Readiness for Hospital Discharge in Lung Cancer Influenced by Nursing Interventions

Patients with lung cancer who are receiving chemotherapy will be better prepared for discharge with effective discharge guidance and targeted intervention measures, according to the results of a recent study in Thoracic Cancer. 

A team of researchers conducted a cross-sectional study of patients with lung cancer who received chemotherapy between February and April 2023 at a hospital in Beijing, China. The researchers analyzed data from 452 patients to learn more about the correlation between patients’ fear of disease progression and the current status of discharge preparation and quality of discharge teaching.  

The survey was administered within 2 to 4 hours prior to each patient’s discharge from the hospital after receiving treatment, education, and other nursing interventions.

Patients completed a questionnaire designed to self-assess their readiness for hospital discharge. The researchers used the Chinese version of the Readiness for Hospital Discharge Scale, which assessed 12 items in 3 dimensions: personal status, adaptability, and expected support.  On a scale of 0 to 10, a score lower than 7 indicated inadequate readiness; 7 to 8, moderate readiness; 8 to 9, good readiness; and higher than 9, very good readiness. The mean total RHD score was 99.11±14.79, while the average score per item was 8.26±1.23. 

The results showed readiness for hospital discharge among patients with lung cancer was relatively high. “However, the scores of coping ability and disease knowledge in patients with chronic disease after discharge were relatively low,” stated the researchers. This suggests clinician understanding of how patients experience the transition from hospital to home, where they must manage their own care, is important. This understanding is a key to improving the discharge process. 

The researchers also explored the quality of discharge teaching (QDT) and patients’ fear of disease progression. They found QDT in this patient population positively correlated with discharge readiness; in fact, it influenced patients’ readiness for hospital discharge. 

Meanwhile, fear of disease progression negatively correlated with patients’ readiness for hospital discharge. Additionally, these results were consistent with previous results that suggested divorce and widowhood were associated with a pronounced fear of disease recurrence and depressive symptoms.

“Therefore, nurses should focus on improving the QDT, reducing the degree of [fear of disease progression], and providing targeted psychological, lifestyle, and specialized nursing measures and instruction based on different categories and influencing factors,” the researchers concluded. “Furthermore, the specialized oncology nursing team management model can be utilized to enhance the level of patient preparedness for discharge and improve the QDT. This, in turn, can improve the overall [quality of life] in these patients.”

Reference

Wang Y, Li J, Zhai M, Zhao Y, Li Q. Exploring readiness for discharge, quality of discharge teaching, and fear of disease progression in lung cancer patients undergoing chemotherapy: a correlation analysis. Thorac Cancer. Published online November 20, 2023. doi:10.1111/1759-7714.15164