Application effect of discharge preparation service based on theory of goal attainment on patients with cervical spinal cord injury
Objective To investigate the application effect of discharge preparation service based on theory of goal attainment on patients with cervical spinal cord injury.Methods A retrospective cohort study was conducted to analyze the clinic data of 60 patients with cervical spinal cord injury admitted to Zhengzhou Orthopedics Hospital from January 2017 to December 2022,including 49 males and 11 females,aged 23-79 years[(52.2±13.5)years].Patients were all treated with cervical decompression fusion and internal fixation.Patients admitted from January 2017 to December 2019 were treated with conventional nursing intervention(conventional nursing group,n=30)and patients admitted from January 2020 to December 2022 were treated with discharge preparation service based on theory of goal attainment(discharge preparation service group,n=30).The readiness for hospital discharge of the two groups was compared using the Chinese version of Readiness for Hospital Discharge Scale(RHDS)at 4 hours before discharge.The degree of cervical spinal cord dysfunction of the two groups were compared using Japanese Orthopedic Association(JOA)score before intervention,at discharge and at 6 months after discharge.The complication and unplanned readmission rates of the two groups were compared at 6 months after discharge.Results All the patients were followed up for 6 months.At 4 hours before discharge,the scores of the three parameters of RHDS containing personal status,adaptability and anticipatory support and the total score of the discharge preparation service group were(20.9±3.5)points,(35.9±2.2)points,(30.4±3.O)points and(87.1±7.8)points respectively,higher than those of the conventional nursing group[(16.2±1.7)points,(32.5±2.2)points,(26.3±2.l)points and(75.0±5.6)points respectively](P＜0.01).There was no statistically significant difference in the JOA score of the two groups before intervention(P＞0.05).The JOA scores of the discharge preparation service group at discharge and at 6 months after discharge were(11.8±1.7)points and(13.8±1.5)points respectively,higher than those of the conventional nursing group[(10.3±1.8)points and(11.6±1.9)points respectively](P＜0.01).At 6 months after discharge,the complication rate of the discharge preparation service group was 6.7％(2/30),lower than that of the conventional nursing group[36.7％(11/30)](P＜0.05).The unplanned readmission rate of the discharge preparation service group was 3.3％(1/30),lower than that of the conventional nursing group[23.3％(7/30)](P＜0.05).Conclusion For patients with cervical spinal cord injury,discharge preparation service based on theory of goal attainment can improve the discharge readiness,promote spinal functional recovery and reduce the complication and unplanned readmission rates.
Cervical vertebraeSpinal cord injuriesPatient dischargeNursing care
NETL
NSTL
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