| 【Objective】To understand the characteristics and influencing factors of postoperative discharge readiness of bladder cancer patients undergoing total cystectomy.To provide a theoretical basis for intervention measures to improve the readiness of patients with bladder cancer who received total cystectomy and bilateral ureterostomy.【Methods】108 cases of bladder cancer patients were selected as the research subjects.The self-made general data questionnaire was used for general information survey,and the Chinese version of readiness for hospital discharge scale(RHDS)was used to evaluate the readiness for discharge.General Self-efficacy Scale(GSES)was used for self-efficacy assessment.The social support assessment scale is used for social support assessment,and the discharge guidance quality scale is used to evaluate patients’ perception of discharge guidance quality.The Hamilton Anxiety Scale(HAMA)and Hamilton Rating Scale for Depression(HAMD)were used to evaluate anxiety and depression.Multivariate linear regression was used to analyze the influencing factors of discharge readiness,and SPSS21.0 software was used for data analysis.【Results】1.The average RHDS score of 108 patients was(75.5 ± 10.7),and the average scores of personal status,adaptability,and expected support were(17.3 ±4.5),(31.8 ± 6.2),and(26.4 ± 5.8).The average score of each item was the highest in expected support(6.6 ± 1.6),and the average score of the individual item in personal status was the lowest(5.8 ± 1.8).2.The average score of social support score was(40.4 ± 6.8),and the average scores of objective support,subjective support,and utilization of support were(9.3 ±2.7),(23.1 ± 4.3),and(8.0 ± 2.3)respectively.3.The results of HAMA classification evaluation showed that the proportion of patients without anxiety,possible anxiety,definitely anxiety,obvious anxiety and severe anxiety were 59.3%,25.9%,9.3%,4.6% and 0.9%,respectively.The HAMD classification evaluation results showed that the proportions of no depression,mild depression,and moderate depression were 65.7%,25.9%,and 8.3%.4.The GSES evaluation showed that 108 patients with abdominal stoma had a GSES score of 15～38 points,with an average score of(24.3 ± 4.5).5.The total quality of discharge guidance is 70～162 points,the average score is(123.7 ± 10.8),and the average score of each item is(6.9 ± 1.6);the average scores of content,guidance skills and effects are(37.3 ± 7.4)and(86.4 ± 12.5).6.Univariate analysis: The RHDS scores of patients with different age groups,education levels,marital status,occupational characteristics,length of stay,and TNM stage were significantly different(P <0.05),and the RHDS of patients with depressive mood at discharge significantly reduced(P <0.05).7.Correlation analysis shows :There was a strong correlation between social support scores and RHDS scores(r=0.785,P<0.001),a strong correlation between GSES scores and RHDS scores(r=0.734,P <0.001),and the quality of discharge guidance scores had moderate correlation with the RHDS score(r = 0.679,P <0.001).8.Multivariate analysis: age,education,GSES score,quality of discharge guidance,length of stay,depression,and quality of discharge guidance were independent factors affecting the readiness of patients with bladder cancer who underwent abdominal stoma.【Conclusion】1.Patients with bladder cancer who underwent total radical cystectomy plus ureterocutaneostomy were at a low-medium level,personal status score was the lowest,so the quality of transitional care should be improved through a reaesonable nursing plan so as to improve their RHDS.2.Social support score,self-efficacy score and discharge guidance quality score are related factors of discharge readiness.3.Age,education,self-efficacy,discharge guidance quality score,length of stay after surgery,combined with depression,and social support are predictors of discharge readiness.The evaluation and intervention of the above factors have positive significance for improving discharge readiness. |
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