了解造口患者出院准备的挑战：一项混合方法研究。

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

作者信息

Lin Liying, Zheng Jianwei, Lin Zhenglong, Xiao Huimin

机构信息

School of Nursing, Fujian Medical University, Fuzhou, China.

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

出版信息

J Clin Nurs. 2025 May;34(5):1704-1712. doi: 10.1111/jocn.17654. Epub 2025 Jan 14.

DOI:10.1111/jocn.17654

PMID:39809578

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.

摘要

目的

确定影响出院准备情况的关键因素，并深入了解造口患者的出院体验。

设计

一项混合方法研究。

方法

共纳入374例结直肠癌造口患者，以评估出院准备情况及其影响因素。此外，28名利益相关者（包括外科医生、护理管理者、外科护士、造口治疗师、造口患者及其家庭照顾者）参与了半结构化访谈。使用经过验证的量表收集出院准备情况、出院指导质量、造口自我效能感和社会支持方面的数据。深入访谈进一步深入了解了出院准备体验。使用IBM SPSS 26.0进行多变量逻辑回归分析，并通过NVivo 12.0进行主题分析以进行数据分析。