The Effectiveness of Discharge-Planning Program on Quality of Life after brain tumor surgery Patients

Abstract

The Research and Development (R&D) study aims to survey the discharge planning situation in patients after brain tumor surgery, develop a standardized discharge planning program, and examine its effectiveness. After conducting focus groups with 20 neurosurgical nurses and investigating 201 patient files, it was observed that there was no clear discharge planning sheet flow or nursing guideline. Additionally, outdated brain surgery preparation videos were identified. Consequently, the researchers conducted a systematic review, analyzing 32 suitable articles to create a discharge planning program for brain tumor surgery patients, adapting a conceptual framework from McKeehan (1985) and the Nursing division’s D-METHOD (1996). The program, implemented between January and February 2024, involved 29 eligible patients divided into a Control group (14 patients) and an Intervention group (15 patients). The Intervention group received an educational guideline with up-to-date instructional media and a 6-step discharge planning process, including health and knowledge evaluation upon admission with pre-operation enlightenment, re-evaluation one day before operation with corrected misleading information, post-operation evaluation within 1-5 days after brain tumor surgery for assessing complications and providing self-care management knowledge, self and home care knowledge evaluated 1-2 days before discharge with corrected misleading information, health status follow-up 1 week after discharge with Tele-nursing, and handing patient’s health status to their physician on the first follow-up date. The Health-Related Quality of Life for Brain Tumor (HRQOL-BT) served as the research evaluation tool at admission, 1-2 days before discharge, and 1 month after discharge. The data were analyzed using Repeated Measurement ANOVA, pair t-test, and independent t-test. The mean HRQOL-BT scores within the Control group at admission, 1-2 days before discharge, and 1 month after discharge were 142.43(±22.15), 138.00(±19.40), and 155.79(±29.72) respectively. In the Intervention group, the scores were 130.80(±20.08), 139.80(±18.19), and 160.60(±13.85) respectively. Repeated Measurement ANOVA revealed that at least two means were significantly different in both Control and Intervention groups. However, the mean score in the Intervention group significantly increased each time (p=0.000), whereas the mean score in the Control group between admission and 1-2 days before discharge was not significantly different. Nevertheless, there were no significant differences between the two groups for HRQOL-BT mean scores at every evaluation time.