Chapter 8 134 associated increased levels of uncertainty among patients. Consequently, a panel of three nurse practitioners, an interventional cardiologist (electrophysiologist) and an epidemiologist developed a questionnaire consisting of 10 questions using a Likert scale from 1 to 10 as depicted in Figure 2. The questionnaire measured the comprehensibility of the given information by reviewing the responses provided. Patients unable to comprehend the written documents were excluded from the study. Therefore, no levels of comprehension are reported. As well as sending questionnaires to participants, nurses and nurse practitioners received a short questionnaire to evaluate their experiences with the computergenerated patient tailored discharge document. This questionnaire consisted of one Likert scale question, one categorized question, two yes/no questions and three open questions as outlined in Figure 3. The Medical Ethics Committee of our center reviewed the study and deemed the study was not subject to the Dutch Medical Research Involving Human Subjects Act and hence no formal approval was required. The study was conducted in accordance with the Declaration of Helsinki.(12) All participants provided written consent. 2.4 Study endpoint The primary endpoint was an improvement in comprehension of the discharge information. Secondary endpoints were usability and feasibility as reported by the nurses and nurse practitioners. 2.5 Data collection and analysis Baseline characteristics were collected from the electronic patient record. The comprehension of the discharge information (control group vs study group) was measured using the Likert scales in the questionnaire, completed one-week postdischarge and compared using the Student’s t-test, Pearson’s chi-squared test or Mann–Whitney U test, as deemed appropriate. In addition, the use of computer-generated discharge information was evaluated among nurse(-practitioners).
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