Factors influencing discharge readiness among patients with mild-to-moderate ischemic stroke:a cross-sectional study

Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.Methods:A total of 120 patients with mild-to-moderate ischemic stroke were recruited using simple random sampling.Five instruments,namely,the Demographic Data Questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale(RHDS_C),the SelfEfficacy for Managing Chronic Disease 6-Item Scale(SES6),the Perceived Social Support Scale(PSSS),and the Quality of Discharge Teaching Scale(QDTS),were used for data collection.Descriptive statistics and standard multiple linear regression were used for data analysis.Results:The mean score of discharge readiness among patients with mild-to-moderate ischemic stroke was at a moderate level(M=7.6,SD=0.92),and 75.8%of the participants felt ready for discharge.Standard multiple linear regression revealed that selfefficacy(β=0.62,P<0.001)and the quality of discharge teaching(β=0.28,P<0.001)were the influencing factors.However,social support could not predict discharge readiness significantly.All the factors combined explained 64.9%of the variance in discharge readiness.Conclusions:Intervention programs aimed at improving self-efficacy and the quality of discharge teaching may be helpful in promoting discharge readiness in patients with mild-to-moderate ischemic stroke,especially in coping ability.

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.

Factors Influencing Readiness for Hospital Discharge among Patients Undergoing Breast Cancer Surgery

Background: Breast cancer has become an important disease burden harmful to women’s health. The treatment of breast cancer is mainly surgical treatment. In the context of enhanced recovery after surgery, the average length of hospital stay has been reduced, so there is increasing concern about postoperative patient discharge readiness. Objective: To identify factors influencing readiness for hospital discharge among patients having undergone breast cancer surgery and to explore the relationship between discharge readiness and the quality of discharge teaching. Methods: A total of 99 patients after breast cancer surgery at a regional tertiary medical tumor center in Guangzhou between June 2021 and December 2021 were collected using the convenience sampling method. A general data questionnaire, readiness for hospital discharge scale, and quality of discharge teaching scale were used to conduct a questionnaire survey on the subjects. Results: 83.8% of the patients feel ready for discharge, and the score of discharge readiness was 155.98 ± 28.87. The patients’ content received and the skills in teaching delivery were the influencing factors of discharge readiness. Discharged with a drainage tube was an independent factor of discharge readiness. Conclusions: Readiness for hospital discharge among patients undergoing breast cancer surgery was above medium level, and perfect intervention measures should be formulated for the influencing factors of discharge readiness. Especially, specific executable safeguard measures should be formulated for patients who are discharged early after surgery to promote the safety of home care.

Reliability and validity of the Chinese version of the Readiness for Hospital Discharge Scale-Parent Form in parents of preterm infants

Background: The Readiness for Hospital Discharge Scale (RHDS)-Parent Form shows satisfactory reli-ability and validity to assess the readiness of parents to take care of their children discharged from hospitals in Western countries. However, the reliability and validity of this instrument has not been evaluated in Chinese populations.Objectives: Evaluate the psychometric features of the RHDS-Parent Form among Chinese parents of preterm infants. Methods: The RHDS-Parent Form was translated into a Chinese version following an international in-strument translation guideline. A total of 168 parents with preterm infants were recruited from the neonatal intensive care units of two tertiary-level hospitals in China. The internal consistency of this measure was assessed using the Cronbach's a coefficient;confirmatory factor analysis was conducted to evaluate the construct validity;and Pearson correlation coefficient was used to report the convergent validity. Results: The Chinese version of RHDS (C-RHDS)-Parent Form included 22 items with 4 subscales, ac-counting for 56.71% of the total variance. The C-RHDS-Parent Form and its subscales showed good reliability (Cronbach's a values 0.78-0.92). This measure and its subscales showed positive correlations with the score of Quality of Discharge Teaching Scale. Conclusion: The factor structure of C-RHDS-Parent Form is partially consistent with the original English version. Future studies are needed to explore the factors within this measure before it is widely used in Chinese clinical care settings.

Analysis of the Current Status and Influencing Factors of the Readiness for Discharge of Patients after Prostate Cancer Surgery Based on the Concept of Enhanced Recovery after Surgery (ERAS)

Objective To investigate the level of readiness for discharge of patients after prostate cancer surgery based on the concept of Enhanced Recovery After Surgery (ERAS), and to explore its influencing factors, so as to provide references for improving the readiness for discharge of patients after prostate cancer surgery. Methods The general information questionnaire, the discharge preparation scale, and the discharge guidance quality scale were used to investigate 119 patients discharged from the urological surgery department of a tertiary A-level hospital in Guangzhou after radical prostatectomy. Results The total score of discharge readiness of patients after radical prostatectomy was 147.74 ± 35.71 points, which was at a lower middle level and the total score of discharge guidance quality was 180.68 ± 38.91 points, which was at a medium level. Multiple linear regression analysis showed that education level, family monthly income, Gleason score, whether to perform lymphatic dissection, whether to discharge with a urinary catheter, and the quality of discharge guidance were the main factors influencing the readiness for discharge of patients after prostate cancer surgery. Conclusion In clinical nursing work, it is necessary to implement individualized health education according to the characteristics and needs of different patients to improve the level of preparation for discharge of patients after prostate cancer surgery.

