Yang Jie, Ge Ling, Ju Xin-Xing, Liu Xiao-Xin
Intensive Care Unit, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
J Clin Nurs. 2025 Apr 10. doi: 10.1111/jocn.17743.
To investigate the status of discharge readiness of patients undergoing daytime lung cancer surgery and analyse its influencing factors.
This was a cross-sectional study.
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.
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.
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.
The reporting of the study was guided by the STROBE checklist: cross-sectional studies (Table S1).
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.
调查日间肺癌手术患者的出院准备情况，并分析其影响因素。
这是一项横断面研究。
本研究采用便利抽样法，选取2022年8月至2023年2月在上海一家三级甲等医院接受日间肺癌手术的患者。使用一般资料问卷、出院准备度量表、简短疾病感知问卷和10项康纳-戴维森韧性量表对203例患者进行评估。采用多元线性回归分析影响出院准备的因素。
日间肺癌手术患者出院准备度量表总分为72.76±20.91。多元回归分析显示，居住地、家庭月收入、术后不良反应的存在、疾病感知和韧性是出院准备的影响因素（p<0.05），其中疾病感知（β=-0.391，p<0.001）和韧性（β=0.317，p<0.001）是最显著的因素，二者共同解释了总变异的44.9%。
肺癌日间手术患者的出院准备情况中等，表明有改善空间。临床实践应关注低收入、农村或术后有不良反应的患者。此外，促进患者对疾病的积极认知并增强其韧性可进一步提高其出院准备程度。
本研究的报告遵循STROBE清单：横断面研究（表S1）。
医疗保健专业人员应专注于评估患者的出院准备情况，这与世界卫生组织对以患者为中心的出院计划的强调一致。我们建议：（1）为农村和低收入患者建立出院后支持系统；（2）在术前教育中纳入增强韧性的干预措施；（3）采用多种形式的健康促进方法来改变负面的疾病认知和应对策略。此外，我们强烈主张制定由护士主导的过渡性护理计划，以满足医疗和心理社会需求，从而优化患者康复和长期健康状况。
