***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES to investigate the effectiveness of a  pharmacy discharge plan  in elderly hospitalized patients . DESIGN r and omized controlled trial . SUBJECTS AND SETTING S we r and omized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care . INTERVENTIONS the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient . A copy was given to the patient and to all relevant professionals and carers . This was followed by a domiciliary assessment by a community pharmacist . In the control group , patients were discharged from hospital following st and ard procedures that included a discharge letter to the general practitioner listing current medications . OUTCOMES the primary outcome was re-admission to hospital within 6 months . Secondary outcomes included the number of deaths , attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period , together with patients ' general well-being , satisfaction with the service and knowledge of and adherence to prescribed medication . RESULTS we recruited 362 patients , of whom 181 were r and omized to each group . We collected hospital and general practice data on at least 91 and 72 % of patients respectively at each follow-up point and interviewed between 43 and 90 % of the study subjects . There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months . There were no significant differences in any of the secondary outcomes . CONCLUSIONS we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes This pilot study 's objective was to determine the effectiveness of postpartum education received by midwifery clients at the University of New Mexico Hospital . The authors of the study r and omized 100 women following delivery to two groups . Group one , n = 55 , received written postpartum instructions only .  Group two , n = 45 , received oral instructions by the certified nurse-midwife in addition to the written instructions . Both groups answered a written question naire after the teaching . Analyses were carried out on 100 posttest scores . Mean test scores for group one was 17.9 out of a possible score of 20 . Mean score for group two was 18.3 . No significant difference was detected between these two mean scores . A 95 % confidence interval for the difference between mean scores was -1.9 to 1.1 ( P > .05 ) . Reliability of instrument was established via the Kuder-Richardson formula 21 . This conservative estimate of internal consistency yielded r = .50 . The authors found that oral instructions by the certified nurse-midwife did not significantly increase the knowledge of primiparas as evidence d by posttest results . However , results must be interpreted cautiously for three reasons : low reliability of the instrument , the small difference between groups , and the sample size . The need to determine how best to approach postpartum education is imperative in this era of early hospital discharge . A certified nurse-midwife 's time may be better spent focusing on individual concerns rather than on a set teaching agenda . Alternative opportunities such as postpartum home visits need to be explored as a means of providing support and guidance to new mothers For this study a r and omized clinical trial was design ed to test the effects of an early home recovery information intervention on physical functioning , psychological distress , and symptom frequency 1 month following coronary artery bypass graft surgery ( CABG ) . Recovery outcomes were compared between two groups : those receiving an audiotape of information on expected physical sensations and their management ( Cardiac Home Information Program [ CHIP ] ) in addition to the usual care , and those receiving the usual cardiac discharge information protocol .  A nonprobability sample of 180 patients ( 84 women and 96 men ; mean age = 62 years ) was equally distributed between the two study groups . When controlling for age , comorbidity , and cardiac functional status , the results showed positive effects on physical functioning in women and psychological distress , vigor and fatigue in men . Consistent with other studies , women had worse physical functioning and more symptom frequency than men . These findings indicate that the CHIP intervention is an effective method to prepare CABG patients for home recovery To determine whether st and ardized instructions enhance communication of discharge information , we provided 197 parents of children in whom otitis media was diagnosed with one of three types of instruction at the time of discharge from a pediatric emergency department : ( 1 ) instruction by individual housestaff and medical students after consultation with an attending physician ( control group ) ; ( 2 ) st and ardized verbal instructions given by housestaff and students trained in their use ( verbal group ) ; or ( 3 ) the same instructions given to the verbal group , together with a type-written copy of the information to take home ( verbal + written group ) . Prior to leaving the emergency department and , again , by phone , 1 and 3 days later , parents were question ed concerning the prescribed medication 's name , dose , frequency , and duration of administration ( medication data ) , three signs of improvement , and eight signs indicating the need for medical advice ( worrisome signs ) . The mean percentage of correct responses per parent in each group was computed for each