Exploring the Humanistic Care Competencies of Nurses in Infectious Disease Hospitals in China: A Modified Delphi Study

ABSTRACT

Aim

This study aims to develop an indicator system for assessing the humanistic care competencies of nurses in infectious disease hospitals and provide a scientific measurement tool to understand the current humanistic care competencies level of infectious disease nurses.

Design

A mixed-methods design integrating qualitative interviews and a modified Delphi study.

Methods

Initially, we derived a list of potential indicators of humanistic care for nurses in infectious disease hospitals from literature reviews and interviews with a nominal group technique (n=41). Following this, 26 experts from across China participated in two Delphi rounds from May to July 2023. Then the indicators were screened, revised and supplemented using the boundary value method and expert opinions. Next, the hierarchical analysis method was utilised to determine the weights of the indicators.

Results

The average effective response rate across the two Delphi rounds was 94%. The authority coefficients for the first and second rounds were 0.85 and 0.90, respectively, suggesting the experts were highly authoritative. There was a consistent rating among experts with a coordination coefficient for each indicator (p < 0.001). Ultimately, this study identified 4 primary indicators, 8 secondary indicators, and 35 tertiary indicators. The four primary indicators and their weights are basic care competency (0.158), therapeutic care competency (0.544), spiritual care competency (0.158) and safety care competency (0.140).

Conclusion

This research provides a scientifically rigorous and comprehensive framework to evaluate the humanistic care competencies of nurses in infectious disease hospitals in China. This system will serve as an effective tool for evaluating the humanistic care competencies of nurses in specialized infectious disease hospitals in China and other overseas regions.

Implications for the Profession and/or Patient Care

This study provides a new tool to assess the humanistic care competencies of nurses in infectious disease hospitals. Form an effective humanistic care competencies index system that can be used to build and develop the need for nurses to possess different aspects of humanistic care competencies tailored to infectious disease patients in hospitals.

Patient or Public Contribution

No patients or public contribution.

Effect of the index of consciousness 2 on intraoperative opioid dosage in ovarian cancer patients receiving neoadjuvant chemotherapy: a study protocol for a randomised controlled trial

Positive Psychological Experiences in Chronic Heart Failure: A Qualitative Meta‐Synthesis

ABSTRACT

Aims

Determine the positive psychological experience of patients with chronic heart failure through a systematic literature review and to provide a reliable basis for their psychological care.

Design

Qualitative meta-synthesis.

Data Source

A qualitative meta-synthesis was conducted to extract and analyse qualitative research from PubMed, Web of Science, Embase, Cochrane, CINAHL, PsycINFO and Chinese Database, including China National Knowledge Internet, Wanfang Database, China Biology Medicine Disc and VIP database from the inception of the database to 24 March 2024.

Review Methods

Two researchers screened, extracted and cross-checked data. Disputes resolved via discussion or 3rd researcher. Irrelevant titles/abstracts were excluded; full-texts were reviewed for final inclusion.

Results

A total of 17 qualitative studies yielded 58 results, categorised into 10 groups and synthesised into three themes: positive attitudes and emotional responses, positive changes after the disease diagnosis and supportive factors for positive psychology.

Conclusions

Heart failure patients can experience positive psychology post-illness. Care providers should prioritise psychological assessment and support factors to meet needs, foster rehabilitation and improved quality of life.

Patient or Public Contribution

CHF patients crucially contributed to this qualitative meta-synthesis by sharing insights into their positive psychological experiences, resilience and coping strategies.

Abnormal Time and Space Experiences Among Transitional‐Age Youth With a Major Depressive Disorder: A Phenomenological Qualitative Study

ABSTRACT

Aim

To explore the abnormal experiences of time and space among transitional-age youth with major depressive disorder.

Design

A descriptive phenomenological qualitative study.

Methods and Setting

The study was conducted at a psychiatric hospital in China. Purposive sampling was used to recruit transitional-age youth with major depressive disorder. Data were collected through semi-structured interviews and analysed using Colaizzi's method.

Findings

Seventeen participants were interviewed. The abnormal experiences of time and space among transitional-age youth with major depressive disorder were synthesised into five overarching themes: (1) Disturbance of Time Order; (2) Slackening of the Flow of Time; (3) Vital Inhibition; (4) Desynchronisation of Social Rhythms; and (5) Disturbance of Lived Space.

Conclusions

This study highlights that pervasive abnormalities in temporal and spatial experiences characterise transitional-age youth with major depressive disorder. These disturbances shape their sense of self, personal development, relationships and engagement with the world, underscoring the need for interventions that address these temporal and spatial disturbances within the context of developmental transition.

