The effectiveness of discharge planning on the knowledge, clinical symptoms and hospitalisation frequency of persons with schizophrenia: a longitudinal study in two hospitals in Tehran, Iran

Abstract

Aims and objectives: To investigate the effectiveness of discharge planning on the knowledge, clinical symptoms and frequency of hospitalisation of persons with schizophrenia.

Background: Discharge planning is associated with decreases in the duration of hospitalisation, readmission to hospitals and decreases in medical costs. Yet, there is little known about the effectiveness of discharge planning among persons with schizophrenia in Iran.

Design: Longitudinal clinical trial.

Methods: In this longitudinal clinical trial, 46 persons with schizophrenia admitted to psychiatric hospitals were selected and classified into either intervention or control groups. For the intervention group, the discharge planning was designed using the nursing process model. The intervention was implemented across six sessions in the hospital and six sessions in patient's home (up to three months after discharge). Friedman test, independent t-tests, chi-squared test, Mann-Whitney U-test and Mc-Nemar's test were used to analyse demographic characteristics, knowledge scores, clinical symptoms and the frequency of hospitalisation.

Results: The intervention group demonstrated improved clinical symptoms between the time of discharge and three months after discharge and had higher knowledge levels compared with the control group. In addition, the frequency of patients' hospitalisation preintervention and three months postintervention was statistically significantly lower in the intervention group, while no such differences were found among the control group during this same time period.

Conclusion: This study suggests that there are a number of advantages to discharge planning including an increase in the knowledge of patients, a decline in clinical symptoms and a reduction in the frequency of admission to hospitals.

Relevance to clinical practice: Due to high frequency of relapse, rehospitalisation and high remedial costs of persons with schizophrenia, it is important to consider discharge planning as a therapeutic approach for patients.

Keywords: clinical symptoms; discharge planning; frequency of hospitalisation; knowledge; schizophrenia.