The Status Quo Of Hospital Discharge Readiness And Influencing Factors Of Elderly Patients With Chronic Obstructive Pulmonary Disease

Research purpose:To investigate the status quo of discharge readiness of elderly patients with chronic obstructive pulmonary disease(COPD)in a tertiary care hospital in Chengdu,analyze the influencing factors,and explore the relationship between discharge readiness of elderly patients with COPD and the quality of discharge guidance and social support,in order to provide the basis for the development of more targeted discharge intervention measures for this group in the process of clinical practice and improve discharge management.Materials and Methods:In this study,a cross-sectional survey was designed and convenience sampling method was used.According to the inclusion and exclusion criteria,302 elderly inpatients diagnosed with COPD in the Department of Respiratory and Critical Care Medicine of a tertiary care hospital in Chengdu from December 2021 to June 2022 were selected.Demographic sociological data and disease-related data questionnaire,discharge preparation scale(RHDS),discharge guidance quality scale(QDTS),and social support rating scale(SSRS)were used to investigate the status quo of discharge preparation in elderly patients with COPD.Valid data were entered into Microsoft Excel to establish a database,and SPSS 26.0 software and Graph Pad Prism 8 software were used for statistical analysis and graphical preparation of the data.Descriptive analysis was used to describe the demographic sociological data,disease-related data,discharge readiness status,discharge guidance quality score and social support of elderly COPD patients,combined with univariate analysis and multiple linear regression analysis to analyze the influencing factors of discharge readiness of elderly COPD patients,and Pearson correlation was used to analyze the correlation between discharge readiness and discharge guidance quality and social support.Result:1.Descriptive analysis of the current state of readiness for discharge in elderly patients with COPD:The mean total score of discharge readiness in elderly patients with COPD was(77.72±11.86)points,the items were equally divided into(6.48±0.19)points,the scores of the three dimensions were:Pearsonal state dimension score was(21.05±3.60)points,adaptability dimension score was(31.11±6.26)points,and anticipatory support dimension score was(25.57±4.00)points.2.Descriptive analysis of the current situation of discharge instructions quality in elderly patients with COPD:the mean total score of discharge instructions quality was(110.54±15.66)points,the mean of entries was(6.12±0.15)points,the scores of three dimensions were(49.48±6.13)points for the required conten,(29.40±6.35)points for the actual obtained content,and the score of guidance skills and effects was(81.14±11.11)points.3.Descriptive analysis of social support level in elderly COPD patients:social support assessment score(23.39±5.01)points,subjective support(15.56±3.09)points,objective support(6.94±1.41)points,support utilization(6.57±1.94)points.4.Univariate analysis of demographic sociology and disease-related data in elderly patients with COPD:there were significant differences in discharge readiness scores in14 aspects:age,education level,marital status,mode of medical cost payment,course of disease,whether they were hospitalized for the first time due to COPD,mode of admission,type of comorbidities,mMRC grade,whether they used ventilators during hospitalization,length of hospitalization,number of drugs discharged,whether inhalers were prescribed for discharge,and long-term home oxygen therapy after discharge(P<0.05).5.The results of multiple linear regression analysis showed that 8 independent variables,including marital status,admission method,length of hospital stay,mMRC grade,number of drugs taken at discharge,presence or absence of inhalants prescribed at discharge,home oxygen therapy and quality of discharge instructions,were related to discharge readiness score in elderly patients with COPD.F=18.672,P<0.05,R~2=0.528,Adjusted R~2=0.501.6.There was a linear positive correlation between discharge readiness scores and discharge instruction quality(r=0.46,P<0.001)and social support(r=0.38,P<0.001)in elderly COPD patients.Conclusion:1.In this study,the readiness of elderly COPD patients for discharge was poor,at a low level,and in need of further improvement;the quality of discharge instructions was inadequate,and social support was at an intermediate level.2.Discharge readiness of elderly COPD patients is linearly and positively correlated with the quality of discharge instructions and social support.3.mMRC grade,quality of discharge instructions,admission method,home oxygen therapy,whether there are inhalants in the doctor’s advice with drugs at discharge,marital status,type of drugs at discharge,and length of hospital stay are the main influencing factors of discharge readiness in elderly COPD patients.