| Objective:To explore the status quo of discharge readiness of postoperative patients with oral cancer and analyze its influencing factors.To construct an intervention plan for discharge preparation service for patients with oral cancer under the guidance of timing theory based on literature review and expert consultation,and to explore the application effect of the plan.Methods:A total of 124 patients with oral cancer who were hospitalized in the Department of Oral and Maxillofacial Surgery of a Class3 Grade A hospital in Guangdong Province from August to December 2021 were investigated with the general information questionnaire,Readiness for Hospital Discharge Scale(RHDS)and Quality of Discharge Teaching Scale(QDTH)to understand their discharge readiness and its influencing factors.Guided by the timing theory,combined with the current situation survey results and literature review,the first draft of the discharge preparation service intervention plan was formed.After two rounds of expert consultation,the final intervention program was formed after modification according to expert opinions.A total of 77 patients with oral cancer who were hospitalized in the Department of Oral and Maxillofacial Surgery of a Class 3 Grade A hospital in Guangdong Province from March to August 2022 were selected by convenience sampling.A total of 38 patients who were hospitalized from March to May2022 were selected as the control group and received routine nursing.A total of 39 patients who were hospitalized from June to August in 2022 were selected as the intervention group.On the basis of routine nursing,the intervention program of discharge preparation service for patients with oral cancer constructed by the research group was implemented.The scores of readiness for hospital discharge,quality of discharge instruction,quality of life,length of hospital stay,incidence of complications during hospitalization,and30-day unplanned readmission rate were compared between the two groups.Results:1.The total discharge readiness score of patients after oral cancer surgery was(86.04±14.95),which was at an intermediate level.Multiple linear regression analysis showed that age,number of days in hospital,whether or not to discharge with a tube(gastric tube),and quality of discharge instructions were the main factors influencing the readiness to discharge of patients after oral cancer surgery.2.Combining the results of the current survey and literature review,and after consultation with Delphi experts,the final intervention plan for hospital discharge preparation services was developed,including the place,time,content,form,personnel and outcome evaluation of the intervention;the specific contents include the establishment of a multidisciplinary team,comprehensive needs assessment of patients,preoperative functional exercise,nursing skills guidance,psychological adjustment,postoperative functional exercise and guidance,provision of referral services and follow-up.There are a total of 5 level 1entries,13 level 2 entries and 47 level 3 entries.3.(1)Shedding of the reseach objectives:Among the 40 patients in the control group,2 patients could not be contacted during the follow-up after discharge and dropped out,and 38 patients finally completed the follow-up.Among the 40 patients in the intervention group,1 patient dropped out because of voluntary withdrawal,and 39 patients finally completed the study.Finally,38 patients in the control group and 39 patients in the intervention group were included in the study.(2)After the intervention,the total score and scores of all dimensions of readiness for hospital discharge of the intervention group were higher than those of the control group,and the differences were statistically significant(P<0.001).The total score and dimension scores of discharge instruction quality of the intervention group were higher than those of the control group,and the differences were statistically significant(P<0.05).The scores of quality of life of patients in the intervention group were higher than those in the control group at discharge,1 month and 3 months after discharge,and the differences were statistically significant(P<0.05),and the scores of quality of life of patients in the two groups were significantly different in time,between groups and interaction effects(P<0.05).There were 7 cases of complications in the intervention group and 15 cases of complications in the control group during hospitalization,and the difference was statistically significant(P<0.05).The median length of hospital stay was 17 days in the control group and 16 days in the intervention group,and there was no statistically significant difference between the two groups(P>0.05).Among the 38 patients in the control group,4patients had unplanned readmission,and among the 39 patients in the intervention group,1 patient had unplanned readmission.There was no statistically significant difference in the unplanned readmission rate between the two groups(P>0.05).Conclusion:1.In this study,the readiness of patients to be discharged after oral cancer surgery was moderate,with age,length of stay,discharge with a tube(gastric tube)and quality of discharge instructions being the main influencing factors.2.This study constructed the discharge preparation service intervention program for patients with oral cancer under the guidance of "timing it Right".The program can effectively improve the discharge readiness and discharge guidance quality of patients with oral cancer,reduce the incidence of complications during hospitalization,and improve the early quality of life of patients after surgery,which can provide a reference for the discharge preparation service practice of patients with oral cancer. |
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