Nursing Department, Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Department of Chemotherapy, Guangxi Academy of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
J Oncol Pharm Pract. 2023 Jul;29(5):1135-1143. doi: 10.1177/10781552221100720. Epub 2022 May 12.
Readiness for hospital discharge is associated with patients' health outcomes after they return home. However, little is known about this association among cancer patients receiving oral chemotherapy at home. This study aimed to examine whether patients' reported readiness for hospital discharge was associated with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home.
A prospective study was conducted, and 151 cancer patients receiving oral chemotherapy were recruited from a provincial level hospital in South China between October 2018 and December 2019. The primary outcome was readiness for hospital discharge assessed by the Readiness for Hospital Discharge Scale-Short Form on the day of discharge. The secondary endpoints were symptoms assessed by MD Anderson Symptom Inventory and non-routine utilization of post-discharge services within one cycle of chemotherapy at home (21 days).
Among these 151 participants, 74.2% of them reported as ready for discharge. Patients who were employed, lived in suburban area or villages, had a higher Eastern Cooperative Oncology Group score, took Tegafur as oral chemotherapy, and took oral chemotherapy for the first time reported lower readiness for hospital discharge. These five factors explained 28.1% of variance in readiness for hospital discharge. Patients who were not ready for discharge were prone to report higher symptom severity ( 0.038). No differences in non-routine utilization of post-discharge services were found between the readiness versus non-readiness for discharge groups ( 0.891).
Most cancer patients receiving oral chemotherapy at home were ready for discharge, which was influenced by employment status, residence status, Eastern Cooperative Oncology Group score, type of oral chemotherapy drug, and the experience of taking oral chemotherapy at home. Patients with lower readiness reported worse symptom severity at home. Routine assessment was suggested to recognize unready patients, and more extensive preparations for discharge were recommended to help them manage symptoms at home.
出院准备情况与患者出院回家后的健康结果相关。然而，在家中接受口服化疗的癌症患者中，人们对这种关联知之甚少。本研究旨在探讨在家中接受口服化疗的癌症患者出院准备情况与出院后症状和非常规使用服务之间的关系。
采用前瞻性研究方法，2018 年 10 月至 2019 年 12 月，从华南地区一家省级医院招募了 151 名在家中接受口服化疗的癌症患者。主要结局指标为出院日采用简化版出院准备情况评估量表评估的出院准备情况。次要结局指标为 MD 安德森症状量表评估的症状和在家中一个化疗周期（21 天）内非常规使用出院后服务。
在这 151 名参与者中，74.2%的人表示准备好出院。在职、居住在郊区或农村、东部合作肿瘤组评分较高、使用替加氟作为口服化疗药物、首次接受口服化疗的患者报告的出院准备情况较差。这五个因素解释了出院准备情况 28.1%的变异性。准备不充分的患者更有可能报告更高的症状严重程度（0.038）。准备出院组和未准备出院组在出院后服务的非常规使用方面无差异（0.891）。
在家中接受口服化疗的大多数癌症患者准备出院，这受就业状况、居住状况、东部合作肿瘤组评分、口服化疗药物类型以及在家中接受口服化疗的经验的影响。准备不充分的患者在家中报告的症状严重程度更差。建议常规评估以识别未准备好的患者，并为他们提供更多的出院准备，以帮助他们在家中管理症状。
