Construction Of Discharge Preparation Service Scheme For Patients Undergoing Thoracoscopic Lung Cancer Resection

Objectives(1)To determine the status of discharge readiness and discharge guidance quality of patients undergoing thoracoscopic lung cancer resection.(2)To understand the perception of discharge preparation and the needs of discharge preparation services of patients undergoing thoracoscopic lung cancer resection.(3)To construct a discharge preparation service scheme for patients undergoing thoracoscopic lung cancer resection.Methods(1)Status survey: From January to August 2021,248 patients who were about to be discharged from the Department of thoracic surgery of a hospital in Zhuhai City were recruited.The questionnaire was conducted by using general data scale,Readiness for Hospital Discharge Scale(RHDS),Quality of Discharge Teaching Scale(QDTS),Health Literacy Management Scale,Self-efficacy for Managing Chronic Disease 6-Item Scale.To analyze the current situation of patients’ discharge readiness and discharge guidance quality,and explore its influencing factors.(2)Qualitative research: From March to June 2021,10 patients who were about to be discharged from the Department of thoracic surgery of a hospital in Zhuhai City were recruited.Using phenomenological research in qualitative research,semi-structured interview method was used to collect data,and Colaizzi method was used to sort out and analyze,which was to understand the perception of discharge preparation and discharge preparation service needs of patients.(3)Scheme construction: On the basis of current situation investigation and qualitative research,combined with literature review,this study constructs the first draft of discharge preparation service scheme for patients undergoing thoracoscopic lung cancer resection,and determines the final draft through 17 experts who were invited to two rounds of consultation.Results(1)Status survey:(1)The average total score of RHDS of patients undergoing thoracoscopic resection of lung cancer was(88.15 ±14.78),the average total score of QDTS was(132.08 ± 22.55).(2)Univariate analysis showed that different age,education level,working status,average income per person in family,type of medical insurance,whether there is indwelling drainage tube,length of indwelling tube and postoperative hospital stay were related to RHDS(P < 0.05).(3)Multiple linear stepwise regression analysis showed that five variables were finally entered into the regression equation: the score of QDTS,the score of self-efficacy,average income per person in family,working status and length of stay,which could account for 55.5% of the variance in discharge readiness.(2)Qualitative research: After summarizing and refining the 10 interview materials,there themes were finally revealed:(1)unknown discharge preparation status;(2)ambivalence at discharge(expectation of discharge,anxiety and confusion);(3)demands for discharge preparation services(basic disease information,self and family care skills,daily life health guidance and out of hospital support).(3)Scheme construction: The specific contents of discharge preparation service include overall evaluation(basic situation,medical care problems,post discharge care needs and evaluation time),in-hospital intervention(before,after and on the day of discharge),follow up consultation(answer content and answer method),out of hospital follow-up(follow-up time,follow-up method and follow-up content),effect evaluation(pre discharge evaluation and post discharge evaluation).The implementation plan of discharge preparation service includes interactive nursing evaluation,nurses and patients jointly formulate compliance objectives,implementation of interactive compliance measures(intervention time,intervention content,intervention form and intervention personnel),and effect evaluation.Conclusions(1)The discharge preparation and discharge guidance quality of patients undergoing thoracoscopic lung cancer resection are at a medium level,which needs to be further improved.(2)There are still many unmet care needs for patients undergoing thoracoscopic lung cancer resection before discharge.(3)The discharge preparation service scheme for patients undergoing thoracoscopic lung cancer resection,including the specific content and implementation plan,has certain scientific and reliability,and can provide reference for clinical discharge preparation service.