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聚焦解决方案模式的出院准备指导干预对中国小儿肝移植患者父母的影响:一项单中心观察性研究。

The effects of a solution-focused model discharge readiness coaching intervention on the parents of Chinese pediatric liver transplantation patients: a single-center observational study.

作者信息

He Ting, Huang Xiaobo, Feng Zhaoyan, Huang Fang, Yang Fanfan, Chen Chunrong, Minani Jeremie, Wei Qin, Pocha Christine, Tang Lihua

机构信息

Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Department of Professional Nursing Studies, Kulliyyah of Nursing, International Islamic University Malaysia Kuantan, Pahang, Malaysia.

出版信息

Transl Pediatr. 2025 May 30;14(5):992-1002. doi: 10.21037/tp-2025-66. Epub 2025 May 23.

Abstract

BACKGROUND

Liver transplantation (LT) is the only effective treatment for pediatric diseases such as cholestatic diseases, genetic metabolic diseases, acute liver failure, and liver malignancies. With the continuous improvement of LT technology, more and more children with end-stage liver disease are receiving this life-saving treatment. Parents of pediatric LT patients often face significant psychological challenges, including anxiety, depression, and a lack of confidence in their ability to provide postoperative care. This study aimed to evaluate the impact of a solution-focused based model discharge readiness coaching intervention on improving the discharge readiness and mental health status of parents of pediatric LT patients.

METHODS

A convenience sampling method was used to select either the father or the mother of 110 pediatric LT patients hospitalized in the Organ Transplantation Department of The First Affiliated Hospital of Guangxi Medical University as study participants. The study was conducted over 2 years, with 55 parents of children who underwent LT in 2022 serving as the control group and 55 parents of children who underwent LT in 2023 serving as the experimental group. The experimental group received routine education plus tailored, solution-focused counseling sessions lasting approximately 20 to 30 minutes each, conducted every Tuesday and Friday. The control group received standard care. Discharge readiness scores before and after the intervention, as well as the quality scores for the discharge counseling provided, were assessed.

RESULTS

The experimental group showed significantly higher discharge readiness scores (total and subscales: personal status, coping ability, anticipatory support) and discharge counseling quality compared to the control group (P<0.05). The effect size for the total discharge readiness score was 0.85, indicating a large effect. The intervention also reduced unplanned readmissions and improved postoperative quality of life. However, due to the limitations of the study design, including the single-center nature and small sample size, the findings should be interpreted with caution.

CONCLUSIONS

The solution-focused model intervention improved parents' discharge readiness and the quality of discharge counseling, thus improving the patients and caregivers postoperatively quality of life and reducing the unplanned readmission rate of pediatric LT patients. Future studies should address these limitations through multicenter trials with larger sample sizes.

摘要

背景

肝移植(LT)是治疗诸如胆汁淤积性疾病、遗传代谢性疾病、急性肝衰竭和肝脏恶性肿瘤等儿科疾病的唯一有效方法。随着肝移植技术的不断进步,越来越多的终末期肝病患儿正在接受这种挽救生命的治疗。小儿肝移植患者的父母常常面临重大的心理挑战,包括焦虑、抑郁以及对自身术后护理能力缺乏信心。本研究旨在评估基于聚焦解决方案模式的出院准备指导干预对提高小儿肝移植患者父母的出院准备度和心理健康状况的影响。

方法

采用便利抽样法,选取广西医科大学第一附属医院器官移植科住院的110例小儿肝移植患者的父亲或母亲作为研究对象。研究历时2年,2022年接受肝移植患儿的55名父母作为对照组,2023年接受肝移植患儿的55名父母作为试验组。试验组接受常规教育以及量身定制的、聚焦解决方案的咨询课程,每周二和周五各进行一次,每次时长约20至30分钟。对照组接受标准护理。评估干预前后的出院准备度得分以及所提供出院咨询的质量得分。

结果

与对照组相比,试验组的出院准备度得分(总分及各子量表:个人状况、应对能力、预期支持)和出院咨询质量显著更高(P<0.05)。出院准备度总分的效应量为0.85,表明效果显著。该干预还降低了非计划再入院率并改善了术后生活质量。然而,由于研究设计的局限性,包括单中心性质和样本量较小,研究结果应谨慎解读。

结论

聚焦解决方案模式干预提高了父母的出院准备度和出院咨询质量,从而改善了患者及其照护者的术后生活质量,并降低了小儿肝移植患者的非计划再入院率。未来的研究应通过多中心、大样本量试验来解决这些局限性。

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