Factors Associated with the Transition from Discharge Preparation to Home Rehabilitation in Elderly Day Surgery: A Structural Equation Modeling Study

Purpose: To explore the key factors influencing the transition from discharge preparation to home-based rehabilitation in elderly day surgery patients. Patients and Methods: A cross-sectional study was conducted on 340 elderly patients (≥ 60 years) who underwent day surgery at Huadong Hospital Affiliated to Fudan University in Shanghai from November 2024 to September 2025. Standardized scales were used to conduct questionnaire surveys, and the collected data were analyzed by means of correlation analysis, multiple linear regression and structural equation modeling (SEM). Results: Correlation analysis revealed that discharge readiness was positively correlated with gender, health behavior capacity and discharge teaching quality, while it presented a negative correlation with family support (P< 0.05). Multiple linear regression further verified that health behavior capacity served as a significant positive predictive factor for discharge readiness ( β =0.233, P< 0.001). However, the SEM yielded inconsistent findings: family support exhibited the strongest positive direct predictive effect on discharge readiness with a path coefficient of 0.47, health behavior capacity showed a weak positive predictive effect (path coefficient = 0.31), and discharge teaching quality exerted only a trivial impact (path coefficient = 0.15). The contradictory results between correlation analysis and SEM might be attributed to the complex mediating or moderating relationships among latent variables in the holistic model. Conclusion: Family support is the core factor, and health behavior capacity is an important factor affecting the discharge readiness of elderly day surgery patients, while the current discharge teaching has a limited direct effect. In clinical practice, it is necessary to strengthen family support, improve patients’ health behavior self-efficacy, and optimize the discharge teaching model with effective linkage to family support. Further research should adopt multi-center longitudinal studies with extended variables to obtain more comprehensive and accurate results. Plain Language Summary: This study explores key factors affecting elderly day surgery patients’ discharge preparation and home rehabilitation transition. We surveyed 340 elderly patients (≥ 60 years) who had day surgery at Huadong Hospital (Nov 2024–Sep 2025) via standardized questionnaires and analyzed data scientifically. Results show family support has the strongest positive impact on discharge readiness, followed by patients’ self-confidence and ability to manage health (health behavior self-efficacy); hospital discharge guidance has little direct effect. Other unconsidered factors may exist. Clinically, we should strengthen family support, improve patients’ self-care ability and optimize discharge guidance. Future multi-hospital, long-term studies are needed for more comprehensive results. Keywords: discharge, elderly, day surgery, home-based rehabilitation, structural equation modeling