information category . Both at exit interview and at follow-up , parents receiving either form of st and ardized instructions showed significantly greater knowledge of information related to their child 's illness than did controls . Information regarding medication data was more likely to be communicated to parents in all groups than were signs of improvement or worrisome signs . The addition of written instructions to st and ardized verbal instructions did not improve parental recall of discharge information Abstract Objective : To examine the consistency of survey estimates of patient satisfaction with interpersonal aspects of hospital experience . Design : Interview and postal surveys , evidence from three independent population surveys being compared . Setting : Scotl and and Lothian . Subjects : R and omly selected members of the general adult population who had received hospital care in the past 12 months . Main outcome measures : Percentages of respondents dissatisfied with aspects of patient care . Results : For items covering respect for privacy , treatment with dignity , sensitivity to feelings , treatment as an individual , and clear explanation of care there was good agreement among the surveys despite differences in wording . But for items to do with being encouraged and given time to ask questions and being listened to by doctors there was substantial disagreement . Conclusions : Evidence regarding levels of patient dissatisfaction from national or local surveys should be calibrated against evidence from other surveys to improve reliability . Some important aspects of patient satisfaction seem to have been reliably estimated by surveys of all Scottish NHS users commissioned by the management executive , but certain questions may have underestimated the extent of dissatisfaction , possibly as a result of choice of wording . Key messages High levels of satisfaction with regard to personal treatment by hospital staff , involvement in decisions , and communication with doctors have been reported in successive interview surveys in Scotl and Levels of satisfaction with doctor-patient com- munication and involvement in decisions are sensi- tive to changes in wording Asking patients if they agree with a negative description of their hospital experience tends to produce greater apparent satisfaction than asking if they agree with a positive To evaluate the influence of a modular , multidisciplinary , pediatric burn discharge book on burn-care-related knowledge and satisfaction of caregivers  , we studied children less than 17 years of age admitted with an acute thermal injury to the pediatric burn unit of a large , tertiary care hospital in Winnipeg , Canada over a 32 month period . Demographic characteristics of the population are similar to published profiles of other pediatric burn units with the exception that North American Indian ( NAI ) families were disproportionately admitted , with 59 out of the 123 ( 48 % ) admissions from a geographic area that has less than 15 % NAIs . We r and omly assigned the families to receive discharge instructions with the book ( intervention group ) or routine discharge teaching without the book ( comparison group ) . Knowledge levels of burn care and satisfaction with discharge teaching of caregivers were evaluated with a question naire administered in single-blind fashion at the first outpatient follow-up visit . Sixty-two families received the book and 61 families received  st and ard discharge teaching . Bivariate analysis showed greater knowledge in the intervention group , with an average score ( range , 0.0 to 1.0 ) of 0.79 + /- 0.15 versus 0.73 + /- 0.15 in the comparison group ( p < 0.05 ) . We did not observe this positive effect of the book when we analyzed NAI families separately : 28 families instructed with the book scored 0.68 + /- 0.14 versus 0.63 + /- 0.13 in 31 families provided with routine teaching ( p = 0.18 ) . Stepwise multiple-regression analysis found that the influence of the book was limited to families with children who sustained scald burns ( p < 0.05 ) . Factors negatively related to the knowledge levels of caregivers ( p < 0.05 ) were being of NAI origin and being NAI with no safety devices in the home . A positive correlation ( p < 0.05 ) was found with having English as the first language , having a child with more extensive burns , having a younger age of the child with burns , and having fewer children in the home . In conclusion , we found that the discharge book improved the burn-care-related knowledge of caregivers . However , other factors , particularly ethnic and language background , were of greater influence PURPOSE The purpose of this study was to test a strategy for improving  patient 's retention of discharge teaching . METHODOLOGY A pretest-posttest experimental design was used . Forty postpartum women were r and omly assigned to a group . All subjects received infant feeding instruction until they reached criterion on the Infant Feeding Question naire . The experimental group received additional instruction on the same material ( overlearning ) . The two groups were compared 2 weeks later on the same question naire . Mean scores were compared by a t-test , demographic variables were correlated to outcomes , and effect of race or culture was analyzed by ANOVA . FINDINGS The pretest showed no significant difference between the groups . Posttest