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Objective:To explore the application effect of dyadic intervention scheme based on dyadic disease management theory and Information, Knowledge, Attitude, and Practice model in the discharge preparation of elderly stroke patients and family caregivers.Methods:The 92 pairs of elderly stroke patients and their caregivers hospitalized in the Department of Neurology in People′s Hospital of Zhengzhou University were conveniently selected. The non synchronous control method quasi experimental research was adopted. Totally 46 pairs of subjects who met the criteria for admission and discharge from May to July 2022 were set as the control group, and routine nursing was carried out; from August to October 2022, 46 pairs of subjects who met the criteria for admission and emission were set as the observation group to implement the dyadic intervention program. The scores of discharge readiness, self-efficacy and unplanned readmission rate of patients between the two groups were compared, and the scores of caregiver readiness, self-efficacy and caregiver stress between the two groups were compared.Results:Finally, 85 pairs of subjects completed the study, with 42 pairs in the control group and 43 pairs in the observation group. On discharge day, the total scores of discharge readiness and caregiver readiness in the observation group were (95.19 ± 4.47), (23.02 ± 2.20) points, respectively, which were higher than those in the control group (85.71 ± 5.31), (19.57 ± 1.65) points, with statistically significant differences ( t=8.91,8.16, both P<0.01); the self-efficacy levels of patients in the observation group at discharge and one month after discharge, as well as those of caregivers at discharge and one month after discharge were (73.86 ± 4.87), (75.91 ± 4.51), (75.67 ± 4.99), (79.21 ± 4.90) points, respectively, higher than those in the control group (71.62 ± 5.19), (73.33 ± 4.91), (73.48 ± 4.24), (75.48 ± 4.24) points, with statistically significant differences ( t values were from 2.05 to 3.75, all P<0.05); the pressure levels of caregivers in the observation group at discharge and one month after discharge were (7.51 ± 2.48), (6.28 ± 1.99) points, respectively, lower than those in the control group (8.76 ± 2.55), (7.45 ± 2.36) points, with statistically significant differences ( t=-2.29, -2.48, both P<0.05); the unplanned readmission rate of patients in the observation group one month after discharge was 7.0% (3/43), lower than the control group′s 23.8% (10/42), with statistically significant difference ( χ2=4.65, P<0.05). Conclusions:The implementation of dyadic intervention on elderly stroke patients and caregivers can make their discharge preparation process more adequate, thus reducing the caregiver′s care pressure, reducing the unplanned readmission rate of patients, and improving their health outcomes.
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Objective:To implement evidence-based practice of discharge preparation service in maternal and to explore the clinical effect.Methods:Based on the evidence-based continuous quality improvement framework, apply the evidence on the clinical through evidence acquisition, baseline evaluation, evidence introduction, and after-effect evaluation. Sixty women hospitalized in the obstetrics department of the Affiliated Hospital of Chengde Medical College from January to March 2021 were selected as the baseline group, and 60 women hospitalized in the obstetrics department of the hospital from April to July 2021 were selected as the evidence application group, to evaluate and compare the quality of discharge guidance for practitioners, discharge readiness level, maternal and newborn management knowledge level, incidence of maternal and newborn complications and the compliance of practitioners to evidence.Results:Finally, 10 pieces of evidence applied to clinical practice were included and 15 review indicators were translated. After the application of evidence, the quality of discharge guidance of practitioners increases from (141.83±24.66) to (166.13±10.30), the maternal discharge readiness increased from (127.12 ± 26.29) to (137.63 ± 22.59) , the score of maternal knowledge level increased from (164.58 ± 20.10) to (176.08 ± 24.25) , t values were -7.04, -2.39 and -2.83, all P<0.05. The incidence of postpartum women breast disease, postnatal constipation and newborn eczema, newborn red buttocks, newborn diarrhea, newborn jaundice decreased significantly, the difference were statistically significant, χ2 values were 5.21-7.50, all P<0.05. After the application of evidence, the implementation rate of the review indicators increased from ≤31.67% to ≥86.66%. Conclusions:The evidence-based practice of discharge preparation service in postpartum women improve the quality of discharge guidance for practitioners and compliance with evidence, promote clinical quality improvement, can be used for clinical reference.
