Abstract:

Objective

To explore the current state of discharge readiness among caregivers of pediatric recipients following living related liver transplantation (LRLT) and to identify the influencing factors, thereby offering a reference for developing personalized discharge readiness services in clinical practice.

Methods

From September 2023 to February 2024, questionnaires were administered to 172 caregivers of pediatric LRLT recipients at the Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine.Data were collected using a general demographic questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale-Parent Form (hereinafter RHDS),and the Chinese version of the Quality of Discharge Teaching Scale-Parent Form (hereinafter QDTS).Pearson correlation analysis was used to examine the relationship between discharge readiness and the quality of discharge teaching.Group comparisons were conducted with t-tests and one-way analysis of variance.Multiple stepwise linear regression was performed to identify the factors affecting discharge readiness among caregivers after LRLT.A P-value of <0.05 was considered statistically significant.

Results

A total of 161 valid questionnaires were returned, with an effective response rate of 93.6%.Among the 161 caregivers, 133(82.6%) believed that they were well-prepared for discharge, while 28(17.4%) felt unprepared.The total scores for the RHDS and QDTS in the 161 caregivers were(227.5±20.3) and (143.4±16.7), respectively, with corresponding average item scores of (7.8±0.7)and (8.0 ± 0.9).The RHDS scores for caregivers whose pediatric recipients had a postoperative hospitalization duration ≤16 d were (241.6 ±6.8), which were significantly higher than that for those with a hospitalization duration >16 d (212.1 ±19.0), with a statistically significant difference (t =12.901, P<0.05).Caregivers in married families had a higher RHDS total scores (228.0 ±19.9)compared to those in divorced families (187.0 ±2.8), with a statistically significant difference (t =2.902, P<0.05).There was a significant difference in RHDS total scores among caregivers with different monthly household incomes (F =4.974, P <0.05).The total scores of QDTS and its subdimension scores were positively correlated with the RHDS total scores and its sub-dimension scores (all P<0.05).Discharge guidance quality, postoperative hospitalization duration, family monthly income,and marital status were independent risk factors for discharge readiness among LRLT pediatric recipients′caregivers (all P <0.05).

Conclusions

The discharge readiness of caregivers of pediatric recipients after LRLT is at a moderate level.Healthcare providers should pay attention to caregivers with low discharge guidance quality, long postoperative hospitalization, low family income, and divorced marital status, and provide targeted discharge guidance interventions to improve their discharge readiness.

Key words: Living related liver transplantation, Pediatric, Discharge readiness, Influencing factor