Analysis of the Status Quo and Influencing Factors of Readiness for Hospital Discharge of Patients Undergoing Hysteromyomectomy

Objective: To evaluate the status quo and influencing factors of readiness for hospital discharge of patients undergoing hysteromyomectomy. Methods: A total of 240 patients with uterine fibroid undergoing hysteromyomectomy from 2 hospitals in Jingzhou were investigated using a self-designed general information questionnaire, the Readiness for Hospital Discharge Scale and the Quality of Discharge Teaching Scale. Results: The total score of readiness for hospital discharge was (91.36 ± 18.46), the multiple linear regression analysis showed that the quality of discharge guidance, the scope of myomectomy, pain degree of incision and the average monthly income per family were the main influencing factors of readiness for hospital discharge. Conclusion: The readiness for hospital discharge was at a medium level in patients with uterine fibroid undergoing hysteromyomectomy, medical personnel should give specific discharge guidance according to the specific conditions of patients to ensure the safety of patients after discharge.

Survey on the Readiness for Hospital Discharge and Its Influencing Factors among Patients with Cardiac Valve Replacement

Background: There are about 200,000 patients in China who need to undergo valve replacement surgery each year. With the promotion and application of the Fast-Track Surgery concept and the increase in hospital bed turnover rate, the average hospital stay of patients undergoing CVR surgery has been significantly shortened, and thus the patients are still in the recovery stage rather than fully recovered when they are discharged from the hospital. Good preparation for discharge can improve patients’ post-discharge self-care ability, reduce the risk of re-admission, and save medical resources. Objective: To describe the status of readiness for hospital discharge among postoperative patients that have undergone CVR, and to explore its influencing factors. Methods: The general information questionnaire, the Readiness for Hospital Discharge Scale and the Quality of discharge Teaching Scale were utilized to investigate 130 post-CVR patients admitted to the Cardiothoracic Surgery Department of a tertiary A-Class hospital in Guangzhou from July 2019 to October 2020. Results: The Readiness for Hospital Discharge Scale was at a moderate level with a total score of 163.88 ± 39.082, while the Quality of Discharge Teaching Scale was also at a moderate level with a total score of 194.09 ± 40.643. Multiple linear regression analysis revealed that the quality of discharge guidance, gender, and occupation were the influencing factors of CVR patient’s readiness for hospital discharge. These three variables jointly explained 45.8% of the total variation. Conclusion: The level of CVR patients’ readiness for hospital discharge is at a moderate level, and the quality of discharge guidance positively affects patients’ readiness for discharge. Therefore, in clinical work, attention should be paid to patient discharge guidance. Personalized health education should be implemented to improve the quality of patient guidance.

A Study on the Effect of Comprehensive Intervention Based on Transition Theory on the Readiness for Discharge of Post-Operative Breast Cancer Patients

Purpose: To explore the effect of comprehensive intervention based on transition theory in enhancing the readiness for discharge of post-operative breast cancer patients. Method: In a non-simultaneous controlled study test, 99 post-operative breast cancer patients hospitalized between August 2019 and February 2020 were selected as the control group and 93 post-operative breast cancer patients hospitalized between March and August 2020 were selected as the test group at a Grade A tertiary tumor hospital. While the control group used the conventional care model, the test group added a comprehensive intervention based on transition theory to the routine nursing, which focused on stimulating patients’ awareness of health transitions, assisting patients to identify health critical events, strengthening social support and promoting self-management. The differences between the two groups were compared in terms of patient readiness for discharge and patient evaluation of the quality of discharge teaching. Result: The total score of readiness for discharge was higher in the test group than in the control group (171.7 ± 24.5 vs. 155.9 ± 28.9) and the scores for “Self-condition” (55.6 ± 8.2 vs. 50.8 ± 9.7), “Disease Knowledge” (64.7 ± 13.1 vs. 57.7 ± 13.8), “Coping Ability after Discharge” (24.6 ± 4.8 vs. 22.2 ± 5.6), “Expected Social Support after Discharge” (26.8 ± 4.5 vs. 25.2 ± 4.8) were higher than those of the control group, and all differences were statistically significant (p < 0.05). The total score of the test group on the quality of discharge teaching scale was higher than that of the control group (162.1 ± 19.9 vs. 152.6 ± 28.7), and the scores for “Content that Patients Self-perceived they required before discharge” (53.2 ± 9.5 vs. 49.4 ± 12.1), “Content that Patients Actually Acquired before Discharge” (51.2 ± 9.2 vs. 48.3 ± 11.3) and “Guiding Skills and Effects of Discharge for Nurses” (110.9 ± 12.6 vs. 104.3 ± 19.00) were also higher than those of the control group (p Conclusion: Comprehensive intervention based on transition theory for post-operative breast cancer patients is beneficial to improve the quality of discharge nursing guidance, thereby improving the readiness for discharge of patients and enhancing the sense of control and identity of patients after discharge.

A Review of readiness for hospital discharge of patients after cardiac surgery

Background Severe cardiac surgery trauma can lead to cardiopulmonary function injury,resulting in prolonged postoperative bed occupancy and slowed recovery which in turn can cause a range of complications.Consequently,preparation for discharge is a critical aspect of patient recovery,thereby necessitating the utmost attention to discharge management.The objective of this paper was to review the concept of discharge readiness for patients after cardiac surgery,along with the current situation,evaluation tools,existing problems,and improvement strategies.The aim is to gain an understanding of the research progress made in this area and provide suggestions for enhancing the discharge readiness of patients.This study intended to offer theoretical guidance for further research on improving the discharge readiness of patients following cardiac surgery.