Readiness for hospital discharge and influencing factors: a cross-sectional study on patients discharged with tubes from the department of hepatobiliary surgery

(2021) 21:121 Qian et al. BMC Surg https://doi.org/10.1186/s12893-021-01119-0 RESEARCH ARTICLE Open Access Readiness for hospital discharge and influencing factors: a cross‑sectional study on patients discharged with tubes from the department of hepatobiliary surgery Jingyu Qian1, Miaofang Qian1, Yanyan Ren1, Linyan Ye1, Fangfang Qian2, Linlin Jin2, Lili Chen2 and Haixia Xu3* Abstract Background: To investigate the readiness for hospital discharge of patients discharged with tubes from the department of hepatobiliary surgery and to explore the influencing factors. Methods: A cross-sectional survey was conducted for the 161 patients with tubes who were discharged from the department of hepatobiliary surgery of Shaoxing Second Hospital by using the modified Chinese version of Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS). General data of the patients, such as gender, age, BMI (body mass index), and educational level, were collected. Results: According to the statistical results, the total score of the RHDS was 142.40 ± 23.98, and that of the QDTS was 148.14 ± 17.74. Multiple linear step-wise regression analysis revealed that the total score of the QDTS, residence and educational level were the independent influencing factors of the readiness for hospital discharge (p < 0.05). Conclusion: The level of the readiness for hospital discharge of the 161 discharged patients with tubes from the department of hepatobiliary surgery was in the middle and lower level. For the patients who are far away from the hospital and have a low education level, we should pay more attention to health education and discharge teaching, so as to improve the readiness for hospital discharge of relatively vulnerable patients, reduce the incidence of adverse events after discharge with tubes, and ensure the health and safety of patients. Keywords: Department of hepatobiliary surgery, Discharged patients with tubes, Readiness for hospital discharge, Influencing factors Background With the wide implementation of fast track surgery in clinical practice, the improvement of tiered medical services, and the increasingly strict assessment of the average length of stay of patients by medical institutions at *Correspondence: 3 Department of General Surgery, Shaoxing People’s Hospital, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), 568 Zhongxing North Road, Shaoxing 312000, Zhejiang, China Full list of author information is available at the end of the article all levels [1–6], many patients treated in the department of hepatobiliary surgery often leave hospital with tubes [7–11]. These tubes mainly include T-tubes [12], percutaneous transhepatic cholangial drainage (PTCD) tubes, and percutaneous transhepatic gallbladder drainage (PTGD) tubes, and some of the patients need to return to the hospital for extubation several days after discharge or go to the lower level hospital and stay at home for continuing rehabilitation treatment. The shortening of the average length of hospital stay will inevitably lead to many patients’ poor mastery of the relevant knowledge of © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Qian et al. BMC Surg (2021) 21:121 tube maintenance and complications observation when they are discharged, which may lead to the occurrence of adverse events such as accidental extubation, tuberelated infection, tube blockage, etc. and thus affect the prognosis and even aggravate the disease. Therefore, it is very important to evaluate the readiness for hospital discharge of discharged patients with tubes. The concept of readiness for hospital discharge [13] was put forward by a British scholar called Fenwick in 1979 [14]. It is used to comprehensively evaluate the health status of patients, including the state of physical and psychological readiness or the process of gradual preparation over time. Its connotation is also constantly improved in the course of development. According to Weiss and other colleagues [15], readiness for hospital discharge refers to the ability of patients or (and) their families to leave the hospital, return to family and society, and further recover, after the physiological, psychological and social conditions of the patients were comprehensively evaluated by medical staff. A Readiness for Hospital Discharge Scale (RHDS) was thereby invented which was more commonly used in western countries. After that, Lin [16], a Taiwan scholar, and Zhao [17], a doctor working in the West China Hospital, developed a modified Chinese version of the RHDS considering local conditions, and conducted validity test and reliability measurement. This scale provided theoretical support, scale template and data model for the follow-up readiness evaluation in various patients. The purpose of this study is to explore the status quo of the readiness for hospital discharge of the patients discharged with tubes from the department of hepatobiliary surgery of Shaoxing Second Hospital, a prefectural-level city tertiary hospital, analyze the influencing factors, and provide theories and data reference for clinical nursing practice and health education. Methods Subjects In all, 161 patients discharged with tubes from the department of hepatobiliary surgery of Shaoxing Second Hospital from January 2017 to November 2019 were selected as the research subjects, and their discharge conditions were investigated. General information questionnaire, Chinese version of RHDS and Quality of Discharge Teaching Scale (QDTS) were filled in 4 h before discharge. There were 85 males and 76 females with an average age of 47.26 years old and an average hospital stay of 7.9 days. Inclusion criteria: a. Voluntary participation with informed consent; b. No cognitive dysfunction and communication barriers; c. No mental diseases; d. Age ≥ 18 years old. Exclusion criteria: a. Automatically discharged patients with un (...truncated)