Development of a Discharge Planning Model for Type 2 Diabetic Patients with Hyperglycemia in the Inpatient Ward, Kaedam Hospital

Abstract

Objective: To investigate the situation and needs, develop a discharge planning model, and evaluate the effects of the model for type 2 diabetic patients with hyperglycemia in the inpatient ward of Kaedam Hospital

Methods: This study employed an action research design consisting of four phases: planning, action, observation, and reflection. The participants were divided into three groups: 1) key informants; 2) a model development team (n = 15); and 3) patients with type 2 diabetes mellitus with hyperglycemia (n = 30), selected using purposive sampling. Research instruments included a knowledge test, a satisfaction questionnaire, a fasting blood sugar (FBS) record form, and focus group interview guidelines. Quantitative data were analyzed using descriptive statistics, mean, standard deviation, and paired t-test, while qualitative data were analyzed using content analysis.

Results: The findings revealed that: 1) major problems included patients’ lack of knowledge and self-care skills, limited caregiver involvement, and unclear continuity of care systems; 2) the developed discharge planning model consisted of four steps: initial assessment, health education, knowledge reinforcement and collaborative care planning, and discharge preparation, integrating the D-METHOD approach with the 3E 2S principles (healthy eating, exercise, emotional management, smoking cessation, alcohol cessation, supportive environment, and social support); and 3) after implementation, patients’ knowledge scores significantly increased (p < .001) ( = 12.13, SD = 1.50) compared to before the intervention   ( = 8.30, SD = 1.44), and fasting blood sugar levels significantly decreased (p < .001) ( = 183.10, SD = 10.05) compared to baseline ( = 297.97, SD = 14.85). Overall patient satisfaction was at the highest level ( = 4.63, SD = 0.42). In addition, focus group results indicated that the model improved systematic care, enhanced patients’ confidence in self-care, and reduced hospital readmission.

Conclusion: The discharge planning model integrating the D-METHOD approach with the 3E2S principles was effective in improving patients’ knowledge, glycemic control, and satisfaction. This model can be applied in community hospitals to enhance the quality of diabetes care.