Impact

This study addresses a knowledge gap regarding the subjective experience of time and space among transitional-age youth with major depressive disorder. This study highlights that transitional-age youth with major depressive disorder experience desynchronisation across temporal, spatial, bodily and social domains. Moreover, the desynchronisation of social rhythms appears to be a unique and developmentally salient challenge for transitional-age youth with major depressive disorder. These insights expand phenomenological understandings of major depressive disorder and highlight the developmental vulnerabilities of major depressive disorder as it navigates this critical life phase.

Patient or Public Contribution

Five participants were involved in reviewing and providing feedback on the interview content and results. Their contributions included enhancing the authenticity and credibility of the findings.

Reporting Method

The study followed the Consolidated Criteria for Reporting Qualitative Research guidelines.

Is air pollution negatively associated with physical fitness?—A cross-sectional study in 174,246 Chinese students

by Weixin Chen, Jiaming Yan, Zhenxing Kong, Yuliang Sun, Wenfei Zhu, Jie Kang

Air quality in China has become an increasing concern, its association with physical fitness remains unclear. This study represents one of the largest nationwide investigations of this association, leveraging data from 174,246 students aged 7–22 years across 30 provinces.

Annual concentrations of PM₂.₅, PM₁₀, SO₂, NO₂, CO, O₃, and the Air Quality Index (AQI) were obtained from the Tracking of Atmospheric Pollution in China dataset. Physical fitness was evaluated through a comprehensive set of field-based tests covering anthropometric, cardiopulmonary, flexibility, muscular strength, and endurance. Associations were examined using generalized linear models with progressive adjustments: Model 1 controlled for demographic factors (age, sex, residence, province), Model 2 additionally accounted for physical activity and parental factors, and Model 3 further incorporated temperature and humidity.

After adjusting for covariates, each 1 μg/m³ increase in PM₂.₅ and PM₁₀ was associated with decreases in physical fitness scores of 0.18 [95% CI: −0.22, −0.14] and 0.12 [−0.16, −0.08] points, respectively. SO₂, O₃, and CO showed similar negative associations, with reductions of 0.42 [−0.47, −0.38], 0.21 [−0.25, −0.16], and 0.16 [−0.20, −0.11] points, respectively. In contrast, NO₂ exhibited a positive association, with an increase of 0.29 [0.25, 0.33] points per 1 μg/m³. AQI was also inversely related to fitness, decreasing scores by 0.17 [−0.21, −0.13] points per 1-unit increase.

Ambient air pollution is adversely associated with physical fitness among Chinese children, adolescents, and young adults, highlighting the importance of air quality improvement strategies for youth health. Future longitudinal studies are warranted to strengthen causal inference.

‘From Expert to Novice’, Perceptions of General Ward Nurses on Deployment to Outbreak Intensive Care Units during the COVID‐19 Pandemic: A Qualitative Descriptive Study

Abstract

Aims and objectives

This study aimed to explore the perceived preparedness and psychosocial well-being of general ward nurses prior to their deployment into the outbreak intensive care units (ICUs) during the COVID-19 pandemic.

Background

With the surge in COVID-19 cases requiring ICU care, non-ICU nurses maybe deployed into the ICUs. Having experienced through SARS, hospitals in Singapore instituted upskilling programs to secure general ward nurses’ competency in providing critical care nursing. However, no studies have explored the perceptions of general ward nurses on deployment into the ICUs during the COVID-19 pandemic.

Design

Qualitative descriptive study.

Methods

The study was conducted at Singapore’s epicentre of COVID-19 management. Five focus groups were conducted following purposive sampling of 30 general ward nurses identified for outbreak ICU deployment. Focus groups were audio-recorded, transcribed verbatim and data thematically analysed. This study was conducted and reported in accordance with the COREQ checklist.

Results

Three salient themes arose, exemplifying the transition from clinical experts in the general wards to practising novices in the outbreak ICUs. Firstly, ‘Into the deep end of the pool’ described general ward nurses’ feelings of anxiety and stress associated with higher exposure risk and expanded responsibilities to nurse critically ill patients. Secondly, ‘Preparing for “war”’ illustrated deployed nurses’ need for clear communication and essential critical care nursing training. Lastly, ‘Call of duty’ affirmed the nurses’ personal and professional commitment to embrace this transition into the ICUs, and their desire for greater psychosocial support.

Conclusion

The study findings highlight that though general ward nurses perceived their impending ICU deployment positively, they require ongoing support to facilitate a smoother transition.

