Psychometric properties of transitional care instruments and their relationships with health literacy: Brief prepared and care transitions measure

Abstract

Objective: To assess the psychometric properties of the Brief PREPARED (B-PREPARED) and the Care Transitions Measure (CTM) in patients discharged from hospitals in Korea, and examine their relationships with health literacy. Design: A cross-sectional study with a follow-up telephone survey 4 weeks post-discharge. Setting: Six medical and surgical wards in a tertiary hospital in Seoul. Participants: 293 patients discharged from general wards. Main Outcome Measures: Psychometric properties of the Korean versions of the B-PREPARED and the 15- and 3-item CTM (CTM-15 and CTM-3), and the 3-item Brief Screening Questionnaire for health literacy. Results: All instruments discriminated well between patients who were satisfied with hospital care and the discharge process, and those who were not. One month post-discharge, the CTM-15 score was significantly higher in patients with good health status than the others, and the CTM-3 score was significantly higher in patients who used outpatient care than the others. However, no significant difference was found in the scores for all instruments by emergency department visits, rehospitalization, and medication adherence. Cronbach’s alpha values were 0.69 for B-PREPARED, 0.91 for CTM-15 and 0.67 for CTM-3. Intraclass correlation coefficients were 0.64, 0.75 and 0.66, respectively. Approximately 33% of the participants had limited health literacy. After adjusting for other patient variables, those with inadequate health literacy had lower scores on all instruments. Conclusions: Although the three instruments had acceptable validity and reliability, they showed limited criterion validity. Patients with limited health literacy should be supported to ensure the quality of transitional care.