Readiness For Hospital Discharge In Patients With Colostomy And The Analysis Of Its Impact Factors

ObjectivesThe objectives of this study are to investigate the readiness for hospital discharge in patients with colostomy,and to explore related factors which can affect the readiness for hospital discharge.According to the analysis result,we attempt to propose targeted interventions to improve the level of readiness for hospital discharge,promoting self-management and rehabilitation of patients after discharge,so as to theoretically provide a scientific basis for clinical nursing.MethodsThis study is a descriptive study where 157 patients with colostomy were recruited from two tertiary hospital in Henan Province from February to December in 2017.The investigative tools include a self-designed general information questionnaire which includes socio-demographic and disease-related data,the Chinese version of the Readiness for Hospital Discharge Scale,the Quality of Discharge Teaching Scale,Stoma Self-efficacy Scale and Social Support Rating Scale.Data inputted by EpiData 3.1 was analyzed in software SPSS 17.0.Descriptive statistics analysis method(mean,standard deviation,frequency,constituent ratio)is used to describe the data.The analysis includes t-test,variance analysis,chi-square test,univariate analysis and stepwise multiple regression.Two-tailed analyses were conducted with the level of significance set at P< 0.05.Results1.A total of 170 questionnaires were distributed in this research.There were 157 valid questionnaires indicating the effective recovery rate was 92.35%.2.The mean score of readiness for hospital discharge in patients with colostomy was 77.24±11.69 points;the average score of personal status subscale was 18.67±4.21 points;the average score of coping ability subscale was 32.58±6.04 points;the average score of expected support subscale was 28.41±5.25 points.3.The average score of social support in patients with colostomy was(41.31±4.56)points,and the mean score of objective support was(9.08±2.15)points,the mean score of subjective support was(24.76±2.97)points,and the mean score of utilization of social support was(7.46±1.51)points.4.The mean score of quality of discharge teaching in patients with colostomy was(130.08±18.86)points,and the mean score of content received was(39.24±8.87)points,the mean score of teaching delivery was(90.78±12.35)points.5.The mean score of stoma self-efficacy in patients with colostomy was(75.41±17.37)points,among which the low level self-efficacy was 33.8%,the moderate and hing self-efficacy was 55.4% and 10.8% separately.6.Univariate analysis and correlation analysis show that factors affecting the readiness for hospital discharge of patients with colostomy are age,marital status,education,payent,live style,length of hospital stay,social support,self-efficacy,quality of discharge teaching.7.Multiple regression analysis shows that: the readiness for hospital discharge of patients with colostomy is influenced by education,subjective support,teaching delivery,colostomy care effectiveness,payor,length of hospital stay,age.The readiness for hospital discharge in patients with colostomy gradually declines with the increase of age.Patients with higher education and not live alone have higher scores on readiness for hospital discharge.Subjective support,teaching delivery,colostomy care effectiveness,length of hospital stay are positively related to the readiness for hospital discharge.In the way of the payment,the self-paid patients had the lowest score of readiness for hospital discharge,while public and commercial insurance patients had a relatively higher score.Conclusions1.The readiness for hospital discharge in patients with colostomy was at a moderate level.2.Education level,subjective support,teaching delivery,colostomy care effectiveness,length of hospital stay,the way of payment and age are the main factors influencing the readiness for hospital discharge in patients with colostomy.3.The readiness for hospital discharge in patients with colostomy is negatively correlated with age while positively correlated with quality of discharge teaching,social support,and self-efficacy.