Factors Influencing Readiness for Hospital Discharge among Patients Undergoing Enterostomy: A Descriptive, Cross-sectional Study.

To examine the factors influencing hospital discharge readiness among Chinese patients who have undergone enterostomy. In this descriptive, cross-sectional study, researchers recruited patients with colorectal cancer who underwent enterostomy at a tertiary hospital in Guangdong Province, China, via convenience sampling between January 2021 and January 2023. Participants completed the Readiness for Hospital Discharge Scale, Ostomy Self-care Ability Scale, and Stoma-Quality of Life-Chinese Questionnaire (Chinese version) at the time of hospital discharge. Univariate, correlation, and multiple linear regression analyses were performed to explore the impact of self-care ability, quality of life, and other clinicodemographic characteristics on patients' readiness for hospital discharge. Of the 200 questionnaires distributed, 177 (88.5%) were completed and included in the final analysis. The median scores for the factors considered in this study were as follows: Readiness for Hospital Discharge Scale was 148.00 (interquartile range [IQR], 117.50, 164.00), self-care intention of the Ostomy Self-care Ability Scale was 36.00 (IQR, 34.00, 40.00), self-care knowledge of the Ostomy Self-care Ability Scale was 17.00 (IQR, 15.00, 19.00), self-care skill of the Ostomy Self-care Ability Scale was 5.00 (IQR, 3.00, 6.00), and the total score for quality of life was 60.00 (IQR, 49.00, 69.00). Multiple linear regression analysis identified several key factors explaining 48.2% of the variance in global readiness for hospital discharge: global quality of life (β = .347, P < .001), self-care knowledge (β = .259, P < .001), leakage during hospitalization (β = -0.241, P < .001), monthly family income (β = .148, P = .008), stoma siting before surgery (β = .130, P = .020), and self-care intention (β = .127, P = .035). The readiness for hospital discharge among patients undergoing enterostomy in this study was high. Factors such as quality of life, self-care knowledge, leakage during hospitalization, monthly family income, stoma siting before surgery, and self-care intention after undergoing enterostomy influenced the patients' readiness for hospital discharge. Therefore, future studies should focus on developing interventions to enhance patients' readiness for hospital discharge.

Li S ，Luo C ，Xie M ，Lai J ，Qiu H ，Xu L ，Chen J ，Mo L ，Guan X ，Tang F ，Zhang Y ，Huang Q ，Liu Y ，Luo W ，Chen J ... -  《-》

A Descriptive, Cross-sectional Study Among Chinese Patients to Identify Factors that Affect Psychosocial Adjustment to an Enterostomy.

Xian H ，Zhang Y ，Yang Y ，Zhang X ，Wang X ... -  《-》

Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: The mediating role of readiness for hospital discharge and stoma self-efficacy.

This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect. It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy. This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson's correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data. Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]). Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.

Lin L ，Fang Y ，Huang F ，Zhang X ，Zheng J ，Xiao H ... -  《PLoS One》

Effect of Orem's self-care model on discharge readiness of patients undergoing enterostomy: A randomized controlled trial.

To evaluate the effectiveness of Orem's self-care model in preparing hospitals for the discharge of patients with colorectal cancer who undergo enterostomy. 92 patients with enterostomy were recruited between February 2022 and February 2023 from a general tertiary hospital. The participants were assigned to either the intervention group or the control group randomly. The intervention group received Orem's self-care program and a three-month follow-up, whereas the control group received only routine care and a three-month follow-up. Discharge readiness, self-care ability, and stoma-quality-of-life data were collected at hospital discharge (T1), 30 days (T2), and 90 days (T3) after discharge. The intervention group had substantially higher discharge readiness (knowledge, p < 0.001; coping ability, p = 0.006; personal status, p = 0.001; expected support, p = 0.021; total score, p < 0.001), better self-care ability at T1 (self-care knowledge, p < 0.001; self-care skills, p = 0.010), better total quality of life (QoL) at T1, T2, and T3 (p < 0.001; p = 0.006; p = 0.014); better stoma management and daily routine at T1 (p = 0.004; p < 0.001); and better daily routine at T2 (p = 0.009) than the control group. The designed discharge readiness program based on Orem's self-care could promote effective patient discharge readiness, self-care knowledge, self-care skills, and QoL. The trial number ChiCTR2200056302 registered on ClinicalTrials.gov.

Li SQ ，Luo CL ，Qiu H ，Liu YX ，Chen JM ... -  《-》

Relationship between psychosocial adaptation and health-related quality of life of patients with stoma: A descriptive, cross-sectional study.

To investigate the relationship between psychosocial adaptation and quality of life of patients with ostomies and to provide reference data for clinical care practice. Surgical enterostomy impacts the life of patient. Most patients are transferred to home or community hospital after discharge and require long-term nursing care. These patients typically face problems with physical, psychological and social adaptation. Descriptive, cross-sectional study. Between March 2017-June 2017, the following questionnaires were electronically administered to 1,053 patients with enterostomy residing in 22 provinces, 4 autonomous regions for ethnic minorities and 4 direct-controlled municipalities in China: Social Support Revalued Scale, validated Chinese version of Ostomy Adjustment Inventory and Stoma-Quality of life-Chinese. Univariate analysis, correlation analysis and hierarchical regression analysis were used to assess the relationship between adaptation level and quality of life of patients with enterostomy, in order to provide reference data for clinical care practice and further improve the quality of life of these patients. The STROBE checklist was used in reporting this study. The mean score for psychosocial adaptation was 43.13 ± 13.09, which corresponded to a medium level; the mean score for quality of life was 56.54 ± 16.87. The level of psychosocial adaptation and each dimension showed a positive correlation with the quality of life of patient and each dimension (r = 0.349-0.890, p < 0.01). Univariate analysis revealed a signification association of quality of life with education level, medical payment method, area of residence, peristomal complications, regular defecation, occurrence of leaking, ability for self-care of stoma, communication between patient and medical staff, and knowledge and skills pertaining to care of stoma. Results of hierarchical regression analysis indicated that psychosocial adaptation level was a predictor of quality of life (R2  = 0.708; p < 0.001). In this study, the quality of life of patients with enterostomy was generally of a medium level. The level of psychosocial adaptation of the patient was closely linked to quality of life. During clinical care, concerted efforts should be made to encourage the patients to deal with the stoma positively and to help the patient and their families accept the stoma and change of image to reduce the adaption course and improve the quality of life. Patients tend to take a long time to adapt to the stoma after ostomy formation. Facilitating the adjustment of patients with enterostomy may improve their quality of life. Medical care providers should focus more attention on patients who have lower ostomy adjustment scores.

Zhang Y ，Xian H ，Yang Y ，Zhang X ，Wang X ... -  《-》