Effect of discharge teaching quality on readiness for hospital discharge in total knee arthroplasty patients: the role of depression and self-efficacy for rehabilitation

Abstract

Background: As the number of total knee arthroplasty (TKA) increases and the length of stay decreases, the readiness of patients for discharge needs attention. The purpose of this study is to clarify the relationship between the quality of discharge teaching, depression, self-efficacy for rehabilitation, and readiness for hospital discharge (RHD), thereby providing evidence support for improving readiness for discharge in patients with TKA.Methods: A total of 319 TKA patients participated in this cross-sectional study. Bivariate Pearson’s correlation was used to test the correlation between the four variables. Multivariate regression models and Bootstrap tests were used to examine the mediating role of depression and self-efficacy for rehabilitation. In addition, we used a mediation model 6 to explore the relationship between the quality of discharge teaching, depression, self-efficacy for rehabilitation, and RHD. All regression models were adjusted for age, sex, residential status, education level, number of joint replacements, and number of co-morbidities.Results: Depression was negatively associated with RHD (r=-0.281, P＜0.01) ,and self-efficacy for rehabilitation was positively associated with RHD (r=0.396, P＜0.01), with both playing a partially mediating role between the quality of discharge teaching and RHD, the effect value being 62.7%. The effect of discharge teaching quality on RHD in patients with TKA was weakened when depression and recovery self-efficacy were added.Conclusions: The results of this study emphasized the importance of depression and self-efficacy for rehabilitation on the RHD of patients with TKA. When providing discharge teaching, physicians and nurses could use relevant psychological intervention methods to improve the patient's physical and mental condition, with the final goal of improving their RHD.