Understanding the Challenges of Readiness for Hospital Discharge in Stoma Patients: A Mixed-Methods Study.

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing Pub Date : 2025-01-14 DOI:10.1111/jocn.17654

Liying Lin, Jianwei Zheng, Zhenglong Lin, Huimin Xiao

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引用次数: 0

Abstract

Aim: To identify key factors influencing readiness for hospital discharge and delve into the experiences of stoma patients regarding their discharge.

Design: A mixed-methods study.

Method: A total of 374 colorectal cancer patients with stomas were involved to assess discharge readiness and its influencing factors. Additionally, 28 stakeholders-comprising surgeons, nursing managers, surgical nurses, enterostomal therapists, stoma patients and their family caregivers-participated in semistructured interviews. Data on discharge readiness, discharge teaching quality, stoma self-efficacy and social support were collected using validated scales. In-depth interviews provided further insights into discharge preparation experiences. Multivariate logistic regression analysis using IBM SPSS 26.0 and thematic analysis via NVivo 12.0 were employed for data analysis.

Results: Six variables accounted for 80% of the variance in discharge readiness: quality of discharge teaching, stoma self-efficacy, social support, age, gender and family income. Four main themes emerged: ambivalence towards discharge, insufficient preparation time, inadequate communication of discharge information and personal planning needs.

Conclusion: Discharge readiness among stomas patients is influenced by perceived discharge teaching quality, self-efficacy, social support, age, gender and family income. Insufficient preparation and poor communication hinder effective discharge information transfer. Enhanced, patient-centred discharge planning is expected to improve the transition from hospital to home.

Implications for the profession and/or patient care: To improve hospital discharge readiness and facilitate a smooth transition to family care, it is essential to implement patient-centred discharge planning.

Reporting method: Reported with the Mixed Methods Reporting in Rehabilitation & Health Sciences guidelines.

Patient or public contribution: None.

Trial registration: ClinicalTrials.gov identifier: ChiCTR2200058756. https://www.chictr.org.cn/bin/home.

查看原文本刊更多论文

了解造口患者出院准备的挑战：一项混合方法研究。

目的：探讨影响口腔造口患者出院准备的关键因素，探讨造口患者的出院经历。设计：混合方法研究。方法：对374例结直肠癌造口患者进行出院准备情况及其影响因素评估。此外，包括外科医生、护理经理、外科护士、肠造口治疗师、造口患者及其家庭护理人员在内的28名利益相关者参加了半结构化访谈。出院准备、出院教学质量、造口自我效能和社会支持等方面的数据采用验证过的量表收集。深入访谈为出院准备经验提供了进一步的见解。采用IBM SPSS 26.0进行多变量logistic回归分析，采用NVivo 12.0进行专题分析。结果：出院教学质量、造口自我效能、社会支持、年龄、性别、家庭收入6个变量占出院准备方差的80%。出现了四个主要主题：对出院的矛盾心理、准备时间不足、出院信息沟通不足和个人规划需要。结论：口腔造口患者的出院准备程度受感知出院教学质量、自我效能感、社会支持、年龄、性别和家庭收入的影响。准备不足、沟通不畅阻碍了有效的出院信息传递。加强以病人为中心的出院计划有望改善从医院到家庭的过渡。对专业和/或病人护理的影响：为了改善出院准备并促进向家庭护理的顺利过渡，实施以病人为中心的出院计划至关重要。报告方法：采用康复与健康科学指南中的混合方法报告。患者或公众贡献：无。试验注册：ClinicalTrials.gov标识符：ChiCTR2200058756。https://www.chictr.org.cn/bin/home。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.