placebo group

Standard Instructions

Placebo Comparator group

Description:

Subjects enrolled in this arm received standardized teach-back regarding discharge instructions as well as the standard printed discharge instructions regarding post-cesarean wound care.

Treatment:

Other: Standard Instructions

Enhanced Instruction

Experimental group

Description:

Subjects enrolled in this arm received standardized teach-back regarding discharge instructions as well as the standard printed discharge instructions regarding post-cesarean wound care AND they received an additional printed visual diagram.

Treatment:

Other: Visual Aid