One Size Does Not Fit All: Discharge Teaching and Child Challenging Behaviors.
Norah L Johnson, Stacee Lerret, Michele Polfuss and 7 others
PMID 34044674WHAT IT FOUND
No significant differences were found in 25 parents between app-guided discharge teaching and usual care, but parents of children with challenging behaviors rated app-guided teaching lower on discharge teaching quality and care coordination.
Key findings
01Parents whose discharge teaching was guided by the iPad app reported lower quality of discharge teaching and care coordination than parents who received usual care, but the differences were not statistically significant.
02The analysis included 25 parents of children with challenging behaviors: 14 received app-guided teaching and 11 received usual care.
03After covariate weighting, adjusted standardized mean differences were 0.554 to 0.775, which the paper describes as moderate to large.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 25 parents were analyzed, so chance could explain the lower scores. Parents were not randomly assigned to the app; the app unit was surgical and the usual care unit was medical. The groups differed before analysis in parent age, race, insurance, employment, child age, diagnoses, and medications. Two covariates, reason for hospitalization and eating disorder, remained unbalanced even after weighting. Outcomes were parent perceptions measured on the day of discharge, not child recovery, readmission, or ability to carry out care. The app was added to usual verbal and written teaching, so its separate effect cannot be isolated.
Declared interests
The authors declared no potential conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that the iPad app caused worse discharge teaching for parents of children with challenging behaviors. The differences were not statistically significant, the sample was only 25 parents, the groups were not randomly assigned, and the app was given alongside usual verbal and written teaching, so the app alone cannot be separated.