Analysis on differences of readiness for hospital discharge of colorectal cancer patients following enhanced recovery after surgery pathway by patients and nurses_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Yuhua ¹ , YANG Jie ¹ , JIANG Lili ¹ ,  LI Ka ²

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Ka, Email: lika127@126.com

Keywords：

enhanced recovery after surgery; colorectal cancer; readiness for hospital discharge; difference analysis

DOI：

10.7507/1007-9424.201807087

Video：

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Objective To compare the differences in evaluating readiness for hospital discharge between nurses and colorectal cancer (CRC) patients following enhanced recovery after surgery (ERAS) pathway. Methods A cross-sectional survey was conducted in Department of Gastrointestinal Surgery, West China Hospital, Sichuan University. Patient-reported Readiness for Hospital Discharge Scale (RHDS) and nurse-reported RHDS were delivered to 130 CRC patients and 40 nurses respectively. All patients were followed ERAS pathway during perioperative periods. The differences were compared in evaluating readiness for hospital discharge between nurses and CRC patients. Results This study investigated 130 CRC patients and 40 responsible nurses. The scores of RHDS from nurses and patients were 162.86±27.95 and 149.86±33.65 respectively. When evaluating whether patients were ready to go home after discharge, the consistency between nurses’ results and patients’ results was weak（κ=0.365, P<0.001）. Items in patients’ RHDS scoring ranking from high to low were expected support, coping ability, knowledge, and personal status. Items in nurses’ RHDS scoring ranking from high to low were expected support, knowledge, coping ability, and personal status. Besides the " social support” dimension, the scores of other 3 dimensions from nurses were significantly higher than those from patients (P<0.05). Conclusion There is a gap between the assessment of RHDS from nurses and patients, nurses overestimated patients’ discharge readiness level.

Citation： HE Yuhua, YANG Jie, JIANG Lili, LI Ka. Analysis on differences of readiness for hospital discharge of colorectal cancer patients following enhanced recovery after surgery pathway by patients and nurses. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(12): 1449-1453. doi: 10.7507/1007-9424.201807087 Copy

