Relationships Between Quality of Discharge Teaching, Readiness for Hospital Discharge, Self‐Efficacy and Self‐Management in Patients With First‐Episode Stroke: A Cross‐Sectional Study

结构方程建模 医学 冲程(发动机) 自我效能感 出院 自我管理 横断面研究 物理疗法 心理学 内科学 机械工程 病理 工程类 心理治疗师 统计 数学 机器学习 计算机科学
作者
Shuang Li,Ran Chen,Lihong Zhang,Hui Li,Yiqiu Gong,Yan-Feng Hang,Jie Cao,Hong Zhang
出处
期刊:Journal of Clinical Nursing [Wiley]
标识
DOI:10.1111/jocn.17481
摘要

ABSTRACT Aims The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first‐episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates. Design Cross‐sectional study. Methods A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self‐efficacy Scale and Southampton Stroke Self‐Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables. Results The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self‐efficacy and self‐management ( r = 0.376–0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ 2 /df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first‐episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD ( p < 0.001); (2) QDT indirectly influenced RHD via self‐efficacy ( p < 0.001); (3) QDT indirectly affected RHD through self‐management ( p < 0.001); and (4) QDT had an indirect effect on RHD via both self‐efficacy and self‐management ( p < 0.05). Conclusion QDT was found to directly influence RHD in patients with first‐episode stroke and also exerted indirect effects through self‐efficacy and self‐management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community. Relevance to Clinical Practice Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long‐term poststroke management are essential for reducing stroke recurrence and mortality rates.
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