Relevance to clinical practice

Findings provided an evidence base to improve the preparedness of general ward nurses deployed into the ICUs during the COVID-19 pandemic within key areas of training, information dissemination and psychosocial resilience.

Negative association between dietary copper intake and human papillomavirus infection: A cross-sectional analysis of the National Health and Nutrition Examination Survey

by Chengya Feng, Xiaohe Lu, Zimian Fan, Xinxing Wang

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection. Copper is essential for immune function, but its association with HPV infection remains unclear. This study aims to investigate the relationship between dietary copper intake and HPV infection.

This cross-sectional study analyzed 8,071 participants from the National Health and Nutrition Examination Survey (2003–2016). Copper intake was assessed using two 24-hour recalls, and HPV status was confirmed by DNA testing. Weighted multivariable logistic regression and restricted cubic splines (RCS) were used.

After adjusting for multiple confounders, dietary copper intake was significantly inversely associated with vaginal HPV infection (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.67–0.92). Compared with women in the lowest quartile of dietary copper intake, those in the highest quartile had a lower adjusted OR for vaginal HPV infection (OR, 0.60; 95% CI, 0.48–0.73). RCS analysis revealed an L-shaped association with a threshold at 1.2 mg/day of copper intake. Subgroup analyses showed that marital status moderated the association between copper intake and HPV infection (P for interaction  Conclusion

An L-shaped association was observed between copper intake and HPV infection, suggesting that maintaining an optimal level of copper intake may be associated with reduced risk of HPV infection and related diseases.

The prognostic value of the direct bilirubin to albumin ratio in critically ill patients with cirrhosis: Insights from MIMIC-IV database

by XingYi Yang, GuangDong Wang, Zhang Min, LiHong Lv, Ji Yang

Patients with severe cirrhosis are at a higher risk of mortality. This study aimed to investigate the association between the direct bilirubin-to-albumin ratio (DBAR) and 28-day mortality in critically ill cirrhotic patients using data from the publicly available MIMIC-IV database.

This study explores DBAR’s relationship with 28-day mortality in severe cirrhosis patients. We first conducted univariate and multivariate analyses to identify independent risk factors. Then, we used Kaplan-Meier (KM) survival analysis to assess DBAR’s link with survival time and created KM curves. DBAR’s predictive accuracy was evaluated using Receiver Operating Characteristic (ROC) analysis, and the relationship was examined using restricted cubic spline modeling and subgroup analyses.

This study enrolled 509 cirrhotic patients with in-hospital and ICU mortality rates of 22.3% and 14.3%, respectively. Univariate and multivariate analyses revealed a significant association between DBAR and 28-day mortality risk, with a hazard ratio of 1.16 (95% CI: 1.10–1.24, p  Conclusion

The DBAR scoring system offers an efficient and user-friendly approach for assessing prognosis in critically ill cirrhotic patients.

Cognitive Impairment in Maintenance Haemodialysis Patients: Early Identification and Management

Association between fat-to-muscle ratio and secondary osteoporosis in rheumatoid arthritis: a cross-sectional study at a tertiary hospital in China

Analysis of global, regional and national trends in the burden of soft tissue and other extraosseous sarcomas from 1990 to 2021: A systematic analysis of the global burden of disease study 2021

by Xing Chen, Zhixiong Zhang, Jiwei Xiang, Ruliu Xiong, Xingmao Zhou

Soft tissue and other extraosseous sarcomas (STSES) are rare malignant tumors originating from mesenchymal tissues with complex etiologies. A systematic analysis of global burden trends is urgently needed.

Utilizing the Global Burden of Disease (GBD) 2021 database, we assessed STSES incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) across regions and countries from 1990 to 2021, stratified by sociodemographic index (SDI). Spatiotemporal models, Joinpoint regression (to calculate average annual percentage changes, AAPC), and decomposition analysis were employed to evaluate the impacts of population growth, aging, and epidemiological factors on disease burden.

In 2021, there were 96,201 new STSES cases globally, resulting in 50,203 deaths and 1.678 million DALYs. While age-standardized rates (per 100,000 person-years) showed declining trends (AAPC for ASIR = −0.13, ASMR = −0.60, ASDR = − 0.94), absolute burden increased by 77.97% due to population growth. Males exhibited consistently higher burden than females, with incidence peaking at 55–74 years. Notably, young females (10–29 years) transiently surpassed males in DALYs. Significant regional disparities emerged: High-SDI regions (e.g., Western Europe) demonstrated lower ASMR attributable to advanced diagnostics and treatment, whereas low-SDI regions (e.g., Uganda, ASMR = 1.96/100,000) faced poorer prognoses due to healthcare deficiencies. SDI exhibited a nonlinear association with disease burden—middle-SDI regions (0.4–0.8) showed rising ASIR, potentially linked to industrial pollution and improved diagnostic capabilities. These findings underscore the critical need for context-specific prevention and resource allocation strategies to address the evolving global STSES burden.