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Objective:To investigate the effect of mind mapping on the discharge readiness of patients undergoing first coronary stent implantation, so as to provide basis for seeking effective discharge guidance in clinical practice.Methods:One hundred patients who were hospitalized in the Department of Cardiology, the Second Affiliated Hospital of Dalian Medical University from December 2019 to August 2020 and who underwent coronary stent implantation for the first time were selected as the study objects. They were divided into the control group and the experimental group with 50 cases in each group by the random number table method. The control group was given routine discharge guidance, and the experimental group was given discharge guidance using mind mapping. Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale were used to compare the differences of discharge readiness and discharge guidance quality between the two groups after intervention.Results:The personal status, adaptability, predictive support and the total score of discharge readiness in the experimental group were (25.18 ± 3.79), (45.24 ± 3.63), (36.62 ± 3.63), (107.04 ± 8.92) points, which were all higher than those in the control group (23.34 ± 3.04), (41.68 ± 3.62), (35.14 ± 2.14), (100.16 ± 7.36) points, with statistically significant differences ( t values were -4.91--2.48, all P<0.05). The actual acquired content, guiding skills and results, total scores of discharge guidance quality of patients in the experimental group were (56.66 ± 6.06), (94.46 ± 4.33), (151.12 ± 8.26) points, which were all higher than those in the control group (45.38 ± 9.19), (89.44 ± 10.87), (134.82 ± 14.31) points, with statistically significant differences ( t values were -7.25, -3.03, -6.97, all P<0.05). Conclusions:Mind mapping can effectively improve the discharge preparation degree and discharge guidance quality of patients undergoing coronary stent implantation for the first time, and it is a simple and practical discharge guidance tool.
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Objective:To investigate the intervention effects of nurse-led discharge planning on discharge readiness and ostomy psychological adaptation in patients with enterostomy.Methods:A total of 70 patients with enterostomy admitted from January 2019 to October 2020 in Jiangsu Province Hospital of Chinese Medicine were enrolled in the present study. They were assigned to experimental group and control group according to the admission time, there were 35 cases in each group. There was one case lost in the control group in the end. The control group received the routine care, while the experimental group implemented nurse-led discharge planning. The Chinese version of Readiness for Hospital Discharge Scale (RHDS) and Ostomy Adjustment Inventory (OAI) were adopted as indicators, the intervention effects was compared between the two groups.Results:On discharge, disease knowledge, coping ability, personal status and expected support dimension scores and total scores in RHDS were (58.06 ± 12.54) , (23.57 ± 3.73), (24.29 ± 3.48) , (30.40 ± 5.25), (136.31 ± 14.32) points in the experimental group, which were significantly higher than those in the control group (49.57 ± 13.28), (18.63 ± 4.97), (22.37 ± 4.28), (26.11 ± 5.66), (101.68 ± 13.04) points, and the differences were statistically significant ( t values were 2.05-4.91, all P<0.05) . On discharge and 1 month after discharge, the persistent worry, acceptance, positive attitude towards life dimension scores and total scores in OAI were (21.34 ± 2.72) , (13.29 ± 2.36), (15.26 ± 3.24), (49.89 ± 5.70) points and (22.03 ± 3.45), (12.49 ± 3.10), (15.09 ± 3.06), (49.60 ± 5.55) points in the experimental group, which were significantly higher than those in the control group (19.35 ± 2.98) , (11.56 ± 2.79), (13.26 ± 3.15), (44.18 ± 5.63) points and (19.91 ± 3.34), (10.76 ± 2.80), (12.24 ± 3.25), (42.91 ± 4.76) points, the differences were statistically significant ( t values were 2.42-5.36, all P<0.05). Conclusions:Nurse-led discharge planning can promote discharge readiness and ostomy psychological adaptation in patients with enterostomy.
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Objective:To construct a discharge preparation service program for elderly lung cancer patients and their caregivers based on binary coping theory, evaluate its clinical feasibility.Methods:To develop discharge preparation service for elderly lung cancer patients and their caregivers by literature retrieval, expert correspondence consultation and theoretical research. The program included three themes: binary evaluation, binary management behaviorand binary health, and six intervention strategies: evaluation of symptoms, care goals and intentions, decision making, emotional communication support, management of physical function changes and general health behavior. From July to September 2021, 30 pairs of elderly lung cancer patients and their caregivers were recruited and assigned into the control group and the experimental group with 15 pairs in each group according to random numbers generated by computer. The feasibility and clinical effect of the program were evaluated by feasibility evaluation index, discharge readiness, dual coping and comprehensive needs scale of caregivers.Results:In this study, the recruitment rate was 76%(32/42), the retention rate was 94%(30/32), and the acceptance rate of the intervention plan in the experimental group was 100%. After intervention, the total scores of discharge readiness was (83.00 ± 2.59), the patient dyadic coping was (136.80 ± 4.54), caregiver dyadic coping was (136.33 ± 3.56) and caregiver comprehensive needs was (124.37 ± 11.69) in the experimental group, which were better than those of in the control group, (74.40 ± 4.17), (129.07 ± 4.83), (120.33 ± 9.17) and (206.57 ± 9.14), the differences were statistically significant ( t values were -6.78- 5.54, all P< 0.05). Conclusion:The discharge preparation service plan for elderly lung cancer patients and caregivers based on dyadic coping theory is scientific and feasible, but the plan still needs further optimization, improvement and large sample randomized controlled trial to verify.
