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

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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.	杨婕, 冯金华, 李卡. 结直肠癌患者术后 1 年内非计划性再入院影响因素分析. 护士进修杂志, 2015, 30(6): 551-552.
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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.
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13.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科•结直肠外科快速流程临床指南 (四). 中国普外基础与临床杂志, 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.	秦环龙, 贾震易. 加速康复外科在结直肠外科应用中应关注的若干问题. 中华结直肠疾病电子杂志, 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.	江志伟, 李宁. 结直肠手术应用加速康复外科中国专家共识 (2015 版). 中国实用外科杂志, 2015, 35(8): 841-843.
20.	王雁飞. 社会支持与身心健康关系研究述评. 心理科学, 2004, 27(5): 1175-1177.
21.	童辉杰, 黄成毅. 当代中国家庭结构的变迁及其社会影响. 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.	蒋超, 蒲杰, 谢静. 我国台湾地区医院出院准备服务的特点及启示. 中国医疗管理科学, 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. 杨婕, 冯金华, 李卡. 结直肠癌患者术后 1 年内非计划性再入院影响因素分析. 护士进修杂志, 2015, 30(6): 551-552.
6. 李卡, 胡艳杰, 刘雨薇, 等. 加速康复外科应用于结直肠癌根治术围手术期管理的效果研究. 中华结直肠疾病电子杂志, 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, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科•结直肠外科快速流程临床指南 (一). 中国普外基础与临床杂志, 2009, 16(5): 413.
11. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科•结直肠外科快速流程临床指南 (二). 中国普外基础与临床杂志, 2009, 16(6): 493-494.
12. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科•结直肠外科快速流程临床指南 (三). 中国普外基础与临床杂志, 2009, 16(7): 581.
13. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院肛肠外科•结直肠外科快速流程临床指南 (四). 中国普外基础与临床杂志, 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. 秦环龙, 贾震易. 加速康复外科在结直肠外科应用中应关注的若干问题. 中华结直肠疾病电子杂志, 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. 江志伟, 李宁. 结直肠手术应用加速康复外科中国专家共识 (2015 版). 中国实用外科杂志, 2015, 35(8): 841-843.
20. 王雁飞. 社会支持与身心健康关系研究述评. 心理科学, 2004, 27(5): 1175-1177.
21. 童辉杰, 黄成毅. 当代中国家庭结构的变迁及其社会影响. 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. 蒋超, 蒲杰, 谢静. 我国台湾地区医院出院准备服务的特点及启示. 中国医疗管理科学, 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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