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Kidney transplant patients are at increased risk for readmissions when complicated post-discharge instructions and lack of empathy from their caregivers compound their stress levels, according to research published in the Journal of Surgical Research.
Researchers from Ohio State University Fisher College of Business and Wexner Medical Center found anxious patients ran more than twice the risk of readmission after the procedure, and lack of empathy combined with confusing post-discharge directions exacerbated the issue.
The researchers interviewed 20 Wexner transplant patients to gauge care quality and found that they often said that their providers rushed to give them information. Researchers also shadowed care teams to note the quality of the care instructions they gave transplant patients. And they found many inconsistencies in the instructions; for example, nurse instructions on how much to drink after the procedure varied widely.
“There must have been 16 different ways to tell them to drink a lot of water,” study co-author Aravind Chandrasekaran said in a statement. Nurses were following protocol, he noted, but they were repeating different guidelines they'd been told throughout their careers.
The shadowing notes and interviews formed the basis of a survey the team distributed to 77 kidney recipients who didn’t participate in the initial interviews. Thirty-one percent of the survey respondents were readmitted to the hospital within 30 days.
The results showed anxiety levels the week after discharge correlated strongly with readmission, and a one-unit increase in anxiety levels upped the chances of readmission by 110 percent. While empathy, or lack thereof, didn’t appear to be directly tied to readmissions, it can affect anxiety levels, according to the study authors.
Research has shown anxiety can similarly affect emergency department outcomes.
"Our study suggests two ways of preventing readmissions through reduction of post-discharge anxiety: standardizing in-hospital care, so that information received by patients is consistent, and by training caregivers to be more empathetic toward patients during the delivery of this information," researchers conclude.