| Research Purpose: This study aims to examine the discharge preparation level,family function,medical coping style,and quality of discharge guidance for elderly patients undergoing radiotherapy for esophageal cancer.The objective is to analyze the impact of family function,medical coping style,and discharge guidance quality on discharge preparation,and to explore the mediating role of medical coping style and discharge guidance quality in the relationship between family function and discharge readiness.Ultimately,this study aims to develop a mediation effect model that improves discharge readiness,promotes the safe discharge of elderly patients with esophageal cancer undergoing radiotherapy,and enhances their postoperative quality of life.Materials and Methods: From November 2021 to July 2022,a continuous sampling method was employed to conduct a questionnaire survey among elderly patients undergoing radiotherapy for esophageal cancer at a tertiary hospital in Chengdu,Sichuan Province.The survey utilized various tools,including a general situation questionnaire,the Readiness for Hospital Discharge Scale(RHDS),the Family APGAR index(APGAR),the Medical Coping Modes Questionnaire(MCMQ),and the Quality of Discharge Teaching Scale(QDTS).The data was verified by two individuals,entered into Excel software,and imported into SPSS26.0 software for analysis.Qualitative data was presented as frequency,while quantitative data was tested for normality using histograms and Q-Q plots.Continuous variables with normal distribution were described using means and standard deviations,while non-normal distribution data was described using median and interquartile intervals.The level of statistical significance was set at bilateral α= 0.05.Independent sample t-tests were used for binary data analysis,one-way ANOVA was used for multiclass data analysis,and multiple linear regression was used to identify factors influencing discharge readiness among elderly patients with esophageal cancer undergoing radiotherapy.The correlation between family function,medical coping style,discharge guidance quality,and discharge readiness was analyzed using Pearson correlation analysis if the bivariate normal distribution was satisfied,otherwise Spearman correlation analysis was applied.A structural equation model was established using AMOS23.0,with family function as an independent variable,medical coping style and discharge guidance quality as intermediary variables,and discharge readiness as the dependent variable.The intermediate effect testing was carried out using the Bootstrap method,with the number of resamples set at 2000 and the confidence interval at 95%.The inspection level was set at α= 0.05.Results:(1)The study distributed a total of 282 questionnaires,which were all recovered resulting in a recovery rate of 100%.Ten questionnaires were deemed invalid,while 272 were valid,resulting in a valid recovery rate of 96%.Of the 272 elderly patients with esophageal cancer who underwent radiotherapy,186 were male(68.4%)and 86 were female(31.6%).The largest age group surveyed was 60-65,which accounted for 46.3% of the total sample.The average age of the patients was(66.70±4.81)years.(2)Single factor analysis results: The total score for discharge readiness was at a moderate level,with a value of(92.3±20.1).The three dimensions of readiness were personal status(23.7±4.7),expected support(37.9±9.9),and adaptability(30.7±8.5).The total score for family care index was(10.05±2.55).The scores for the three dimensions of medical coping style were confrontation(21.2±6.0),avoidance(16.6±6.4),and submission(13.3±4.4).The scores for the three dimensions of discharge guidance quality were knowledge needed before discharge(47.1±7.9)points,knowledge acquired before discharge(46.6±9.1)points,and effectiveness of health guidance(92.2±18.5)points.(3)Correlation analysis: Correlation analysis revealed that readiness for discharge was positively correlated with confrontation dimension(r=0.451,P<0.01),andnegatively correlated with avoidance dimension(r=-0.581,P<0.01)and submission dimension(r=-0.535,P<0.01).It was also positively correlated with family function(r=0.481,P<0.05)and quality of discharge instructions(r=0.459,P<0.01).(4)Multivariate linear regression: Multiple linear regression analysis indicated that whether or not patients had combined chronic diseases,number of hospitalizations,confrontation,avoidance,submission,family function,and quality of discharge instructions were significant influencing factors for discharge readiness with a P-value <0.05.These factors together explained 56.9% of the variance in readiness for discharge.(5)Mediating Chain: Medical coping style and quality of discharge instructions of elderly patients with esophageal cancer radiotherapy showed a chain mediation between family functioning and readiness for discharge.Conclusion:(1)The readiness of elderly patients with esophageal cancer radiotherapy to be discharged from hospital is at a moderate level,and whether or not they have combined chronic diseases,the number of hospitalizations,family care index,medical coping style,and the quality of discharge guidance are the main influencing factors on the readiness of elderly patients with esophageal cancer radiotherapy to be discharged from hospital.(2)Discharge readiness of elderly patients with esophageal cancer radiotherapy was positively correlated with confrontation dimension,family function and quality of discharge guidance;and negatively correlated with avoidance and submission dimensions.(3)The medical coping style and quality of discharge instructions of elderly patients with esophageal cancer radiotherapy showed a chain mediating effect between family functioning and readiness for discharge. |
PDF Full Text Request