Research On The Status And Influencing Factors Of Discharge Readiness In Patients With Bladder Cancer Undergoing Cystectomy

Objective:To investigate the status of discharge readiness of patients undergoing bladder can cer electrosurgical resection of bladder cancer by quantitative and qualitative research,and to analyze the related factors affecting readiness for hospital discharge,so as to p rovide evidence for improving readiness for hospital discharge effectively.Methods:The first part is quantitative research,using cross-section design.A convenient sampling method was adopted to select 256 patients with bladder cancer who were inpatients in urology department of 2 tertiary grade A hospitals in Jinan City,Shandong Province from March 2021 to March 2022.The patients were investigated by using a general information questionnaire,Readiness for Hospital Discharge Scale,Quality of Discharge Teaching Scale,Perceived Social Support Scale and General self-efficacy Scale to understand the status of discharge readiness and the main influencing factors.Statistical analysis using SPSS23.0 software.The statistical methods included descriptive statistics,independent sample t-test,one-way ANOVA,Pearson correlation analysis,multiple linear regression analysis.The level of two-sided test a=0.05,P<0.05 was statistically significant.In the second part,according to the research results of the first part,screening out bladder cancer patients with insufficient discharge readiness and undergoing bladder tumor electric resection(the total score of readiness for hospital discharge is less than 84)and bladder cancer patients with high readiness for hospital discharge and undergoing bladder tumor electric resection(the total score of readiness for hospital discharge is more than 108),adopting a target sampling method,13 patients with inadequate readiness for hospital discharge were selected to conduct one-to-one semi-structured interview to explore the problems in the discharge preparation process.Focus group interviews were conducted in 7 patients with high readiness for hospital discharge to analyze and summarize the experience of patients in the process of discharge preparation.Results:1.The total mean score of discharge readiness of patients undergoing bladder can cer resection was(96.55±15.28),and the readiness for hospital discharge was good;T he items in each dimension are divided into the following categories:The score of an ticipatory support(8.42±1.58),individual status(7.97±1.57)and adaptive ability(7.79±1.56).2.There were statistical differences in the scores of discharge readiness in gender,discharge with or without the catheter,types of chronic diseases,times of TURBT and whether to take urinary catheter to discharge from the hospital(P<0.05).3.Pearson correlation analysis showed that the total score of discharge readiness and the scores of each dimension of discharge readiness of patients undergoing bladder cancer electroresection were compared with the total score of discharge teaching quality,the obtained content dimension score,the score of guidance skills and effects dimension,the total score of social support and each dimension score and the total score of self-efficacy.There was a positive correlation(r=0.198～0.450,P<0.01).4.Incorporate statistically significant variables into the regression equation and perform multiple linear regression analysis to obtain:gender,type of chronic disease,times of TURBT,discharge with or without the catheter,content obtained,guidance skills and effects,family support,and self-efficacy accounted for 37.4%of the total variation in discharge readiness.5.Qualitative research partial results:Patients with inadequate readiness for hospital discharge experienced:Physical discomfort;Psychological stress;Decreased self-efficacy;Uncertainty of disease information;Inadequate social support.Patients with high discharge readiness are:The positive psychological derivations;Support system enhancements:Personal power increases.Conclusion:1.The discharge readiness of patients with bladder cancer undergoing bladder tum or resection was good,but 43%of them were medium or lower,and the overall situa tion was not very optimistic.2.Gender,type of chronic disease,times of TURBT,discharge with or without t he catheter,content obtained,guidance skills and effects,family support,self-efficacy were the main factors influencing the discharge readiness of patients undergoing bladd er cancer electrosurgery.3.There are many problems in the discharge preparation process for patients with bladder cancer undergoing bladder tumor electric resection,but there are still positive experiences for reference.Medical staff should strengthen the positive experience in t he discharge preparation process and pay attention to the problems in the discharge pr eparation process.Seek reasonable countermeasure from different angle to improve th e patient’s discharge readiness.