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To identify key factors influencing readiness for hospital discharge and delve into the experiences of stoma patients regarding their discharge.
A mixed-methods study.
A total of 374 colorectal cancer patients with stomas were involved to assess discharge readiness and its influencing factors. Additionally, 28 stakeholders—comprising surgeons, nursing managers, surgical nurses, enterostomal therapists, stoma patients and their family caregivers—participated in semistructured interviews. Data on discharge readiness, discharge teaching quality, stoma self-efficacy and social support were collected using validated scales. In-depth interviews provided further insights into discharge preparation experiences. Multivariate logistic regression analysis using IBM SPSS 26.0 and thematic analysis via NVivo 12.0 were employed for data analysis.
Six variables accounted for 80% of the variance in discharge readiness: quality of discharge teaching, stoma self-efficacy, social support, age, gender and family income. Four main themes emerged: ambivalence towards discharge, insufficient preparation time, inadequate communication of discharge information and personal planning needs.
Discharge readiness among stomas patients is influenced by perceived discharge teaching quality, self-efficacy, social support, age, gender and family income. Insufficient preparation and poor communication hinder effective discharge information transfer. Enhanced, patient-centred discharge planning is expected to improve the transition from hospital to home.
To improve hospital discharge readiness and facilitate a smooth transition to family care, it is essential to implement patient-centred discharge planning.
Reported with the Mixed Methods Reporting in Rehabilitation & Health Sciences guidelines.
None.
ClinicalTrials.gov identifier: ChiCTR2200058756. https://www.chictr.org.cn/bin/home
To evaluate the prevalence of frailty and its impact on quality of life (QoL) in older Chinese breast cancer (BC) patients, which have not been thoroughly reported in this population.
A prospective multi-centre cross-sectional registry study.
Data were collected from Cancer Hospital of the Chinese Academy of Medical Sciences, Peking University Third Hospital and Beijing Chaoyang District San Huan Cancer Hospital between October 2021 and July 2023.
BC patients aged over 65 years were enrolled in this study. They completed three assessment scales including the FRAIL scale, Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30), to screen for frailty, related factors and QoL. Clinical and pathological data were also collected. Analysis of frailty and prefrailty risk factors was performed via logistic regression. A multivariable linear regression model was used to evaluate the mean differences in scores for each QoL domain between patients with different frailty statuses.
A total of 946 patients were enrolled from three hospitals in Beijing between October 2021 and July 2023. Their median age was 69 years and 73.6% of them had early-stage breast cancer. Further, 37.2% of these patients had ≥ 1 comorbidity. The prevalence of frailty was 8.8% and frailty was more common in those with aged ≥ 75 years (22.3%), those with advanced tumours (15.6%), those with anxiety (31.3%) and those with depression (29.3%). More than half (57.2%) of the patients were prefrail. Regression analysis revealed that older age (odds ratio [OR] 1.12 [95% CI 1.07–1.17], p < 0.001), an advanced tumour (OR 2.27 [1.33–3.89], p = 0.003), anxiety (OR 2.74 [1.37–5.48], p = 0.004) and depression (OR 3.84 [1.97–7.49], p < 0.001) were significantly associated with frailty. After adjusting for other factors, different frailty states were shown to be independent influencing factors for QoL in both the functional and the symptom domains (all p < 0.05).
Our study provides data on the prevalence of frailty and prefrailty in older Chinese patients with BC. Both conditions are closely related to poor QoL. It is helpful for oncologist and clinical care to making intervention and better treatment decisions.
The study adhered to the STROBE checklist.
This study provides detailed data on the prevalence of frailty in older Chinese patients with BC and correlative factors. It suggests that clinical care should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.
Patients participated in the implementation of the project (including the informed consent and questionnaire process). No other public contribution to this research.
This study provides data on the prevalence of frailty in Chinese older BC patients and correlative factors. It indicates that clinicians should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.
ChiCTR2200056070
To investigate the trajectory, influencing factors and dynamic relationships between fear of cancer recurrence (FCR) and quality of life (QOL) in lung cancer patients.
Prospective longitudinal study.
Longitudinal data from 310 lung cancer patients across three hospitals in China were assessed at 1, 3, 6 and 12 months postoperatively (T1–T4). Descriptive statistics characterised patient demographics, clinical characteristics, levels of FCR and QOL. A linear mixed-effects model was employed to analyse FCR trajectories, identify influencing factors on these trajectories, and predict the impact of FCR on QOL.
FCR changed significantly over time, with a slight decrease during T1–T2, an increase at T3 and gradual decline at T4. Higher fear levels were associated with female sex, suburban or rural residency, being a family breadwinner, presence of comorbidities and negative coping behaviours, and low family resilience. QOL negatively correlated with FCR, and FCR predicted lower QOL.
At 3 and 6 months postoperatively, lung cancer patients, especially women, suburban or rural residents, family breadwinners, those with comorbidities, negative coping behaviours and low family resilience, reported high levels of FCR. Healthcare providers should pay special attention to lung cancer patients especially during the period of 3–6 months post-surgery and offer tailored interventions to improve their QOL.
Understanding the FCR trajectories, its influencing factors and its negative impacts on QOL can guide the development of targeted interventions to reduce fear and enhance well-being in patients with cancer.
Identifying the trajectories and influencing factors of fear of lung cancer recurrence in patients at different time points informs future research on targeted interventions to improve QOL.
The study adhered to the guidelines outlined in the Statement on Reporting Observational Longitudinal Research.
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