Interaction mechanism of discharge readiness between discharge teaching and post-discharge outcomes in gynecological inpatients: a mediation analysis.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2024-09-02 DOI:10.1007/s00423-024-03450-5

Huaxuan You, Anjiang Lei, Li Liu, Xiaolin Hu

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Abstract

Background: With the rapid implementation of enhanced recovery after surgery, most gynecological patients are discharged without full recovery. Discharge planning is necessary for patients and their families to transition from hospital to home. Discharge teaching and discharge readiness are two core indicators used to evaluate the quality of discharge planning, which impacts the post-discharge outcomes. To improve post-discharge outcomes, the interaction mechanism of the three variables needs to be determined, but few studies have focused on it.

Objectives: Explore the mediating effect of discharge readiness between discharge teaching and post-discharge outcomes of gynecological inpatients.

Methods: Discharge teaching and discharge readiness were measured by the Quality of Discharge Teaching Scale (QDTS) and Readiness for Hospital Discharge Scale (RHDS). Post-discharge outcomes on postoperative Day 7 (POF-D7) and postoperative Day 28 (POF-D28) were measured by a self-designed tool. Spearman correlations, Kruskal‒Wallis tests and Mann‒Whitney U tests were conducted to explore the correlation between post-discharge outcomes and other variables. Mediation analysis was used to explore the mediating effect of discharge readiness between discharge teaching and post-discharge outcomes.

Results: QDTS and RHDS showed strong positive correlations with post-discharge outcomes. The mediation analyses verified that RHDS was a full mediator between QDTS and POF-D7, and the indirect effect accounted for 95.6% of the total direct effect. RHDS was a partial mediator between QDTS and POF-D28, and the indirect effect accounted for 50.0% of the total direct effect. RHDS was a full mediator between QDTS and total scores of post-discharge outcomes, and the indirect effect accounted for 88.9% of the total direct effect.

Conclusions: Discharge teaching can improve the post-discharge outcomes of gynecological inpatients through the intermediary role of discharge readiness. Doctors and nurses should value the quality of discharge teaching and the discharge readiness improving of gynecological inpatients. Future studies should note the interaction mechanism of the three variables to explore more efficient ways of improving post-discharge outcomes of gynecological inpatients.

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妇科住院病人出院教学与出院后疗效之间的出院准备互动机制：中介分析。

背景：随着加强术后恢复措施的迅速实施，大多数妇科患者在没有完全康复的情况下就出院了。出院计划是患者及其家属从医院过渡到家庭所必需的。出院指导和出院准备是用于评估出院计划质量的两个核心指标，而出院计划质量影响出院后的效果。为了改善出院后的效果，需要确定这三个变量之间的相互作用机制，但很少有研究关注这一问题：探讨出院准备在出院指导与妇科住院患者出院后效果之间的中介效应：方法：通过出院教学质量量表（QDTS）和出院准备量表（RHDS）测量出院教学和出院准备情况。术后第 7 天（POF-D7）和术后第 28 天（POF-D28）的出院后效果通过自行设计的工具进行测量。采用斯皮尔曼相关性检验、Kruskal-Wallis 检验和 Mann-Whitney U 检验来探讨出院后结果与其他变量之间的相关性。使用中介分析来探讨出院准备度在出院教学和出院后结果之间的中介效应：结果：QDTS和RHDS与出院后疗效呈强正相关。中介分析证实，RHDS是QDTS和POF-D7之间的完全中介，其间接效应占总直接效应的95.6%。RHDS是QDTS和POF-D28之间的部分中介因子，间接效应占总直接效应的50.0%。RHDS是QDTS与出院后结果总分之间的完全中介因子，间接效应占直接效应总量的88.9%：出院指导可通过出院准备的中介作用改善妇科住院患者的出院后预后。医生和护士应重视出院指导的质量和妇科住院患者出院准备度的提高。今后的研究应注意三个变量的相互作用机制，以探索更有效的改善妇科住院患者出院后预后的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.