National Cancer Center & National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical Sciences, Beijing, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39314. doi: 10.1097/MD.0000000000039314.
To investigate and analyze the characteristics and factors associated with readiness for hospital discharge and continuing care needs of postoperative patients with lung cancer undergoing fast-track surgery (FTS). FTS aims to reduce the body's stress response to surgery and improve patient outcomes. The study included adult patients with confirmed lung cancer who underwent lung cancer surgery under FTS management and were discharged from the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, between June 2020 and September 2020. Patients with severe illnesses, comorbidities, disturbance of consciousness, cognitive disorders, or communication impairments were excluded. One-hundred-and-eighty patients were included, and 167 (92.8%) indicated that they were discharge-ready. Multivariable regression analysis showed that age 60 years or older (β = 16.29, 95% confidence interval (CI): 4.11-28.46, P = .009) and living alone (β = 37.07, 95% CI: 16.30-45.84, P < .001) were associated with the discharge readiness scores. In addition, those who were able to take care of themselves (β = 43.57, 95% CI: 19.60-67.54, P < .001) and needed little assistance at home (β = 28.39, 95% CI: 5.52-51.26, P = .015) had higher discharge readiness scores than those who needed a lot of assisted care. Patients who were cared for at home by children (β = 40.32, 95% CI: 4.91-75.73, P = .026), parents (β = 56.68, 95% CI: 12.33-101.03, P = .013), or spouses (β = 35.92, 95% CI: 2.45-69.38, P = .036), had higher discharge readiness scores than nursemaid. The discharge readiness scores of patients requiring continuing care were 146.5 ± 39.3, while patients who had no need scored 179.8 ± 36.5 (P < .01). Most patients with lung cancer undergoing FTS are discharge-ready. Discharge readiness is influenced by living conditions and self-care ability. This study identified factors influencing discharge readiness, and that could be used to identify patients who could benefit from help to improve discharge readiness.
调查和分析接受快速通道手术（FTS）的肺癌术后患者出院准备情况和继续护理需求的特点和相关因素。FTS 的目的是减轻身体对手术的应激反应，改善患者的预后。该研究纳入了 2020 年 6 月至 2020 年 9 月在中国医学科学院肿瘤医院接受 FTS 管理并出院的成年肺癌患者。排除严重疾病、合并症、意识障碍、认知障碍或沟通障碍的患者。共纳入 180 例患者，其中 167 例（92.8%）表示准备出院。多变量回归分析显示，60 岁或以上（β=16.29，95%置信区间：4.11-28.46，P=0.009）和独居（β=37.07，95%置信区间：16.30-45.84，P<0.001）与出院准备评分有关。此外，那些能够自理（β=43.57，95%置信区间：19.60-67.54，P<0.001）和在家需要很少帮助（β=28.39，95%置信区间：5.52-51.26，P=0.015）的患者比需要大量辅助护理的患者出院准备评分更高。在家由子女（β=40.32，95%置信区间：4.91-75.73，P=0.026）、父母（β=56.68，95%置信区间：12.33-101.03，P=0.013）或配偶（β=35.92，95%置信区间：2.45-69.38，P=0.036）照顾的患者出院准备评分更高。需要继续护理的患者的出院准备评分是 146.5±39.3，而无需护理的患者评分为 179.8±36.5（P<0.01）。大多数接受 FTS 的肺癌患者都准备出院。出院准备情况受生活条件和自理能力的影响。本研究确定了影响出院准备情况的因素，这些因素可用于识别受益于帮助提高出院准备情况的患者。
