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      Colorectal patients’ readiness for hospital discharge following management of enhanced recovery after surgery pathway : A cross-sectional study from China

      research-article
      Author(s): , RN, MD a , , RN, MD a , , RN, BSc a , , RN, MD b , ∗
      Editor(s):
      Publication date (Electronic):
      Journal: Medicine
      Publisher: Wolters Kluwer Health
      Keywords: cancer, colorectal surgery, enhanced recovery after surgery, readiness for hospital discharge

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          Abstract

          The aim of this study was to ascertain the status quo of perceived readiness for hospital discharge in colorectal cancer patients who underwent enhanced recovery pathway and identify the variables that affect patients’ perceptions about their readiness for discharge.

          A cross-sectional survey was conducted in West China Hospital, Sichuan University. The Readiness for Hospital Discharge Scale and the Quality of Discharge Teaching Scale were delivered to 130 colorectal cancer (CRC) patients who underwent enhanced recovery pathway. Data collection was carried out 4 hours before discharge.

          The total score of readiness for hospital discharge was 149.86 ± 33.65. The multiple linear regression analysis revealed that the quality of discharge teaching, discharge to a rehabilitative institution were associated with the readiness for hospital discharge.

          The level of CRC patients’ readiness for hospital discharge needs to be improved. Medical staff should improve the quality of discharge guidance and pay more attention to patients transferred to rehabilitation institutions when they leave hospital.

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          Most cited references20

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          Evidence-based surgical care and the evolution of fast-track surgery.

          Henrik Kehlet, Douglas Wilmore (2008)
          Optimization of postoperative outcome requires the application of evidence-based principles of care carefully integrated into a multimodal rehabilitation program. To assess, synthesize, and discuss implementation of "fast-track" recovery programs. Medline MBASE (January 1966-May 2007) and the Cochrane library (January 1966-May 2007) were searched using the following keywords: fast-track, enhanced recovery, accelerated rehabilitation, and multimodal and perioperative care. In addition, the synthesis on the many specific interventions and organizational and implementation issues were based on data published within the past 5 years from major anesthesiological and surgical journals, using systematic reviews where appropriate instead of multiple references of original work. Based on an increasing amount of multinational, multicenter cohort studies, randomized studies, and meta-analyses, the concept of the "fast-track methodology" has uniformly provided a major enhancement in recovery leading to decreased hospital stay and with an apparent reduction in medical morbidity but unaltered "surgery-specific" morbidity in a variety of procedures. However, despite being based on a combination of evidence-based unimodal principles of care, recent surveys have demonstrated slow adaptation and implementation of the fast-track methodology. Multimodal evidence-based care within the fast-track methodology significantly enhances postoperative recovery and reduces morbidity, and should therefore be more widely adopted. Further improvement is expected by future integration of minimal invasive surgery, pharmacological stress-reduction, and effective multimodal, nonopioid analgesia.
          Article 0 comments Cited 360 times – based on 0 reviews     Review now
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            The Impact of Enhanced Recovery Protocol Compliance on Elective Colorectal Cancer Resection: Results From an International Registry.

            (2015)
            The ERAS (enhanced recovery after surgery) care has been shown in randomized clinical trials to improve outcome after colorectal surgery compared to traditional care. The impact of different levels of compliance and specific elements, particularly out with a trial setting, is poorly understood.
            Article 0 comments Cited 176 times – based on 0 reviews     Review now
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              Perceived readiness for hospital discharge in adult medical-surgical patients.

              Marianne Weiss, Sue Holmes, Susan Gresser … (2007)
              The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients' perceptions of their readiness for hospital discharge.
              Article 0 comments Cited 70 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: February 2020
                Publication date (Electronic): 21 February 2020
                Volume: 99
                Issue: 8
                Electronic Location Identifier: e19219
                Affiliations
                [a ]Department of Gastrointestinal Surgery, West China Hospital
                [b ]West China School of Nursing, Sichuan University, Chengdu 610041, PR China.
                Author notes
                [∗ ]Correspondence: Ka Li, West China School of Nursing, Sichuan University, #37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, PR China (e-mail: 326474094@ 123456qq.com ).
                Article
                Publisher ID: MD-D-18-06498 Accession ID: 19219
                DOI: 10.1097/MD.0000000000019219
                PMC ID: 7034666
                PubMed ID: 32080116
                SO-VID: a32bf0ae-b0f6-406d-b61c-5869287de3a7
                Copyright © Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                Date received : 10 September 2018
                Date revision received : 18 September 2019
                Date accepted : 20 January 2020
                Categories
                Subject: 5700
                Subject: Research Article
                Subject: Observational Study
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: cancer,colorectal surgery,enhanced recovery after surgery,readiness for hospital discharge
                Data availability:
                Keywords: cancer, colorectal surgery, enhanced recovery after surgery, readiness for hospital discharge

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