亲属活体肝移植儿童受者照护者出院准备及影响因素分析  

Discharge readiness among caregivers of pediatric recipients after living related liver transplantation and its influencing factors

作　　者：王燕橙 王艳[1,2] 王贝贝 陆晔峰[1,2] 黄明珠[1,2] Wang Yancheng;Wang Yan;Wang Beibei;Lu Yefeng;Huang Mingzhu(Department of Nursing,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Liver Surgery,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院护理部,200127 [2]上海交通大学医学院附属仁济医院肝脏外科,200127

出　　处：《中华移植杂志(电子版)》2024年第6期403-408,共6页Chinese Journal of Transplantation(Electronic Edition)

基　　金：上海交通大学医学院护理学科建设项目(SJTUHLXK2024);上海交通大学文科青年人才培育计划项目(2024QN018);2023年度上海交通大学医学院护理科研重中之重项目(Jyhz2302)。

摘　　要：目的探究亲属活体肝移植(LRLT)术后儿童受者照护者出院准备现况并分析其影响因素,为临床制订个性化出院准备服务提供参考。方法使用一般资料调查表、中文版出院准备量表(RHDS)—父母版(以下简称RHDS)和中文版出院指导质量量表(QDTS)—父母版(以下简称QDTS)对2023年9月至2024年2月在上海交通大学医学院附属仁济医院肝脏外科行LRLT的172例儿童受者照护者进行问卷调查。采用Pearson相关分析评估出院准备水平与出院指导质量之间的相关性;组间比较采用t检验和单因素方差分析;多元逐步线性回归用于分析LRLT术后患儿照护者出院准备度的影响因素。P【0.05为差异有统计学意义。结果最终回收有效问卷161份,有效回收率为93.6%。133例(82.6%)LRLT儿童受者照护者认为自身已做好出院准备,余28例(17.4%)表示未做好准备。161例LRLT儿童受者照护者RHDS和QDTS总得分分别为(227.5±20.3)和(143.4±16.7)分,总条目均分分别为(7.8±0.7)和(8.0±0.9)分。术后住院时间≤16 d LRLT儿童受者照护者RHDS得分[(241.6±6.8)分]高于术后住院天数】16 d照护者[(212.1±19.0)分],差异有统计学意义(t=12.901,P【0.05)。已婚家庭照护者RHDS总得分[(228.0±19.9)分]高于离异者[(187.0±2.8)分],差异有统计学意义(t=2.90,P【0.05)。家庭月收入不同的照护者RHDS总得分差异有统计学意义(F=4.974,P【0.05)。QDTS总得分及其各维度得分均与RHDS总得分及其各维度得分呈正相关(P均【0.05)。QDTS总得分、术后住院天数、家庭月收入、婚姻状况均为LRLT术后儿童受者照护者出院准备水平的独立危险因素(P均【0.05)。结论LRLT术后儿童受者照护者出院准备度为中等水平。医护人员应重视出院指导质量低、术后住院天数长、家庭月收入低、婚姻离异的儿童受者照护者,针对性予出院指导干预,以提升其出院准备度水平。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

关 键 词：亲属活体肝移植 儿童 出院准备 影响因素 

分 类 号：R47[医药卫生—护理学]