The Study On The Status And Influencing Factors Of The Readiness For Discharge Of The Patients With Ischemic Stroke

Objective:To investigate the status of the readiness for discharge of patients with Ischemic Stroke and the influcing factors,laying the foundation for improving the level of the readiness for discharge and developing an intervention plan for discharge readiness services.Methods:A total of 417 patients with Ischemic Stroke who met the inclusion and exclusion criteria were conveniently selected from the Department of Neurology of a tertiary Grade-A hospital in Chengde from October 2019 to May 20-20.The research instruments include the general information questionnaire,the Readiness for Hospital Discharge Scale(RHDS),the Social Support Rating Scale(SSRS),the Multidimensional Health Locus of Control Scale(MHLC)and the Quality of Discharge Teaching Scale(QDTS).The collected data were entered into Excel,SPSS21.0software were respectively applied for data analysis.Statistical methods included one-way ANOVA,t-test,correlation analysis and multiple linear regression analysis and mediation effect analysis.Results:1.The total score of RHDS of patients with Ischemic Stroke was(6.39±0.73)and the average scores of each dimension from low to high were personal status(6.16±1.06),adaptability(6.33±0.95)and anticipation support(6.64±1.11).2.Single factor analysis and independent samples t test: The scores of the RHDS of patients with Ischemic Stroke of different age,gender,education-al levels,marital status,caregivers,family income,complicated chronic diseases types,length of stay,Stroke recurrence risk rating,Grading of selfcare ability,types of health psychological control sources were significantly different and the difference is statistically significant(P<0.05).3.Correlation analysis shows:NIHSS score was negatively correlated with the RHDS(r=-0.403,P<0.01);NIHSS score was negatively correlated with individual status(r=-0.216,P<0.01);NIHSS score was negatively correl-ated with adaptive ability(r=-0.352,P<0.01);NIHSS score was positively correlated with expected support(r=0.295,P< 0.01).4.Correlation analysis shows:Social Support was positively correlated with the RHDS(r=0.343,P<0.01);The subsubjective support was positively correlated with the RHDS(r=0.181,P<0.01);Objective support was positively correlated with the RHDS(r=0.190,P<0.01);The utilization of social support was positively correlated with the RHDS(r=0.280,P< 0.01).5.Correlation analysis shows:the scores of the QDTS was positively correlated with the scores of the RHDS(r=0.415,P<0.01).the scores of the Actual acquisition of content was positively correlated with the scores of the RHDS(r=0.368,P<0.01).the scores of the Guidance skills and effects were positively correlated with the scores of the RHDS(r=0.265,P< 0.01).6.The Multiple linear stepwise regression analysis showed that gender,culture degree,the length of time,Stroke recurrence risk rating,NIHSS score,Social Support,the utilization of social support,the types of health psycholog ical control sources,the quality of discharge teaching were the influencing fact-ors of the RHDS of the patients with Ischemic Stroke.7.The mediating effect test results showed that the Social Support plays a partial mediating role between the dismension of the internal health locus of control and RHDS,the Risk ratio is 15.06%.The QDTS plays a partial mediating role between the dismension of the others health locus of control and RHD-S,the effect ratio was 14.21%.Conclusion:The score of readiness for discharge of the patients with Ischemic Stroke is at a medium level,which needs to be improved.Patient’s gender,culture degree,the length of time,NIHSS score,Stroke recurrence risk rating,Social Support,the utilzation of social support,the types of health psychological control sources,the quality of discharge teaching is the influence factors.So the medical staff should take corresponding interventions according to the factors,to improve the level of the discharge for readiness the patients with Ischemic Stroke.The Social Support plays a partial mediating role between the dismension of the internal health locus of control and RHDS;The QDTS plays a partial mediating role between the dismension of the others health locus of control and RHDS.