| ObjectivesTo construct and explore the effects of a discharge preparation services(DPS)intervention for colorectal cancer patients with laparoscopic surgery.MethodsThis study was divided into two parts which were integrated used of the following research strategy.1.Construction the intervention:Using literature review to analyze the research status on readiness for discharge of surgical patients.Based on the Individual and Family Self-management Theory and Transitions Theory,a DPS intervention protocol was developed for colorectal cancer patients with laparoscopic surgery.Through two rounds of expert consultation and a pilot investigation for 10 patients,the intervention project was revised and formed.2.Application the intervention:The DPS intervention trial was conducted in two general surgery departments of a tumor hospital in Henan.Cluster sampling method was used in the department to recruit colorectal cancer patients that met inclusion criteria.The control group(n=67)received perioperative care and routine discharge teaching,and the intervention group(n=70)also received the perioperative care and the DPS.SPSS 19.0 was used to do descriptive statistics,t test,chi square test and rank sum test to evaluate two groups in the consistency about the score of the Readiness for Hospital Discharge Scale(RHDS),the Quality of Discharge Teaching Scale(QDTS)and the Patient Views on Nursing Care with the implementation of bedside report(PVNC-BR),time to readiness for discharge(TRD),complication rate and unplanned readmission rate.Results1.Nine education themes and three discharge communication strategies of DPS intervention were formed.The education themes were hand-in-hand and go together,self-care and you can,sunshine after rain,diet and exercise step by step,careful with disease observation,medication safety and regular follow-up,upgrade self-care skills of stoma,summary and feedback,return visit and continuing nursing.The education contained a toolkit and was conducted by team member,combining with one-to-one and group intervention.The phone call and WeChat were used in continuing teaching and follow-up after hospital.The communication strategies included daily Nurse-Physician team bedside rounding,SBAR bedside shift report,communication process improvement.2.3 cases(4.5%)were lost in the control group and 4 cases(5.7%)were lost in the intervention group.Then the final effective samples of the two groups were 64 cases and 66 cases.After the intervention,the total score and every dimension score of the RHDS,the QDTS and the PVNC-BR in the intervention group were higher than in the control group,and the differences were significant(P<0.05).The content required dimension score of the QDTS was significantly higher than content received(P<0.05)in the control group,but no significant difference was identified(P=0.069)in the intervention group.Meanwhile,the difference in TRD was not significant(P=0.153),but in time to recover gastrointestinal function and mobilization and self-care abilities were significant(P<0.05)between two groups.The complication rate at 4 weeks after surgery was 21.8%in the control group and was 9.1%in the intervention group,the difference was significant(P=0.043).The difference in unplanned readmission rate at 4 weeks after surgery between the control group and the intervention group,which were 12.5%and 1.5%,was also significant(P=0.034).ConclusionThe DPS program for colorectal cancer patients with laparoscopic surgery,which based on literature review and theory,could improve the readiness for hospital discharge,the quality of discharge teaching and the satisfaction,and reduce complication rate and unplanned readmission rate after surgery. |
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