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Objective:To explore the impact of Green model-based health education on the readiness for discharge of newly treated lymphoma patients undergoing chemotherapy, providing a reference for improving the quality of discharge guidance for such patients.Methods:From May 2021 to October 2021, 116 patients with newly treated malignant lymphoma who received chemotherapy in Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital were selected as the research subjects. According to the single or double date on the day of admission, they were divided into control group (59 cases) and intervention group (57 cases); the control group carried out health education according to the content of the lymphoma nursing routine, and the intervention group implemented Green model-based health education. After the second chemotherapy cycle, compared the differences in discharge readiness and the quality of discharge guidance between the two groups.Results:Before the intervention, there was no significant difference in the scores of the two groups of patients′discharge readiness and the quality of discharge guidance ( P>0.05). After the intervention, the three dimensions and total scores of hospital discharge readiness in the intervention group were (24.65 ± 4.29), (43.47 ± 3.49), (35.58 ± 5.73), and (103.70 ± 9.10) points, respectively, which were higher than those in the control group (20.64 ± 3.81), (37.24 ± 6.18), (30.42 ± 6.03), and (88.31 ± 12.07) points, and the differences were statistically significant ( t values were 4.72-7.74, all P<0.01); the two dimensions and total scores of the quality of discharge guidence in the intervention group were (48.05 ± 8.87), (109.26 ± 18.73), and (157.32 ± 23.84) points, respectively, which were higher than those in the control group (40.17 ± 12.81), (92.85 ± 22.58), and (133.02 ± 29.38) points, the differences were statistically significant ( t=3.84, 4.25, 4.88, all P<0.01). Conclusions:Green model-based health education can improve the readiness for discharge and the quality of discharge guidance for newly treated lymphoma patients undergoing chemotherapy.
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Objective To describe the status of discharge readiness of patients with intracranial aneurysm undergoing interventional therapy and explore its influencing factors. Methods Easy sampling method was used to select 136 patients with intracranial aneurysm undergoing interventional therapy at the Department of Neurosurgery, Liaocheng People's Hospital. Clinical data questionnaire was applied to collect the clinical data of patients. Discharge readiness scale and discharge guidance quality scale were adopted to assess patients′ discharge readiness and discharge guidance quality. Pearson correlation analysis was used to analyze the correlation between discharge guidance quality and discharge readiness, while multi-linear regression analysis was used to analyze the influencing factors of discharge readiness. Results In this study, the total score of discharge readiness in patients with intracranial aneurysm undergoing interventional therapy was (157.90 ± 26.98) points, which was at a moderate level. Pearson correlation analysis showed that the discharge guidance quality was positively correlated with the discharge readiness for patients with intracranial aneurysm (r=0.619, P<0.01). Multi-linear regression analysis showed that the education level, family average monthly income, place of residence, numbers of long-term medications required, and discharge guidance quality were factors influencing the discharge readiness of patients with intracranial aneurysm undergoing interventional therapy (β′=0.102, 0.175, 0.391,- 0.226, 0.314, P<0.05). Conclusion In patients with intracranial aneurysm undergoing interventional therapy, the discharge readiness was at a moderate level, and the medical staff should make interventional strategies, taken the factors affecting the discharge readiness into consideration, and strength the discharge guidance quality to improve the patients′discharge readiness and prognosis.
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The discharge preparation service is a complete process, which is of great significance for ensuring the patients′ discharge safety and the home sustainability of rehabilitation nursing. It has become a hot issue among international nursing scholars. This paper reviews the concept, implementation content, assessment tools, nursing practice of patient discharge preparation services, so as to provide theoretical basis for forming patient discharge preparation services system with medical environment in China.
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Objective To investigate the level of readiness for hospital discharge in elderly patients with chronic obstructive pulmonary disease (COPD) and its correlation with patients'self-efficacy. Methods A questionnaire survey was administered to 240 elderly COPD patients admitted to the people's hospital of Wuhan University in Hubei Province from November 2017 to March 2018, using the Readiness for Hospital Discharge Scale and the Self-Efficacy for Managing Chronic Disease 6-Item Scale. Pearson correlations were used for analysis. Results Total scores for hospital discharge readiness were (6.13±0.89) and for self-efficacy were (3.42±1.46) in elderly COPD patients. Pearson correlation analyses indicated that there were significant positive correlations between the total scores and all dimensions of readiness for hospital discharge and self-efficacy in elderly patients with COPD (r=0.256-0.651, P<0.01). Conclusion The readiness for hospital discharge in elderly patients with COPD is still at a medium level, and the level of self-efficacy is low. Readiness for hospital discharge and self-efficacy are positively correlated in elderly patients with COPD. Health care workers should pay active attention to the readiness for hospital discharge in elderly patients with COPD so as to help them improve their self-efficacy, and promote disease recovery.