scores were significantly higher for the experimental group . The mother 's education was the only demographic variable that was correlated to the results . CONCLUSION Mothers who receive overlearning beyond the mastery level retain significantly more of the material This study examines the contribution of hospital discharge planning in meeting the needs of patients for care after their return home . A r and om sample of 919 admissions ( age 60 and over ) to five hospitals was studied to obtain information on characteristics of discharge planning during the patients ' hospital stay . Specifically , information was obtained on the involvement of a design ated professional for managing and coordinating the discharge plan , and the extent to which the planning was interdisciplinary . Patient interviews conducted two weeks after discharge provided information on needs for care related to : ( 1 ) treatment , ( 2 ) activity limitations , and ( 3 ) other self-sufficiency limitations . Patients were asked about their need for care in these three areas and about whether or not these needs were being met . Overall , 97 percent reported one or more needs for care and 33 percent reported that at least one of these needs was not being met . Findings show that the involvement of a discharge planning case manager is related to a significant reduction in unmet treatment needs , but not to reductions in activity limitation , other self-sufficiency needs , or overall needs . No significant effects of interdisciplinary planning were identified . These findings suggest that treatment-related benefits result when a case manager has specific responsibility for the discharge planning of elderly patients returning home after hospitalization . These results provide insights into what is being achieved through current discharge planning practice s. The meeting of specific patient needs through enhanced discharge planning may save future costs by reducing the rates of complications and hospital readmissions in an era of prospect i ve payment , thus potentially off setting the increased costs involved in planning and coordinating postdischarge care for older adults Objectives : To assess the impact of information packs on patients with stroke and their carers , and to pilot some of the methodology for a trial of a Family Support Organiser ( FSO ) . Subjects : Seventy-one patients admitted to Oxford hospitals with acute stroke during February – July 1995 , and 49 informal carers of these patients . Design : R and omized controlled trial . Intervention group received an information pack containing various Stroke Association publications one month after their stroke , or at discharge from hospital , whichever was sooner . Control group received nothing . Follow-up was by interview at the place of residence of the patients six months after their stroke . Measures : Outcome measures assessed knowledge about stroke ; satisfaction with information received ; patient behaviour in terms of access to community services and benefits ; and health status and quality of life . Results : Patients and carers in the intervention group tended to know more about stroke , but these differences were not significant once adjusted for age . Patients in the intervention group ( but not carers ) tended to be more satisfied with the information that they had received , but the differences were not significant . There were no differences with regard to any aspects of quality of life in patients in the intervention group , though carers in the intervention group were found to have significantly better mental health ( p = 0.04 ) . Conclusions : While the study was too small to generate firm conclusions , information leaflets may lead to improved knowledge about stroke several months after they have been distributed . This finding is worth following up with larger studies . The stroke knowledge question naire that was piloted in this trial seems to be able to detect differences between groups BACKGROUND Discharge planning is becoming an important part of the management of childhood asthma in hospital . Readmission to hospital , although often inevitable , might represent a failure of the opportunity for intervention presented by a brief period of supervised care in hospital . AIM To examine the impact of a structured , nurse-led discharge package for children admitted to hospital with acute asthma on readmission to hospital , reattendance at the accident and emergency ( A&E ) department , and general practitioner consultations for asthma . METHODS A structured nurse-led discharge package , consisting of a 20 minute patient education programme and self management plan for children with  asthma was developed on the wards of a busy children ’s hospital . A r and omised controlled trial was conducted involving 160 children aged 2–16 years admitted for asthma over a 12 month period . Readmission and A&E reattendance ’s 
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REVIEW ER 'S CONCLUSIONS This review recommends the use of both verbal and written health information when communicating about care issues with patients and /or significant others on discharge from hospital to home .
The combination of verbal and written health information enables the provision of st and ardised care information to patients and /or significant others , which appears to improve knowledge and satisfaction .