Status and Influencing Factors of Discharge Readiness in Day Surgery Lung Cancer Patients Under a Fast-Track Rehabilitation Pathway.

Abstract

Aim: To investigate the status of discharge readiness of patients undergoing daytime lung cancer surgery and analyse its influencing factors.

Design: This was a cross-sectional study.

Methods: In this study, patients who underwent daytime lung cancer surgery from August 2022 to February 2023 at a Tertiary Care Hospital in Shanghai were selected via the convenience sampling method. A general data questionnaire, the Readiness for Hospital Discharge Scale, the Brief Illness Perception Questionnaire and the 10-item Connor Davidson Resilience Scale were used to assess 203 patients. Multiple linear regression analysis was used to analyse the factors influencing discharge readiness.

Results: The total Readiness for Hospital Discharge Scale score for patients who underwent daytime lung cancer surgery was 72.76 ± 20.91. Multiple regression analysis revealed that residence, monthly family income, the presence of postoperative adverse effects, illness perception and resilience were influencing factors for discharge readiness (p < 0.05), with illness perception (β = -0.391, p < 0.001) and resilience (β = 0.317, p < 0.001) being the most significant factors, which together explained 44.9% of the total variance.

Conclusion: The discharge readiness of day surgery patients with lung cancer is moderate, indicating room for improvement. Clinical practice should focus on lower-income, rural or postoperative patients with adverse reactions. Additionally, promoting patients' positive perceptions of their illness and increasing their resilience can further enhance their discharge readiness.

Reporting methods: The reporting of the study was guided by the STROBE checklist: cross-sectional studies (Table S1).

Relevance to clinical practice: Healthcare professionals should focus on assessing patients' readiness for discharge, consistent with the World Health Organization's emphasis on patient-centred discharge planning. We recommend (1) establishing post-discharge support systems for rural and low-income patients, (2) including resilience-building interventions in preoperative education and (3) adopting a multiform health promotion approach to change negative illness perceptions and coping strategies. Additionally, we strongly advocate for the development of nurse-led transitional care plans that address both medical and psychosocial needs to optimise patient recovery and long-term well-being.