Exploring The Current Status And Influencing Factors Of Discharge Readiness Of Patients With Hepatomegaly Baased On Structural Equation Modeling

Objectives1.To investigate the self-perception of patients with hepatomegaly on their readiness for discharge,to understand their readiness for discharge to home,and to find out where their readiness is inadequate.2.To investigate the current situation of patients with hepatomegaly and the factors affecting their readiness for discharge,to understand the specific effects of in-hospital factors on patients with hepatomegaly,to identify relevant risk factors and protective factors,and to provide a theoretical basis for further appropriate interventions.3.To analyze in detail the factors affecting the readiness of patients with hepatomegaly to be discharged from hospital and the direct and indirect effects of each factor by using structural equation modeling,and to develop targeted clinical practice measures.Methods1.In this study,281 patients with hepatomegaly hospitalized in a tertiary care hospital in Anhui Province were selected by convenience sampling method,and the General Information Questionnaire,Discharge Readiness Scale,Discharge Guidance Quality Scale,Medical Coping Questionnaire,Social Support Rating Scale and Chronic Disease Management Self-Efficacy Scale were used to survey the study subjects through on-site surveys.The questionnaires were administered to the subjects through on-site surveys.2.Descriptive analysis was performed using SPSS25.0,and the measurement data were described by mean±standard deviation((?) ±s),and the count data were described by number of cases and composition ratio.The differences in readiness for discharge scores of patients with different characteristics of hepatomegaly were compared by two independent samples t-test and ANOVA if they conformed to normal distribution and variance,and Mann-Whitney U-test or Kruskal-Wallis H-test if they did not;Pearson correlation coefficient was used for correlation analysis if it conformed to normality,and Spearman correlation coefficient was used for analysis if it did not;multiple stepwise regression was used to deeply explore the factors influencing the readiness for discharge of patients.Structural equation modeling was used to analyze and test the pathways and influence sizes of quality of discharge instructions,coping styles,social support,and chronic disease management self-efficacy on patients’ readiness for discharge,and the effect of mediation models was tested using the bias-corrected percentile Bootstrap technique in AMOS.Results1.281 patients with hepatomegaly were included in the analysis,and the mean score of total readiness for hospital discharge in patients with hepatomegaly was(7.21±0.73).The mean score of personal status(7.62±1.11)had the highest score,followed by adaptability(7.58±0.88)and the lowest score of anticipatory support(6.41±0.92).The total mean score of quality of discharge instructions was(6.47±0.76);the total mean score of social support was(3.60±0.76);the total mean score of coping style was(2.04±0.30);and the total mean score of self-efficacy was(7.66±0.95).2.Independent sample t-test and one-way ANOVA results showed that different age,marital status,education level,work status,per capita monthly income,medical payment status and clinical staging affected patients’ readiness for discharge(P < 0.05).3.Multiple linear regression analysis showed that literacy,monthly per capita household income,quality of discharge instructions,self-efficacy,medical coping style,and clinical staging were the main influencing factors on readiness for discharge in patients with hepatomegaly,explaining 54.5% of the variance in the multiple regression equation.4.Pearson correlation analysis showed that quality of discharge instructions was positively correlated with readiness for discharge in patients with hepatomegaly(r=0.454,P<0.01);social support was positively correlated with readiness for discharge(r=0.449,P<0.01);self-efficacy was positively correlated with readiness for discharge(r=0.719,P<0.01);and medical coping style was positively correlated with readiness for discharge.dimension was positively correlated with readiness for discharge(r=0.808,P<0.01);medical coping avoidance dimension was negatively correlated with readiness for discharge(r=-0.359,P<0.01);and medical coping submission dimension was negatively correlated with readiness for discharge(r=-0.565,P<0.01).5.The results of the mediating effect test showed that the quality of discharge instructions,self-efficacy,and social support played a chain mediating role between medical coping style and readiness for discharge.ConclusionThe level of readiness for discharge in patients with hepatomegaly was moderate.The quality of discharge instructions,self-efficacy,and social support mediated the chain between medical coping style and readiness for discharge in patients with hepatomegaly.Therefore,medical staff should pay close attention to patients’ readiness for discharge in clinical care,improve the quality and level of discharge instructions,enhance patients’ self-efficacy and self-awareness by developing effective interventions,and increase patients’ utilization of social support,so that patients can cope with their disease in a positive and healthy manner and improve their quality of life outside the hospital.