Quality of Discharge Teaching Scale Validity, Reliability, and Measurement Invariance in Pediatric Hematopoietic Stem Cell Transplant.

Abstract

BackgroundAdherence to treatment following hematopoietic stem cell transplant (HSCT) is critical, yet the complexity and demands of postdischarge regimens often lead to suboptimal adherence among families unprepared for the transition home. Discharge teaching has been reliably evaluated using the Quality of Discharge Teaching Scale (QDTS) across several health conditions, with higher scores associated with improved parental readiness and pediatric health outcomes. This scale may be helpful in identifying areas for improvement in pediatric HSCT discharge teaching if validated in a pediatric HSCT population.MethodThis study recruited 120 caregivers of children who recently underwent HSCT to complete the QDTS along with measures of parental efficacy/control, psychological distress, and psychosocial risk factors. Confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the scale, while internal reliability was assessed using Cronbach's alpha and correlations with related constructs.ResultsCFA showed that the QDTS had adequate model fit and was invariant across biological sex and income, but not diagnosis. The QDTS demonstrated good internal reliability (content α = .76; delivery α = .90) and criterion validity, with significant correlations with the subscales of related constructs. Independent samples t-tests revealed that caregivers of children with malignant diagnoses reported worse quality of discharge teaching compared to those with nonmalignant diagnoses.DiscussionThis study supports the use of the QDTS as a valid and reliable tool for assessing the quality of discharge teaching for caregivers of children undergoing pediatric HSCT.