Factors associated with postoperative discharge readiness and continuing care needs in patients with lung cancer undergoing fast-track surgery: A prospective cohort study.

Abstract

To investigate and analyze the characteristics and factors associated with readiness for hospital discharge and continuing care needs of postoperative patients with lung cancer undergoing fast-track surgery (FTS). FTS aims to reduce the body's stress response to surgery and improve patient outcomes. The study included adult patients with confirmed lung cancer who underwent lung cancer surgery under FTS management and were discharged from the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, between June 2020 and September 2020. Patients with severe illnesses, comorbidities, disturbance of consciousness, cognitive disorders, or communication impairments were excluded. One-hundred-and-eighty patients were included, and 167 (92.8%) indicated that they were discharge-ready. Multivariable regression analysis showed that age 60 years or older (β = 16.29, 95% confidence interval (CI): 4.11-28.46, P = .009) and living alone (β = 37.07, 95% CI: 16.30-45.84, P < .001) were associated with the discharge readiness scores. In addition, those who were able to take care of themselves (β = 43.57, 95% CI: 19.60-67.54, P < .001) and needed little assistance at home (β = 28.39, 95% CI: 5.52-51.26, P = .015) had higher discharge readiness scores than those who needed a lot of assisted care. Patients who were cared for at home by children (β = 40.32, 95% CI: 4.91-75.73, P = .026), parents (β = 56.68, 95% CI: 12.33-101.03, P = .013), or spouses (β = 35.92, 95% CI: 2.45-69.38, P = .036), had higher discharge readiness scores than nursemaid. The discharge readiness scores of patients requiring continuing care were 146.5 ± 39.3, while patients who had no need scored 179.8 ± 36.5 (P < .01). Most patients with lung cancer undergoing FTS are discharge-ready. Discharge readiness is influenced by living conditions and self-care ability. This study identified factors influencing discharge readiness, and that could be used to identify patients who could benefit from help to improve discharge readiness.