Patients' experiences of readiness for discharge following a total hip replacement

In recent years there has been a reduction in the length of stay of patients undergoing total hip replacement, as hospitals have attempted to reduce costs. A reduced length of stay requires patients undergoing total hip replacement to achieve independence over increasingly shorter periods. Clinical experience indicates that many of these patients feel unready or reluctant to be discharged to home, even though they are physically capable. Information is required about psychosocial factors that may affect or delay discharge. This naturalistic study used grounded theory methodology to explore the perceptions of discharge readiness of people who had undergone a total hip replacement. Using purposive sampling, five participants were interviewed prior to discharge from an acute hospital. The analysis resulted in the emergence of three categories: 'Confidence', 'Family and friends', and 'Feeling safe'. Participants wanted to feel safe both in the hospital and at home. Their own confidence levels and the presence of family and friends at home had a strong influence on feelings of safety. The core category and main concern of participants appeared to be about feeling safe. Participants who felt safe perceived they were ready to be discharged. Healthcare professionals can recognise and question patients about some of these factors that influence feelings of safety and readiness for discharge. Recognising concerns of patients prior to discharge will promote good patient care and discharge planning that is more acceptable to patients and carers.