Research On Relationship Among Readiness For Hospital Discharge And Stigma,Coping Style In Postoperative Patients With Breast Cancer

【Objectives】To investigate the status quo and correlation of discharge readiness,stigma and coping style of patients after breast cancer surgery,understand the status quo of stigma and coping style of patients after breast cancer surgery,and explore the mediating mechanism of coping style between stigma and discharge readiness of patients after breast cancer surgery,so as to provide reference for developing discharge readiness intervention measures and promoting their return to family.【Methods】From May 2022 to September 2022,postoperative breast cancer patients who met the inclusion criteria in the breast surgery department of a third-grade hospital in Shandong Province were selected as the study objects.The assessment tools in this study include:general situation questionnaire,discharge readiness scale,social impact scale,and medical coping style questionnaire.SPSS26.0 was used for data analysis,and descriptive statistical analysis,T-test,one-way analysis of variance,multiple linear stepwise regression analysis,and Pearson correlation analysis were used.AMOS26.0 was used to analyze the mediation effect and construct the structural equation model.【Results】1.The total score of discharge readiness of 214 patients after breast cancer surgery was(89.01±13.79),which was in the medium to high level.The average score from top to bottom in each dimension is adaptability(7.63±1.38)points,anticipatory support(7.31±1.8)points,personal status(7.22±1.73)points.The total score of postoperative stigma of patients with breast cancer was(54.6±8.11),which was in the medium level.The avoidance score and yield score of the coping style of the patients after breast cancer surgery were higher than the norm(P < 0.01),and the face score was lower than the norm(P < 0.01).The average score of the three dimensions was from high to low as facing(2.35±0.4),avoiding(2.33±0.43)and yielding(1.93±0.42).2.There were significant differences in the level of discharge readiness of patients after breast cancer surgery in the general data of education,residential status,clinical stage and morbidity(P < 0.01).3.The results of multiple linear step-by-step regression analysis showed that education,residence status,disease stage,morbidity,face,yield and stigma were significant predictors of hospital discharge readiness(P < 0.01),accounting for 51.50% of the variation.The regression equation was established as follows: Y = 72.889+4.291× educational level+15.34× residential status-4.649× disease stage +6.297× disease situation +6.103× face-4.749× submission-9.934× stigma.Analysis of variance showed that the regression was statistically significant(F=29.32,P=0.000).4.Pearson correlation analysis showed that the total score of hospital discharge readiness,personal status dimension,adaptive capacity dimension were significantly negatively correlated with the total score of stigma and all dimensions(P < 0.05,P < 0.01).The total score of hospital discharge readiness and its dimensions were positively correlated with coping scores(P < 0.01),and negatively correlated with avoidance coping scores and yielding coping scores(P < 0.01).The total score of stigma and its dimensions were negatively correlated with coping scores(P < 0.01).It was positively correlated with avoidance coping and yield coping scores(P < 0.05,P < 0.01).5.The results of mediating effect analysis showed that stigma indirectly predicted hospital discharge readiness through facing coping and avoiding coping as mediating variables,and the standardized path coefficients were facing coping(-0.039)and avoiding coping(-0.0675),respectively.The overall effect value of stigma on hospital discharge readiness was(-0.039)+(-0.0675)+(-0.37)=-0.4765.The mediating effect of coping style accounted for 22.35% of the total effect,among which,facing coping accounted for 8.18% and avoiding coping accounted for 14.17%.The results of mediating effect analysis showed that stigma indirectly predicted hospital discharge readiness through facing coping and avoiding coping as mediating variables,and the standardized path coefficients were facing coping(-0.039)and avoiding coping(-0.0675),respectively.The overall effect value of stigma on hospital discharge readiness was(-0.039)+(-0.0675)+(-0.37)=-0.4765.The mediating effect of coping style accounted for 22.35% of the total effect,among which,facing coping accounted for 8.18% and avoiding coping accounted for 14.17%.【Conclusion】1.The level of discharge readiness of patients after breast cancer surgery is moderate;The stigma of postoperative breast cancer patients was at a medium level,Breast cancer survivors used more avoidance and facing coping styles.2.Education level,residence status,clinical stage and morbidity,coping style and stigma are the main factors affecting the discharge readiness of patients after breast cancer surgery.3.The discharge readiness of patients after breast cancer surgery is correlated with stigma and coping style.Hospital discharge readiness was negatively correlated with stigma.Discharge readiness was positively correlated with face coping,but negatively correlated with avoidance coping and submission coping.Stigma is negatively correlated with response to conflict and positively correlated with avoidance and submission.4.Coping style partially mediates the relationship between stigma and hospital discharge readiness.The stigma of patients after breast cancer surgery can not only directly affect their readiness for discharge,but also indirectly affect their readiness for discharge through confronting and avoiding coping.