| Research purpose:To look into the popularity quo of discharge readiness of sufferers after radical resection of lung most cancers beneath ERAS;The influencing elements of patients’ discharge readiness had been analyzed.The structural equation mannequin was once used to similarly discover the pathways and mechanisms of motion amongst the elements influencing discharge readiness,presenting atheoretical groundwork for creating scientific,lifelike and high-quality intervention measures to enhance discharge readiness of sufferers after lung most cancers surgery.Research method:A handy sampling technique used to be used to pick 360 sufferers who had been prepared to be discharged after radical lung most cancers surgical treatment in the thoracic surgical procedure branch of a Grade-Ⅲ health facility in Jinan City as the lookup objects.The lookup equipment protected normal demographic information questionnaire,discharge readiness scale,discharge preparation excellent scale,clinical coping fashion questionnaire,ailment uncertainty scale and perceived social aid scale.SPSS 25.0 was once used for statistical evaluation of the data.The evaluation techniques protected descriptive statistical analysis,impartial pattern t test,evaluation of variance,Pearson correlation analysis,and linear hierarchical regression.AMOS 24.0 was used to assemble the structural equation mannequin of influencing elements of discharge readiness of sufferers after lung cancer surgery.Research results:1.Sociodemographic information of patients after lung cancer surgery under ERASAmong the 360 patients with lung cancer after surgery,there were 135 male patients(37.50%)and 225 female patients(62.50%).23.33%of patients with college education or above;Married patients accounted for 90.28%;Patients working in agriculture accounted for 32.78%;The patients with monthly income of 6000～9000 yuan accounted for 39.17%;89.72%of lung cancer patients underwent thoracoscopic surgery;Pathological findings of adenocarcinoma accounted for 92.50%of the patients.2.Status quo of discharge readiness,discharge preparation quality,perceptive social support,sickness uncertainty and coping fashion of patients after radical lung cancer resection under ERASThe whole rating of discharge readiness of patients after lung cancer surgery was(71.70±19.67),and the scores of three dimensions were:personal status(17.81±6.38),adaptability(29.01 ± 10.08)and anticipatory support(24.87±8.69).The total score of discharge guidance quality was(136.81±35.91),the score of three dimensions were:patient self-perception(33.87±11.72),actual gain(33.81±11.61),guidance effect and skills(69.13±22.40);The whole rating of perceptive social aid was once(53.87±14.91),and the ranking of three dimensions was:family support(17.61±6.11),friend support(18.15±6.52),and others support(18.11±6.45).The complete rating of disorder uncertainty was(105.14±19.68),and the ratings of four dimensions were:uncertainty(44.00±9.90),complexity(22.93±6.26),lack of information(21.89±6.38),unpredictability(16.32±4.53).The total score of coping style was(49.66±7.62),and the score of three dimensions was:facing dimension(20.31±6.47),avoidance dimension(17.08±5.53),and yield dimension(12.72±3.97).3.Sociodemographic differences in discharge readiness of patients with lung cancer surgery under ERASUnivariate evaluation confirmed that there have been statistically massive variations in discharge readiness amongst extraordinary businesses in age,education,monthly income,length of stay,whether to live alone and marital status in patients with ERAS.4.Correlation evaluation of discharge readiness,discharge training quality,perceived social support,disease uncertainty and coping fashion in sufferers with radical lung cancer resection under ERASPearson correlation evaluation confirmed that there was a significant positive correlation between discharge readiness and discharge coaching high-quality(r=0.35,P<0.01).There was a significant negative correlation between hospital readiness and disease uncertainty(r=-0.79,P<0.01).Hospital discharge readiness used to be positively correlated with perceived social support(r=0.43,P<0.01).There was a significant positive correlation between discharge readiness and coping style(r=0.75,P<0.01),and a significant negative correlation with avoidance dimension(r=-0.81,P<0.01),and a significant negative correlation with yield dimension(r=-0.77,P<0.01).5.Factors influencing discharge readiness of patients after lung cancer surgeryLinear stratified regression showed that sociodemographic factors,perceived social support,coping style(facing,avoiding,yielding),and disease uncertainty could explain 23.5%,13.2%,17.7%,and 0.6%of the variance in patients’ discharge readiness after lung cancer surgery,respectively,and all variables explained 55%of the variance.6.Structural equation model analysis of factors influencing discharge readiness of patients with lung cancer after surgery under ERAS(1)Structural equation model results showed that the model was well fitted(P<0.001,x2/df=1.612,GFI=0.951,IFI=0.959,TLI=0.947,CFI=0.958,RMSEA=0.041).The quality of discharge guidance had a significant positive effect on discharge readiness(β=0.124,P<0.05).Social support had a significant positive effect on hospital discharge readiness(β=0.290,P<0.05).Disease uncertainty had a significant negative effect on hospital discharge readiness(β=-0.234,P<0.05).Face had a significant positive effect on discharge readiness(β=0.194,P<0.05);Avoidance had a significant negative effect on hospital discharge readiness(β=-0.197,P<0.05).Yield had a significant negative effect on discharge readiness(β=-0.175,P<0.05).(2)The relationship between the total effect size of each influencing factor on discharge readiness was as follows:perceptive social support(0.785)>facing dimension of coping style(0.247)>avoidance dimension(-0.238)>disease uncertainty(-0.234)>yield dimension(-0.220)>quality of discharge guidance(0.124).The quality of discharge guidance and the feeling of disease uncertainty had a direct effect on discharge readiness,and the direct effect was 0.124.-0.234,respectively.We understood that social support had a direct effect on discharge readiness(0.290),and could also indirectly affect discharge readiness through facing,avoiding,giving in and disease uncertainty in coping styles(0.495).Facing,avoidance and submission had direct effects on discharge readiness,and the direct effects were 0.194.-0.197.-0.175,respectively.The indirect effects of disease uncertainty were 0.053.-0.041.-0.045.Research conclusion:1.The preparation for discharge of patients after lung cancer surgery is not high,and it needs to be further improved.2.Factors affecting the readiness for hospital discharge of sufferers with radical lung cancer include age,training level,percapita monthly income of the family,permanent residence after discharge,marital status,living alone,and complications are the main influencing factors for hospital readiness.3.Discharge readiness of patients after lung cancer surgery under ERAS was once positively correlated with discharge instruction quality,perceived social support and coping style,and negatively correlated with disease uncertainty,avoidance and submission in coping style.4.The factors influencing discharge readiness of patients with ERAS under lung cancer surgery include sociodemographic age,residence style,educational background,monthly income,perceived social support,facing,avoiding,submission and disease uncertainty in coping styles.5.The structural equation model showed that the fantastic of discharge guidance,perceived social assist and coping style had a sizable tremendous have an impact on on discharge readiness,while the disease uncertainty,avoidance and submission had a significant negative impact on discharge readiness;Understanding that social assist has the largest total effect on discharge readiness,disease uncertainty and discharge guidance quality have direct effects on discharge readiness,understanding that social assist,facing,avoidance and submission have both direct and indirect effects on discharge readiness,facing,avoidance and submission can indirectly affect discharge readiness through disease uncertainty.Understanding that social support can indirectly affect discharge readiness through facing,avoiding,yielding and disease uncertainty. |
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