Factors Associated with Hospital Discharge Difficulties for Pediatric Patients in Japan - Using the Delphi Technique

Purpose: This study aimed to identify factors associated with discharge difficulties for pediatric patients in Japan in order to develop pediatric discharge screening tools. Design and methods: This study employed the Delphi method by setting consensus level to 80%. A total of 131 acute hospitals were randomly selected by computer from among 261 hospitals. Five nurses with experience in discharge planning for children from each hospital were recruited for this study resulting in 655 participants enrolled. Results: We received 160 responses from participants who expressed consent to participate in the first edition questionnaire, and 112 responses with the second questionnaire. The study identified three factor categories associated with discharge difficulties: patient factors (22 items), family factors (32), and societal factors (12). Among these, 4 patient factors including “Unstable child with congenital disease”, 15 family factors including “Abuse or possibility of abuse”, “Carer with difficulties in bringing up the child due to a tendency towards depression”, and “Carer with a poor opinion of home care”, and 5 societal factors including “No alternative pediatric hospitals for transfers” reached consensus showing them to be considered important for the participants. Implications: The findings suggest that the factors associated with discharge difficulties for Japanese pediatric patients may be useful when used for the screening, in providing discharge planning at an early stage. These factors would provide useful ideas when developing discharge screening tools that will enable nurses to provide discharge planning for pediatric patients at the early stages of hospitalization.