ObjectivesTo explore the status quo of the readiness for hospital discharge and the quality of discharge guidance in patients after total hip/knee arthroplasty, and analyze their correlations.MethodsA cross-sectional survey was conducted to investigate patients who underwent total hip/knee arthroplasty in a tertiary hospital in Chengdu between January and November 2017. The survey included basic patient information questionnaire, Readiness for Hospital Discharge Scale, and the Quality of Discharge Teaching Scale.ResultsThe average age of 352 patients undergoing total hip/knee arthroplasty was (59.56±12.69) years. The total score of readiness for hospital discharge was 177.08±19.41, the average score was 7.82±0.88, and the average quality of discharge teaching was 145.87±14.87. There was a statistically significant difference between the patients’ access and the required discharge teaching (t=28.742, P<0.001). The score of readiness for hospital discharge was positively correlated with the score of the quality of discharge guidance (r=0.645, P<0.001), the obtained content dimension (r=0.542, P<0.001), and the teaching skill dimension (r=0.522, P<0.001).ConclusionsThe readiness for hospital discharge in patients after total hip/knee arthroplasty is in a medium level, and the quality of discharge teaching is higher overall and it is positively correlated with the readiness for hospital discharge. Medical staff should pay attention to the discharge guidance for patients. In the course of health education, not only the content and quantity of guidance should be emphasized, but also the guiding skills should be paid attention to, so as to improve the quality of discharge teaching, thereby improving the patient’s discharge readiness and promoting the patient’s later rehabilitation.
ObjectivesTo investigate the status quo of follow-up services for patients with cervical spondylosis, to explore its influencing factors, and to provide reference for the follow-up management model after postoperative discharge of patients with cervical spondylosis.MethodsA total of 220 patients with cervical spondylosis were selected by using convenient sampling from October 2018 to May 2019, and the general information questionnaire and the follow-up service needs questionnaire were used for the investigation.ResultsThe score of follow-up service content requirement for patients with cervical spondylosis was 54.87±7.56, and the rehabilitation training instruction was the highest. Multiple linear regression analysis showed that the follow-up service content score was influenced by education level [non-standardized partial regression coefficient (b)=3.186, 95% confidence interval (CI) (2.490, 3.882), P<0.001], length of hospital stay [b=5.140, 95%CI (3.914, 6.365), P<0.001], Neck Disability Index [b=1.326, 95%CI (0.189, 2.463), P=0.022], and age [≥75 years as the reference, 45-59 years: b=3.766, 95%CI (0.671, 6.860), P=0.017; 60-74 years: b=4.081, 95%CI(0.849, 7.314), P=0.014]. The method of obtaining follow-up services was mainly based on outpatient follow-up (85.5%), telephone follow-up (50.5%), and established a follow-up service center (40.5%) for discharged patients. The executives were multidisciplinary teams (60.5%) and hospital-community integration teams (48.2%). There were 19.1% of discharged patients who were willing to pay for relevant follow-up services.ConclusionsPatients with postoperative cervical spondylosis have strong demand for post-discharge follow-up services, which are affected by many factors. Medical staff should pay attention to this and develop a personalized follow-up service plan according to patient characteristics to meet different discharged patients and improve the quality of medical services.
Objective To analyze current research status of enhanced recovery after surgery of orthopedics in China, and to provide reference for further development of enhanced recovery after surgery in orthopedics department. Methods We searched Wanfang database and China National Knowledge Infrastructure (CNKI) database for articles about enhanced recovery after surgery of orthopedics department which were included by the Chinese Science and Technology Core Journal (2018 version) or Chinese Core Journal criterion of Peking University (2017 version), and bibliometric analysis was performed. Results A total of 135 articles were included in this study, 49 of which were collected in Chinese Core Journal criterion of Peking University. The amount of articles showed a rising trend in general over last decade. The main research topic was joint diseases (69 articles, 51.11%), followed by traumatic diseases (23 articles, 17.04%) and spinal diseases (21 articles, 15.56%); 35.56% (48 articles) of the articles were supported by different funds; Sichuan Province had the largest number of publications (36 articles) and the largest number of funds so far (8 items); clinical studies accounted for 37.78% (51 articles) with 78.43% (40 articles) randomized controlled trials, in which evaluation indicators focused on function scores, pain, length of hospital stay, complications or adverse reactions, patient satisfaction, and hospitalization costs. Conclusions The research on enhanced recovery after surgery of orthopedics in China was in a rising stage, and joint replacement was one of the hotspots. The funds are insufficient, and a series of guidelines should be developed according to the evidence-based study to accelerate the enhanced recovery after surgery of orthopedics.