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哪些因素影响患者的出院准备情况:全膝关节置换术案例:一项横断面研究

What Influences Patients Readiness for Discharge: The Case of Total Knee Arthroplasty: A Cross-Sectional Study.

作者信息

Li Na, Moreira Paulo, Guo Manjie, You Simeng, Dsouza Brayal, Ji Hong

机构信息

Nursing Department, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.

Henan Normal University, School of Social Affairs, Xinxiang, Henan, China.

出版信息

J Nurs Manag. 2024 Apr 1;2024:8032254. doi: 10.1155/2024/8032254. eCollection 2024.


DOI:10.1155/2024/8032254
PMID:40224761
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11918989/
Abstract

BACKGROUND: Evidence has suggested that most clinical staff use clinical laboratory indicators to determine discharge times, while paying little attention to patients' feelings and needs. Additional research findings have suggested a relationship between patients' self-reported readiness for hospital discharge and postdischarge complication rates, readmission rates, mortality, as well as quality of life. RHD is strongly associated with patient health outcomes. Identifying relevant influencing factors can provide guidance for early individualized interventions by healthcare professionals. DESIGN: A cross-sectional study. METHODS: During 2022, a total of 320 post-TKA patients were selected for this study. The patients were divided into the low-RHD group (<7 points) and the high-RHD group (≥7 points) according to the mean score of the Readiness for Hospital Discharge Scale (RHDS). Established scales were used to collect patients' information and to adopt univariate and binary logistic regression analysis to screen for independent factors. RESULTS: In this study, the RHDS score of patients after TKA is 91.90 ± 7.05, of which 12.8% are in the low-RHD group (mean score <7). The binary logistic regression results reveal that age, educational level, postactivity pain, self-efficacy, and family care have to be considered risk factors generating low-RHD in TKA patients. CONCLUSIONS: The present study suggests that over 1/8 TKA patients are not ready at the time of discharge. Physicians and nurses can improve patients' RHD by reducing postactivity pain and improving self-efficacy during their rehabilitation period. . The results of this study can help physicians and nurses early identify high-risk patients with low RHD and provide them with individualized interventions. In addition to this, it is important that nurses use RHDS to assess the readiness of TKA patients before they are discharged from the hospital.

摘要

背景:有证据表明,大多数临床工作人员使用临床实验室指标来确定出院时间,而很少关注患者的感受和需求。另外的研究结果表明,患者自我报告的出院准备情况与出院后并发症发生率、再入院率、死亡率以及生活质量之间存在关联。出院准备度与患者健康结局密切相关。识别相关影响因素可为医护人员早期进行个体化干预提供指导。 设计:一项横断面研究。 方法:2022年期间,本研究共选取了320例全膝关节置换术后患者。根据出院准备度量表(RHDS)的平均分,将患者分为低出院准备度组(<7分)和高出院准备度组(≥7分)。使用既定量表收集患者信息,并采用单因素和二元逻辑回归分析来筛选独立因素。 结果:在本研究中,全膝关节置换术后患者的RHDS评分为91.90±7.05,其中12.8%属于低出院准备度组(平均分<7)。二元逻辑回归结果显示,年龄、教育水平、活动后疼痛、自我效能感和家庭护理必须被视为全膝关节置换术患者出院准备度低的危险因素。 结论:本研究表明,超过八分之一的全膝关节置换术患者出院时未做好准备。医生和护士可以通过在康复期间减轻活动后疼痛并提高自我效能感来改善患者的出院准备度。本研究结果可帮助医生和护士早期识别出院准备度低的高危患者,并为他们提供个体化干预。除此之外,护士在全膝关节置换术患者出院前使用RHDS评估其出院准备情况非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7d0/11918989/ed987d504c59/JONM2024-8032254.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7d0/11918989/ed987d504c59/JONM2024-8032254.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7d0/11918989/ed987d504c59/JONM2024-8032254.001.jpg

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The intermediary effect of perceived social support on the psychological resilience and discharge readiness among gynecological patients of childbearing age.

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本文引用的文献

[1]
Readiness for Hospital Discharge and Its Correlation with the Quality of Discharge Teaching among the Parents of Premature Infants in NICU.

Appl Bionics Biomech. 2022-7-13

[2]
The Time Course of Quadriceps Strength Recovery After Total Knee Arthroplasty Is Influenced by Body Mass Index, Sex, and Age of Patients: Systematic Review and Meta-Analysis.

Front Med (Lausanne). 2022-5-25

[3]
Clinical Outcomes of Revision Total Knee Arthroplasty after High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Orthop Surg. 2022-8

[4]
Discharge teaching, patient-reported discharge readiness and postsurgical outcomes in gynecologic patients undergoing day surgery: a generalized estimating equation.

BMC Surg. 2022-5-10

[5]
Comparison of Nurses' and Patients' Readiness for Hospital Discharge: A Multicenter Study.

J Patient Exp. 2022-4-18

[6]
Readiness for hospital discharge in primary caregivers for children with acute lymphoblastic leukaemia.

J Clin Nurs. 2022-11

[7]
Readiness for Hospital Discharge of Adult Patients with Major Depressive Disorder in China: A Cross-Sectional Study.

Patient Prefer Adherence. 2021-7-30

[8]
Clinical Course of Pain and Function Following Total Knee Arthroplasty: A Systematic Review and Meta-Regression.

J Arthroplasty. 2021-12

[9]
Readiness for Discharge from Hospital after Myocardial Infarction: A Cross-Sectional Study.

Int J Environ Res Public Health. 2021-6-28

[10]
Enhanced Recovery After Primary Total Hip and Knee Arthroplasty: A Systematic Review.

J Bone Joint Surg Am. 2021-10-20

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