Effects of a Discharge Preparation Program Based on the Cox Interaction Model of Client Health Behavior in Patients Undergoing Laryngeal Cancer Surgery.

Abstract

BACKGROUND Readiness for hospital discharge is critical for rehabilitation outcomes, yet traditional discharge education often fails to meet individualized needs after laryngeal cancer surgery. The Cox Interaction Model of Client Health Behavior (IMCHB) provides a patient-centered framework emphasizing interaction and empowerment, but its application in this population is rarely reported. IMCHB-based discharge preparation intervention in patients undergoing laryngeal cancer surgery was evaluated. MATERIAL AND METHODS This quasi-experimental, non-randomized controlled study used convenience sampling to recruit patients undergoing laryngeal cancer surgery at a tertiary hospital. Sixty-five patients (33 intervention, 32 control) were assigned by admission order. The control group received routine nursing care; the intervention group received an IMCHB-based discharge preparation intervention plus routine care. Groups were compared for readiness for hospital discharge, self-management ability, and anxiety/depression before the intervention, at discharge, and 1 month after discharge. Effect sizes and 95% CIs were calculated for key between-group comparisons. RESULTS At discharge, the intervention group had higher readiness-for-discharge scores (99.97±6.31 vs 88.09±6.14; MD=11.88, 95% CI: 8.65-14.71; Cohen's d=1.91), higher self-management ability (174.73±9.35 vs 152.13±12.78; MD=22.60, 95% CI: 17.05-28.15; Cohen's d=2.02), and lower anxiety scores (41.48±2.89 vs 43.19±3.70; MD=-1.71, 95% CI: -3.36 to -0.06; Cohen's d=0.51). One month after discharge, self-management remained higher (189.00 [186.00, 191.50] vs 144.00 [133.00, 154.50]; Mann-Whitney r=0.86), and depression scores were lower (40.73±3.18 vs 46.75±3.09; MD=-6.02, 95% CI: -7.57 to -4.47; Cohen's d=1.92). CONCLUSIONS IMCHB-based discharge preparation was associated with higher readiness for discharge and self-management ability and lower anxiety/depression scores after laryngeal cancer surgery. These findings should be interpreted cautiously, and randomized controlled trials are needed to confirm its effectiveness and clinical utility.