What Influences Patients Readiness for Discharge: The Case of Total Knee Arthroplasty: A Cross-Sectional Study

Abstract

Aims and Objectives. To identify and explore assess factors that influence patients’ readiness for hospital discharge (RHD) after total knee arthroplasty (TKA). Background. Evidence has suggested that most clinical staff use clinical laboratory indicators to determine discharge times, while paying little attention to patients’ feelings and needs. Additional research findings have suggested a relationship between patients’ self-reported readiness for hospital discharge and postdischarge complication rates, readmission rates, mortality, as well as quality of life. RHD is strongly associated with patient health outcomes. Identifying relevant influencing factors can provide guidance for early individualized interventions by healthcare professionals. Design. A cross-sectional study. Methods. During 2022, a total of 320 post-TKA patients were selected for this study. The patients were divided into the low-RHD group (<7 points) and the high-RHD group (≥7 points) according to the mean score of the Readiness for Hospital Discharge Scale (RHDS). Established scales were used to collect patients’ information and to adopt univariate and binary logistic regression analysis to screen for independent factors. Results. In this study, the RHDS score of patients after TKA is 91.90 ± 7.05, of which 12.8% are in the low-RHD group (mean score <7). The binary logistic regression results reveal that age, educational level, postactivity pain, self-efficacy, and family care have to be considered risk factors generating low-RHD in TKA patients. Conclusions. The present study suggests that over 1/8 TKA patients are not ready at the time of discharge. Physicians and nurses can improve patients’ RHD by reducing postactivity pain and improving self-efficacy during their rehabilitation period. Relevance to Clinical Practice. The results of this study can help physicians and nurses early identify high-risk patients with low RHD and provide them with individualized interventions. In addition to this, it is important that nurses use RHDS to assess the readiness of TKA patients before they are discharged from the hospital.