Relationships Between Quality of Discharge Teaching, Readiness for Hospital Discharge, Self-Efficacy and Self-Management in Patients With First-Episode Stroke: A Cross-Sectional Study.

The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates. Cross-sectional study. A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables. The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376-0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ2/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05). QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community. Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.

Li S ，Chen R ，Zhang L ，Li H ，Gong Y ，Hang Y ，Cao J ，Zhang H ... -  《-》

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》

Current Status and Influencing Factors of Readiness for Hospital Discharge of Lung Cancer Patients Receiving ERAS-Guided Postoperative Management.

Zeng F ，Sun M ，Li Y ，Fan T ，Wu X ，Wang L ，Li Y ... -  《-》

The factors of patient-reported readiness for hospital discharge in patients with depression: A cross-sectional study.

WHAT IS KNOWN ON THE SUBJECT?: The attributes of readiness for hospital discharge (RHD) have been identified to be physical stability, adequate support, psychological ability, and adequate information and knowledge. Patient-reported RHD has been regarded as an outcome indicator, and poor RHD leads to unplanned readmission, emergency department visits and even death. Knowledge regarding patient-reported RHD and its factors among patients with depression is limited. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: RHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. The knowledge dimension of the RHDS among patients with depression should be further strengthened. The length of stay, content received and delivery dimensions of the QDTS were significantly associated with RHD. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study encourages nurses to assess patient-reported RHD at discharge in mental health settings. Nurses should pay more attention to patients with hospital stays longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content. Nurses' managers could develop programmes to improve teaching skills via Internet technology, such as simulated patients and online interprofessional discharge planning. ABSTRACT: Introduction Low readiness for hospital discharge (RHD) can be followed by negative healthcare outcomes. However, no studies have investigated RHD among patients with depression. Aim This study aimed to examine patient-reported RHD and its factors among patients with depression. Method In total, 367 inpatients with depression were recruited and completed the Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). A binary logistic regression analysis was performed to explore the factors of RHD among patients with depression. Results The total RHDS score was 7.70 ± 1.52. Approximately 28.9% of the participants had low RHD (RHDS score < 7). The results revealed that RHD was significantly associated with the length of stay, content received and delivery. Discussion RHD among patients with depression is at a moderate level. More than a quarter of people with depression had low RHD. To improve RHD, enhancing the quality of discharge teaching is imperative for patients with depression. Implications for Practice Nurses should pay more attention to patients with a hospital stay longer than 20 days. Nurses could improve RHD by enhancing the quality of discharge teaching, particularly the content received and the skills nurses used to deliver such content.

Wang M ，Wang Y ，Meng N ，Li X ... -  《-》

The association between patient-reported readiness for hospital discharge and outcomes in patients diagnosed with anxiety disorders: A prospective and observational study.

WHAT IS KNOWN ON THE SUBJECT?: Readiness for hospital discharge (RHD) has been an important topic for nurses. RHD can be measured by the Readiness for Hospital Discharge Scale (RHDS), including 4 subscales: personal status, knowledge, coping ability and expected support. There are few studies that focus on RHD in patients diagnosed with mental disorders. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Improving patient-reported RHD can decrease the risks of unscheduled post-discharge clinic visits, readmission and poor quality of life (QOL) in patients diagnosed with anxiety disorders. Improving patient-reported personal status can decrease the risk of poor QOL in patients diagnosed with anxiety disorders. Improving patient-reported knowledge can decrease the risks of unscheduled post-discharge clinic visits and readmission in patients diagnosed with anxiety disorders. Improving patient-reported expected support can decrease the risk of unscheduled post-discharge clinic visits in patients diagnosed with anxiety disorders. Improving the methods of discharge teaching and anxiety severity can enhance RHD in patients diagnosed with anxiety disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses could enhance patient-reported RHD to reduce unscheduled post-discharge medical resource utilization or improve QOL by facilitating knowledge acquisition and skill development and improving social support systems. Nurse managers could add RHD assessment to patients' discharge process and train nurses in the methods of discharge education. Nurses could advance their methods of discharge education, such as listening to and answering patients' questions, choosing a convenient time and engaging in online education. ABSTRACT: Introduction The association between readiness for hospital discharge (RHD) and post-discharge outcomes remains unclear in individuals with anxiety disorders. Aim To explore the factors of RHD and the effect of patient-reported RHD on post-discharge outcomes. Method In the observational study, 373 patients diagnosed with anxiety disorders completed the self-administered Readiness for Hospital Discharge Scale (RHDS) on discharge. After 30 days, phone interviews were conducted to collect data on post-discharge outcomes, including self-reported unscheduled medical service utilization, symptom severity and quality of life (QOL). Multiple logistic regression models were built to explore the relationships among sociodemographic characteristics, the RHDS and its subscales, and post-discharge outcomes. Results The unscheduled clinic visits were significantly associated with low RHD, knowledge and expected support. Readmission was significantly associated with low RHD and knowledge. Poor QOL was significantly associated with low RHD and personal status. Delivery, received content and anxiety severity were the predictors of RHD. Discussion Improved RHD is associated with fewer unscheduled clinic visits and readmissions and better QOL. Enhancing discharge education can improve RHD. Implications for practice Nurses should enhance patient-reported RHD to improve post-discharge outcomes by advancing the quality of discharge education in patients diagnosed with anxiety disorders.

Meng N ，Liu R ，Wong M ，Liao J ，Feng C ，Li X ... -  《-》