| Background:Children with complex congenital heart disease often need palliative repair or radical operation because of the complex cardiovascular malformation.Due to the special postoperative pathophysiological conditions,children still takes a period of time for the complete recovery of cardiac function.The discharge of the children do not represent the end of treatment.Children are still at risk of adverse outcomes such as readmission after discharge.The care needs of children extend from hospital to family after discharge,so that the quality of family care will affect the rehabilitation process of children directly or indirectly.Discharge readiness,as an effective predictor of patients’recovery and safety after discharge,has been widely used in domestic and foreign studies.The lower the level of family discharge readiness,the weaker the ability of family to cope with the health challenges after discharge,and the higher the risk of adverse outcomes.Good family discharge readiness can lay the foundation for the safe transition from hospital to home.It is very important to take the family as the center to evaluate the current situation of the discharge readiness of families with sick children and determine its influencing factors,so as to identify the families with low discharge readiness and carry out targeted intervention.At present,domestic and foreign researches on the discharge readiness in families with children undergoing surgery for complex congenital heart diseases are insufficient.Therefore,it is necessary to investigate the current status of discharge readiness in families with children undergoing surgery for complex congenital heart diseases and analyze its influencing factors,so as to provide theoretical basis for the clinical intervention of controllable factors of discharge readiness in families with children undergoing surgery for complex congenital heart diseases and lay a foundation for the subsequent improvement of clinical nursing services.Objective:To describe the current status and explore the influencing factors of the discharge readiness in families with children undergoing surgery for complex congenital heart diseases.Methods:A descriptive,cross-sectional design was used in this study.Convenient sampling was adopted from Fuwai Hospital,Chinese Academy of Medical Sciences.A total of 252 parents of children with complex congenital heart disease who visited hospital from December 2018 to November 2019 and were discharged after surgical treatment were selected.A series of instruments,the Clinical Disease Data Questionnaire of Child,General Data Questionnaire of Child,General Data Questionnaire of Child’s Family,the Chinese Version of the Readiness for Hospital Discharge Scale-Parent Form,Parental Caring Knowledge and Behavior Scale,Quality of Discharge Teaching Scale-Parent Form were used to measure the current status of the discharge readiness in families with children undergoing surgery for complex congenital heart diseases and determining its influencing factors.Results:①The average score of family discharge readiness of 252 children with complex congenital heart disease was(216.49±37.05),and the standardized score was(7.47±1.28).The standardized scores of five dimensions of the scale from high to low were coping ability(8.15±1.47),expected support(7.93±2.00),parental personal status(7.82±1.52),child personal status(7.20±1.53),and knowledge(6.94±1.86).②Multiple linear regression analysis showed that the quality of discharge teaching,receipt of fund sponsorship,disease risk level,relationship between family members,parent’s perception of the severity of the child’s disease at discharge,and child with previous cardiac surgery were the main factors affecting family discharge readiness.The six variables explained 18.8%of the total variation of discharge readiness in families with children undergoing surgery for complex congenital heart diseases.The level of discharge readiness was higher in families with higher quality of discharge teaching,higher level of disease risk,or children with the history of cardiac surgery.The level of discharge readiness was lower in those who received fund support,family members had a less harmonious relationship,parents perceived the severity of the disease were higher at discharge.Conclusion:The level of the discharge readiness in families with children undergoing surgery for complex congenital heart diseases is at a medium level,which needs to be further improved.Quality of discharge teaching,relationship between family members,receipt of fund sponsorship,disease risk level,parent’s perception of the severity of the children’s disease at discharge,and child with previous cardiac surgery are the main influencing factors.It is recommended that the nursing staff should improve the quality of discharge guidance in clinical nursing practice.Combined with the children’s condition,the family-centered objective evaluation practice system of family discharge readiness for children with complex congenital heart disease should be constructed to promote the physical and mental recovery of children before discharge and the improvement of family coping ability after discharge,so as to further improve the level of family discharge readiness. |
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