Readiness for hospital discharge post-initial invasive percutaneous transhepatic biliary drainage: A mixed-methods study

The experience and needs of self-care in elderly colorectal cancer stoma patients: a qualitative study

PURPOSE

This study aimed to describe the real experiences and needs of stoma self-care in elderly colorectal cancer patients, providing a theoretical basis for healthcare professionals to develop effective intervention measures.

METHODS

Semi-structured, in-depth interviews were conducted with the thirteen elderly colorectal cancer patients with stomas. These interviews were audio-recorded and transcribed verbatim. The interview data were then organized, analyzed, and thematically refined using Colaizzi's 7-step analysis method.

RESULTS

This study extracted three overarching themes and seven corresponding sub-themes. Theme one, actively seeking help, encompassed pre-rehabilitation needs, social support needs, and continuity of care needs. Theme two, new challenges posed by stomas, included sub-themes related to changes in daily life and psychological burdens. Theme three, courageous acceptance and proactive coping, comprised cognitive changes and behavioral changes as its sub-themes.

CONCLUSION

The study's findings suggest that inadequate in-hospital stoma care education and a lack of continuity of care at home can result in heightened challenges for elderly patients. Healthcare professionals should implement a personalized, full-process education program tailored to geriatric patients' specific needs, ensuring seamless care transition and coordinated management between hospital and home environments.

Factors affecting the readiness for hospital discharge of initially treated pulmonary tuberculosis patients in China: a phenomenological study

BACKGROUND

Despite readiness for hospital discharge widespread popularity since readiness for hospital discharge introduction in 1979 and extensive study, readiness for hospital discharge among pulmonary tuberculosis (PTB) patients has not yet been investigated. Moreover, the factors influencing this process remain unclear.

OBJECTIVE

The objective of this study was to investigate the factors influencing readiness for hospital discharge in initially treated PTB patients using the capability, opportunity, motivation-behavior (COM-B) model.

METHODS

This phenomenological study was conducted from December 2023 to March 2024. Face-to-face individual interviews were conducted with 18 initially treated patients with PTB according to a semistructured interview guide developed on the basis of the COM-B model. The interview data were subjected to analysis using NVivo 14 software and Colaizzi's method.

RESULTS

As a result, 6 themes and 14 subthemes were identified. Physical capability for readiness for hospital discharge (subthemes included poor health status, early acquisition of adequate knowledge about PTB, inadequate knowledge about readiness for hospital discharge), psychological capability for readiness for hospital discharge(subthemes included false perceptions about readiness for hospital discharge, high treatment adherence), physical opportunity for readiness for hospital discharge (subthemes included high continuity of transition healthcare, insufficient financial support, insufficient informational support), social opportunity for readiness for hospital discharge (subthemes included stigmatization, inadequate emotional support), reflective motivation for readiness for hospital discharge (subthemes included lack of reflection on coping with difficulties, intention to develop a readiness for hospital discharge plan), and automatic motivation for readiness for hospital discharge (subthemes included strong desire to be cured, negative emotions).

CONCLUSION

We established factors related to readiness for hospital discharge in initially treated PTB patients in terms of capability, opportunity and motivation, which can inform the future development of readiness for hospital discharge plans. To improve patients' readiness for hospital discharge, patients need to be motivated to plan and desire readiness for hospital discharge, patients' knowledge and treatment adherence should be improved, and patients' transition healthcare continuity and emotional support should be focused on. Moreover, the quality of readiness for hospital discharge and discharge education should be assessed in a timely manner to identify impeding factors and provide interventions.

Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study

BACKGROUND

Patients with percutaneous transhepatic biliary drainage (PTBD) need regular drainage tube care after discharge, and transitional care can help solve this problem. However, few studies have focused on the quality of transitional care, the perceptions of patients with drainage tubes after discharge and those of healthcare professionals.

AIM

This study is aimed at exploring the real experience and perceptions of transitional care services among healthcare professionals and PTBD patients who have been discharged with tubes and at providing references for future transitional care service development.

DESIGN

The study uses a qualitative descriptive design. The reporting method followed Consolidated Criteria for Reporting Qualitative Research guidelines.

METHODS

Semistructured interviews were conducted with PTBD patients who had been discharged with tubes and multicentre healthcare professionals using the purpose sampling method. The thematic analysis method was used for analysis.

RESULTS

Thirteen PTBD patients from one hospital and 12 healthcare professionals from three hospitals were interviewed. The analysis of the patient interview data revealed three themes, namely, recognition of the value of transitional care services, patients have some unmet needs and perception of transitional care service pathways. Six subthemes were also identified. The analysis of the interview data of healthcare professionals revealed two themes, namely, harvest and challenges in transitional care services work and expectations for future development of transitional care services. Four subthemes were also identified.

CONCLUSIONS

The transitional care of discharged patients with PTBD tubes deserves the attention of clinical workers, and a series of measures should be taken to improve transitional care services.

PATIENT/PUBLIC CONTRIBUTION

Patients were involved in the formulation of interview questions for this study, and during the interviews, patients presented their suggestions for transitional care services. Healthcare professionals participated in this study as interviewees, and no members of the public were involved in this study.

Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery

BACKGROUND

The liver is an important metabolic and digestive organ in the human body, capable of producing bile, clotting factors, and vitamins.

AIM

To investigate the recovery of gastrointestinal function in patients after hepatobiliary surgery and identify effective rehabilitation measures.

METHODS

A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study subjects. They were divided into a control group and a study group based on the extent of the surgery, with 100 patients in each group. The control group received routine treatment, while the study group received targeted interventions, including early enteral nutrition support, drinking water before gas discharge, and large bowel enema, to promote postoperative gastrointestinal function recovery. The recovery of gastrointestinal function was compared between the two groups.

RESULTS

Compared with the control group, patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa (P < 0.05). They also had shorter time to gas discharge and first meal (P < 0.05), higher overall effective rate of gastrointestinal function recovery (P < 0.05), and lower incidence of postoperative complications (P < 0.05).

CONCLUSION

Targeted nursing interventions (early nutritional support, drinking water before gas discharge, and enema) can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications, which is worthy of promotion.

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

OBJECTIVE

This study ascertained current status and influencing factors of readiness for hospital discharge (RHD) of lung cancer (LC) patients with enhanced recovery after surgery (ERAS) concept-guided postoperative management.

METHODS

This study prospectively and consecutively included 217 LC patients who underwent whole-course ERAS concept-guided postoperative management at the Department of Thoracic Surgery of Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University from November 2023 to April 2024. RHD, quality of discharge teaching (QDT), and social support (SS) were evaluated using RHDS, QDTS, and SSRS, followed by correlation analyses of RHD with the other 2 factors. The clinical baseline and pathological data were compared between the high and low RHD groups, and the characteristics showing statistical significance were assigned as independent variables for regression analysis with RHD as the dependent variable.

RESULTS

RHD, QDT, and SS were above average among LC patients with ERAS concept-guided postoperative management, and RHD was positively correlated with both QDT and SS. Age, education level, self-care ability, number of admissions, and presence of drainage tubes were independent influence factors for RHD of LC patients with ERAS concept-guided postoperative management.

CONCLUSION

In LC patients with ERAS concept-guided postoperative management, RHD may be improved by increasing QDT and SS and intervened by factors such as age, education level, self-care ability, number of admissions, and presence of drainage tubes.