The global STSES burden is predominantly driven by population growth, necessitating targeted prevention strategies addressing occupational exposures in males and subtype-specific risks among young females. While high-SDI regions demonstrate mortality reduction through precision oncology, low-SDI regions require urgent improvements in healthcare accessibility to mitigate survival disparities. Persistent regional heterogeneity underscores the imperative for international collaboration to standardize diagnostic protocols and ensure equitable resource allocation. These insights emphasize the need for stratified surveillance systems and translational research to optimize context-specific intervention frameworks.

Mentor‐Student Relationship and Graduate Students' Satisfaction With Mentors: A Moderated Mediation Model

ABSTRACT

Objective

To explore how the mentor-student relationship affects nursing graduate students' satisfaction with mentors, as well as how mentoring mode and learning motivation work together.

Design

A multi-centre cross-sectional study.

Setting

Thirty universities and colleges in eastern, central and western China.

Participants

A total of 826 nursing graduate students from thirty universities and colleges participated in this study in April 2024.

Methods

Data were collected using the general information questionnaire, mentor-student relationship entry, mentoring mode questionnaire, graduate students' satisfaction item and learning motivation scale. Data were analysed using SPSS 25.0 software. The PROCESS macro-plugin and the bootstrap method were utilised to examine the mediating and moderating effects of learning motivation and mentoring mode.

Results

There was a positive correlation between nursing graduate students' satisfaction with mentors and the mentor-student relationship (r = 0.377, p < 0.001), learning motivation (r = 0.600, p < 0.001), and mentoring mode (r = 0.292, p 0.001). Learning motivation exerted a partial mediation effect between the mentor-student relationship and graduate students' satisfaction with mentors (mediation effect value = 0.182, 95% CI = 0.148–0.218). Mentoring mode moderated the path of learning motivation in the mentor-student relationship (interaction term coefficient = 0.031, 95% CI = 0.005–0.056).

Conclusion

Mentor-student relationship positively predicted nursing graduate students' satisfaction with mentors significantly. Learning motivation played a partial mediating effect between mentor-student relationship and graduate students' satisfaction with mentors and mentoring mode moderated between mentor-student relationship and learning motivation pathways. Therefore, cultivating positive teacher/helpful friend relationship, boosting students' learning motivation and improving mentoring mode techniques can all increase nursing graduate students' satisfaction with mentors.

No Patient or Public Contribution

No patient or public contribution.

Comment on “Mediating Effect of Job Burnout on the Relationship Between Organisational Support and Quiet Quitting in Nurses”

Family Communication to Enhance Adolescent Depression Recovery—Intervention Development Protocol

ABSTRACT

Aim

To develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.

Design

This study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.

Methods

The program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.

Results

The process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.

Conclusion

This research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.

Implications for the Profession and/or Patient Care

The intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.

Impact

The study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.

Reporting Method

This study adhered to the GUIDED guideline for reporting intervention development studies.

Patient or Public Contribution

No Patient or Public Contribution.

Perspectives on the Experience and Role Adaptation of Nursing Doctors in Hospital Environment

Interventions for Improving Coping Strategies in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.

Aims

This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.

Methods

A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.

Results

A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I ² = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I ² = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I ² = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I ² = 96%).

Linking Evidence to Action

Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.

Euglycaemic diabetic ketoacidosis and its risk factors in patients undergoing coronary artery bypass grafting surgery: a single-centre nested case-control study in China

Ignite the Parent–Child Bond: A Qualitative Exploration of Perspective and Need About Family Functioning Among Patients With Advanced Cancer and Their Adolescent Children

ABSTRACT

Background

Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.

Purpose

This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.

Design

A descriptive qualitative study was employed.

Settings and Participants

This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.

Methods

Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.

Findings

Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.

Conclusions

The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.

Clinical Relevance

Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.

Development of a Machine Learning Algorithm‐Based Predictive Model for Physical Activity Levels in Lung Cancer Survivors: A Cross‐Sectional Study

ABSTRACT

Aims

To investigate the physical activity levels of lung cancer survivors, analyse the influencing factors, and construct a predictive model for the physical activity levels of lung cancer survivors based on machine learning algorithms.

Design

This was a cross-sectional study.

