A Mixed Methods Study Of The Current Status Of Discharge Readiness And Its Influencing Factors In Elderly Breast Cancer Patients With Tubes

Objective: To investigate the status quo of discharge readiness in elderly patients with breast cancer after operation with catheter,and to analyze the factors affecting discharge readiness.The descriptive nature of the study provides an in-depth understanding of the reasons for the inadequacy of discharge readiness in elderly patients with postoperative breast cancer with catheter,and provides a basis for intervention measures to improve the level of discharge readiness in this population,and lays a foundation for further research in the field of postoperative breast cancer.Methods: 1.Quantitative study: 130 elderly patients with postoperative catheter who were hospitalized in the breast surgery department of a Grade A Hospital in Shenyang from June 2021 to March 2022 were selected by convenience sampling method to investigate their readiness for discharge.The survey tools included general data questionnaire,discharge readiness table,discharge guidance quality scale,social support rating scale and self-care ability implementation scale.The data results were analyzed by SPSS 25.0 software,including descriptive analysis,Pearson correlation analysis,single factor analysis and multiple linear regression analysis.2.Qualitative research: Objective sampling was used to compile an interview outline based on the dimensions of discharge readiness scale and literature review.10 patients with catheter after breast cancer surgery with insufficient discharge readiness were selected for one-to-one semi-structured interviews.Results:Quantitative results: 1.The total score of discharge readiness was 87.22±9.32,and the total score was 7.26±0.78.The average score of personal status dimension,adaptive ability dimension and anticipatory support dimension were 7.31±1.34,6.51±0.74 and 8.19±1.23,respectively.The total score of discharge guidance quality was 190.15±13.92,the total score of social support was 36.21±5.39 and the total score of self-care ability was 106.40±19.94.Univariate analysis results: age,educational level,residential status,drainage indenture time,length of hospital stay,number of drainage tube,unilateral and bilateral operation,these general data in the test results reached different degrees of significance(P<0.05).3.Pearson correlation analysis results: Discharge guidance quality,social support,self-care ability and discharge readiness were positively correlated.4.Results of multiple linear stepwise regression:age,length of stay,unilateral and bilateral surgery,quality of discharge guidance,and social support had statistical differences on discharge readiness(R2 =0.697,F=19.566,P<0.001).The relationship between self-care ability and discharge readiness was not established.Qualitative results: The reasons for the inadequate discharge readiness of elderly patients with postoperative tube for breast cancer are as follows: poor personal fitness in the dimension of personal status;In the dimension of adaptability,self-care ability is poor,pipeline adaptability is insufficient,and rehabilitation training knowledge is lacking.In the anticipatory support dimension,continuity of care services is lacking.Conclusions: The discharge readiness of elderly patients with catheter after breast cancer surgery was at a medium low level,the main reasons were poor personal fitness,poor self-care ability,inadequate pipeline adaptability,lack of knowledge about rehabilitation training,and lack of continuity of care services.Age,length of stay,unilateral and bilateral surgery,quality of discharge guidance and social support were the factors influencing discharge readiness.