1.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2.	Adamina M, Kehlet H, Tomlinson GA, et al. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery, 2011, 149(6): 830-840.
3.	Zhao JH, Sun JX, Gao P, et al. Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis. BMC Cancer, 2014, 14(1): 607.
4.	ERAS Compliance Group. The impact of enhanced recovery protocol compliance on elective colorectal cancer resection: results from an international registry. Ann Surg, 2015, 261(6): 1153-1159.
5.	楊婕, 馮金華, 李卡. 結直腸癌患者術后 1 年內非計劃性再入院影響因素分析. 護士進修雜志, 2015, 30(6): 551-552.
6.	李卡, 胡艷杰, 劉雨薇, 等. 加速康復外科應用于結直腸癌根治術圍手術期管理的效果研究. 中華結直腸疾病電子雜志, 2018, 7(3): 288-293.
7.	Fenwick AM. An interdisciplinary tool for assessing patients’readiness for discharge in the rehabilitation setting. J Adv Nurs, 1979, 4(1): 9-21.
8.	Rochefort CM, Rathwell BA, Clarke SP. Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: a cross-sectional survey. BMC Nurs, 2016, 15(1): 46-53.
9.	Titler MG, Pettit DM. Discharge readiness assessment. J Cardiovasc Nurs, 1995, 9(4): 64-74.
10.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (一). 中國普外基礎與臨床雜志, 2009, 16(5): 413.
11.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (二). 中國普外基礎與臨床雜志, 2009, 16(6): 493-494.
12.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (三). 中國普外基礎與臨床雜志, 2009, 16(7): 581.
13.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (四). 中國普外基礎與臨床雜志, 2009, 16(8): 671.
14.	Weiss ME, Piacentine LB, Lokken L, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec, 2007, 21(1): 31-42.
15.	Zhao H, Feng X, Yu R, et al. Validation of the Chinese version of the readiness for hospital discharge scale on patients who have undergone laryngectomy. J Nurs Res, 2016, 24(4): 321-328.
16.	Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
17.	秦環龍, 賈震易. 加速康復外科在結直腸外科應用中應關注的若干問題. 中華結直腸疾病電子雜志, 2017, 6(1): 2-5.
18.	Pan X, Dib HH, Wang X, et al. Service utilization in community health centers in China: a comparison analysis with local hospitals. BMC Health Serv Res, 2006, 93(6): 1-8.
19.	江志偉, 李寧. 結直腸手術應用加速康復外科中國專家共識 (2015 版). 中國實用外科雜志, 2015, 35(8): 841-843.
20.	王雁飛. 社會支持與身心健康關系研究述評. 心理科學, 2004, 27(5): 1175-1177.
21.	童輝杰, 黃成毅. 當代中國家庭結構的變遷及其社會影響. 西北人口, 2015, 36(6): 81-84, 88.
22.	Kehlet H. Surgery: fast-track colonic surgery and the ‘knowing-doing’gap. Nat Rev Gastroenterol Hepatol, 2011, 8(10): 539-540.
23.	Steenhagen E. Enhanced recovery aftersurgery: it’s time to change practice. Nutr Clin Pract, 2016, 31(1): 18-29.
24.	Mabire C, Dwyer A, Garnier A, et al. Meta-analysis of the effectiveness of nursing discharge planning interventions for older inpatients discharged home. J Adv Nurs, 2018, 74(4): 788-799.
25.	Gunn S. Patient education and discharge planning to prevent functional decline in the older adult. Gastroenterol Nurs, 2017, 40(4): 272-278.
26.	蔣超, 蒲杰, 謝靜. 我國臺灣地區醫院出院準備服務的特點及啟示. 中國醫療管理科學, 2017, 7(2): 27-30.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. Adamina M, Kehlet H, Tomlinson GA, et al. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery, 2011, 149(6): 830-840.
3. Zhao JH, Sun JX, Gao P, et al. Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis. BMC Cancer, 2014, 14(1): 607.
4. ERAS Compliance Group. The impact of enhanced recovery protocol compliance on elective colorectal cancer resection: results from an international registry. Ann Surg, 2015, 261(6): 1153-1159.
5. 楊婕, 馮金華, 李卡. 結直腸癌患者術后 1 年內非計劃性再入院影響因素分析. 護士進修雜志, 2015, 30(6): 551-552.
6. 李卡, 胡艷杰, 劉雨薇, 等. 加速康復外科應用于結直腸癌根治術圍手術期管理的效果研究. 中華結直腸疾病電子雜志, 2018, 7(3): 288-293.
7. Fenwick AM. An interdisciplinary tool for assessing patients’readiness for discharge in the rehabilitation setting. J Adv Nurs, 1979, 4(1): 9-21.
8. Rochefort CM, Rathwell BA, Clarke SP. Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: a cross-sectional survey. BMC Nurs, 2016, 15(1): 46-53.
9. Titler MG, Pettit DM. Discharge readiness assessment. J Cardiovasc Nurs, 1995, 9(4): 64-74.
10. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (一). 中國普外基礎與臨床雜志, 2009, 16(5): 413.
11. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (二). 中國普外基礎與臨床雜志, 2009, 16(6): 493-494.
12. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (三). 中國普外基礎與臨床雜志, 2009, 16(7): 581.
13. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院肛腸外科?結直腸外科快速流程臨床指南 (四). 中國普外基礎與臨床雜志, 2009, 16(8): 671.
14. Weiss ME, Piacentine LB, Lokken L, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec, 2007, 21(1): 31-42.
15. Zhao H, Feng X, Yu R, et al. Validation of the Chinese version of the readiness for hospital discharge scale on patients who have undergone laryngectomy. J Nurs Res, 2016, 24(4): 321-328.
16. Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
17. 秦環龍, 賈震易. 加速康復外科在結直腸外科應用中應關注的若干問題. 中華結直腸疾病電子雜志, 2017, 6(1): 2-5.
18. Pan X, Dib HH, Wang X, et al. Service utilization in community health centers in China: a comparison analysis with local hospitals. BMC Health Serv Res, 2006, 93(6): 1-8.
19. 江志偉, 李寧. 結直腸手術應用加速康復外科中國專家共識 (2015 版). 中國實用外科雜志, 2015, 35(8): 841-843.
20. 王雁飛. 社會支持與身心健康關系研究述評. 心理科學, 2004, 27(5): 1175-1177.
21. 童輝杰, 黃成毅. 當代中國家庭結構的變遷及其社會影響. 西北人口, 2015, 36(6): 81-84, 88.
22. Kehlet H. Surgery: fast-track colonic surgery and the ‘knowing-doing’gap. Nat Rev Gastroenterol Hepatol, 2011, 8(10): 539-540.
23. Steenhagen E. Enhanced recovery aftersurgery: it’s time to change practice. Nutr Clin Pract, 2016, 31(1): 18-29.
24. Mabire C, Dwyer A, Garnier A, et al. Meta-analysis of the effectiveness of nursing discharge planning interventions for older inpatients discharged home. J Adv Nurs, 2018, 74(4): 788-799.
25. Gunn S. Patient education and discharge planning to prevent functional decline in the older adult. Gastroenterol Nurs, 2017, 40(4): 272-278.
26. 蔣超, 蒲杰, 謝靜. 我國臺灣地區醫院出院準備服務的特點及啟示. 中國醫療管理科學, 2017, 7(2): 27-30.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on differences of readiness for hospital discharge of colorectal cancer patients following enhanced recovery after surgery pathway by patients and nurses

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