Methods

Convenience sampling was used to survey lung cancer survivors across 14 hospitals in eastern, central, and western China. Data on demographic, disease-related, health-related, physical, and psychosocial factors were also collected. Descriptive analyses were performed using SPSS 25.0, and predictors were identified through multiple logistic regression analyses. Four machine learning models—random forest, gradient boosting tree, support vector machine, and logistic regression—were developed and evaluated based on the Area Under the Curve of the Receiver Operating Characteristic (AUC-ROC), accuracy, precision, recall, and F1 score. The best model was used to create an online computational tool using Python 3.11 and Flask 3.0.3. This study was conducted and reported in accordance with the TRIPOD guidelines and checklist.

Results

Among the 2231 participants, 670 (30%), 1185 (53.1%), and 376 (16.9%) exhibited low, moderate, and high physical activity levels, respectively. Multivariate logistic regression identified 15 independent influencing factors: residential location, geographical region, religious beliefs, histological type, treatment modality, regional lymph node stage, grip strength, 6-min walking distance, globulin, white blood cells, aspartate aminotransferase, blood urea, MDASI score, depression score, and SRAHP score. The random forest model performed best among the four algorithms, achieving AUC-ROC values of 0.86, 0.70, 0.72, and 0.67, respectively, and was used to develop an online predictive tool (URL: http://10.60.32.178:5000).

Conclusion

This study developed a machine learning model to predict physical activity levels in lung cancer survivors, with the random forest model demonstrating the highest accuracy and clinical utility. This tool enables the early identification of low-activity survivors, facilitating timely, personalised rehabilitation and health management.

Implications for the Profession and/or Patient Care

The development of a predictive model for physical activity levels in lung cancer survivors can help clinical medical staff identify survivors with relatively low physical activity levels as early as possible. Thus, personalised rehabilitation plans can be formulated to optimise quality of life during their survival period.

Impact

Physical activity has been used as a nonpharmacological intervention in cancer patient rehabilitation plans. However, a review of past studies has shown that lung cancer survivors generally have low physical activity levels. In this study, we identified the key factors influencing physical activity among lung cancer survivors through a literature review. We constructed a prediction model for their physical activity levels using machine learning algorithms. Clinical medical staff can use this model to identify patients with low physical activity levels early and to develop personalised intervention plans to improve their quality of life during survival.

Reporting Method

The study adhered to the relevant EQUATOR reporting guidelines, the TRIPOD Checklist for Prediction Model Development and Validation.

Patient or Public Contribution

During the data collection phase, participants were recruited to complete the questionnaires.

Status and Influencing Factors of Discharge Readiness in Day Surgery Lung Cancer Patients Under a Fast‐Track Rehabilitation Pathway

ABSTRACT

Aim

To investigate the status of discharge readiness of patients undergoing daytime lung cancer surgery and analyse its influencing factors.

Design

This was a cross-sectional study.

Methods

In this study, patients who underwent daytime lung cancer surgery from August 2022 to February 2023 at a Tertiary Care Hospital in Shanghai were selected via the convenience sampling method. A general data questionnaire, the Readiness for Hospital Discharge Scale, the Brief Illness Perception Questionnaire and the 10-item Connor Davidson Resilience Scale were used to assess 203 patients. Multiple linear regression analysis was used to analyse the factors influencing discharge readiness.

Results

The total Readiness for Hospital Discharge Scale score for patients who underwent daytime lung cancer surgery was 72.76 ± 20.91. Multiple regression analysis revealed that residence, monthly family income, the presence of postoperative adverse effects, illness perception and resilience were influencing factors for discharge readiness (p < 0.05), with illness perception (β = −0.391, p < 0.001) and resilience (β = 0.317, p < 0.001) being the most significant factors, which together explained 44.9% of the total variance.

Conclusion

The discharge readiness of day surgery patients with lung cancer is moderate, indicating room for improvement. Clinical practice should focus on lower-income, rural or postoperative patients with adverse reactions. Additionally, promoting patients’ positive perceptions of their illness and increasing their resilience can further enhance their discharge readiness.

Reporting Methods

The reporting of the study was guided by the STROBE checklist: cross-sectional studies (Table S1).

Relevance to Clinical Practice

Healthcare professionals should focus on assessing patients’ readiness for discharge, consistent with the World Health Organization's emphasis on patient-centred discharge planning. We recommend (1) establishing post-discharge support systems for rural and low-income patients, (2) including resilience-building interventions in preoperative education and (3) adopting a multiform health promotion approach to change negative illness perceptions and coping strategies. Additionally, we strongly advocate for the development of nurse-led transitional care plans that address both medical and psychosocial needs to optimise patient recovery and long-term well-being.