Influence Of Intervention Scheme Based On The Theory Of Timing It Right On Family Discharge Readiness Of Children With Henoch-Sch(?)nlein Purpura

Objective:To address the problems of prolonged post-discharge recovery period due to the shortening of the average hospital stay of children with allergic purpura(HSP)and the increase of unplanned readmission rate due to the lack of family readiness for discharge,this study constructs a family readiness for discharge intervention program for children with HSP and applies it to clinical practice to maximize the safety of discharge,reduce disease recurrence and promote recovery.Methods:1.Status investigation: To explore the status quo and influencing factors of discharge readiness of children with purpura.168 children with Schonlein purpura in a Grade-III children’s hospital in Shanxi Province were selected as the study objects by convenient sampling.The Chinese version of discharge readiness scale-parent version,discharge guidance quality scale,caregiver care ability scale and Mishel disease uncertainty parents Scale were used to investigate them.Single factor Spearman linear correlation analysis and multiple linear regression analysis were used to analyze the influencing factors of discharge readiness.2.Program construction: Based on timing theory,combined with previous quantitative studies and literature studies,the preliminary draft of intervention plan for discharge preparation of children with henoch purpura was formed;Then,through the expert meeting,12 experts from the department of dermatology,gastroenterology,nephrology and other departments were organized for consultation,to discuss the first draft of the intervention plan for the discharge preparation of children with henoch purpura,and form the final draft of the intervention plan to ensure the scientific and practical effectiveness of the plan.3.Empirical study: Preliminary application of the established intervention plan for discharged families of children with purpura was carried out through quasi-experimental study.A total of 82 cases from three children’s hospitals in Shanxi Province were conveniently sampled.The control group(n=40)received routine nursing,and the intervention group(n=42)implemented the family preparation scheme for discharging children with henoch purpura based on the timing theory established by the research group.Family readiness for discharge,quality of discharge guidance,caregiver care ability,disease uncertainty and unplanned admission were compared between the two groups.Results:1.Survey results of current situationThe discharge family readiness score of children with HSP(221.25±40.375)was at an intermediate level,and multiple linear regression analysis showed that parental literacy,quality of discharge instructions,caregiver caregiving ability,and illness uncertainty were the main factors affecting the discharge family readiness of children with HSP,explaining 70.3% of the total variance in the discharge family readiness score.2.Results of scheme constructionBased on the current situation investigation,literature review and expert meetings,this study established a scientific,effective and clinically applicable intervention plan for family preparation for discharge of children with henoch purpura,which consists of five targeted intervention measures in different periods: diagnosis period,acute aggravation period,discharge preparation period,adjustment period and adaptation period.3.Empirical research results(1)The total score and each dimension of the readiness of children discharged from hospital in the intervention group were higher than those in the control group,and the difference was statistically significant(P < 0.05).(2)The total score of discharge guidance quality and the scores of each dimension were higher in the intervention group than in the control group,and the difference was statistically significant(P < 0.001)(3)The difference between the scores of the caregiving competencies of the two groups on the dimension of handling personal emotional needs at 3 months after discharge was not statistically significant(P =0.083 > 0.05).(4)The total score of family caregiver caregiving competency and the scores of the dimensions of adapting to the caregiving role,resilience and providing assistance,family and community resources,and adjusting life to meet caregiving needs were lower in the intervention group than in the control group on the day of discharge,1 month after discharge,and 3 months after discharge,and the differences were statistically significant(P < 0.05).(5)The total score of uncertainty about illness and the scores of each dimension in each period were lower in the intervention group than in the control group,and the difference was statistically significant(P < 0.05).Conclusion:The family preparation plan for discharge of children with Purpura based on timing theory can improve the family readiness and discharge guidance quality of children with purpura,improve the caring ability of family caregivers,reduce the disease uncertainty and unplanned readmission rate of children with parents,and provide reference for the family preparation for discharge of children with relapsible diseases.