Skip to main content
JDRS · Open access journal
Joint Diseases and
Related Surgery
Online manuscript submissionSubmit a manuscript e-ISSN 2687-4792

Original Article · Open access

Influencing factors of readiness for discharge of elderly patients with osteoporotic vertebral compression fractures

PDF Cite this article

Ruyu Liao

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0000-0002-7415-4091

Lili Chen

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0009-0001-1348-7669

Shanhong Liu

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0009-0002-9628-9226

Yuanyuan Liu

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0009-0000-8753-1338

Yue Yang

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0009-0006-2056-4008

Lan Chen

Department of Orthopaedics, The Third People’s Hospital of Chengdu, Chengdu, China

ORCID: 0009-0008-3237-5778

Abstract

Objectives: This study aims to investigate the current status of discharge readiness in elderly osteoporotic vertebral compression fractures (OVCFs) patients and to analyze the factors influencing it, providing a basis for the development of personalized discharge plans and interventions.

Patients and methods: Between January 2025 and April 2025, a total of 356 elderly OVCF patients (141 males, 215 females; mean age: 72.9±8.4 years; range, 60 to 98 years) were included. The following data were collected: general information, the Readiness for Hospital Discharge Scale (RHDS), and the Quality of Discharge Teaching Scale (QDTS). Univariate and multivariate linear regression analyses were employed to further analyze factors related to discharge readiness and the correlation between discharge readiness and the quality of discharge guidance.

Results: The mean total score of discharge readiness of elderly OVCF patients was 87.53±16.90, and the mean score of each item was 7.30±1.41. The quality of discharge guidance was 166.16±25.95 and the mean score of each item was 6.92±1.08. Discharge readiness of elderly OVCF patients was positively correlated with the quality of discharge guidance (r=0.354, p<0.001). Multiple linear regression showed that sex, age, length of stay in hospital, marital status, comorbidities, admission mode, and quality of discharge guidance were independent factors of discharge readiness in elderly OVCF patients (p<0.05).

Conclusion: The readiness for discharge and the quality of discharge guidance of elderly OVCF patients need further improvement. Healthcare professionals should strengthen the patients' readiness for discharge as early as possible after admission according to the patient's actual conditions, to help them smoothly achieve the transition from hospital to home.

Declarations

Author Contributions

Conceived and designed the study: L.C.; Performed the formal analysis and investigation, supported: L.C., S.L., Y.L., Y.Y.; Was also responsible for data curation: L.C.; Wrote the original draft, and reviewed and edited the manuscript: R.L.; Also contributed to visualization: R.L.; Supervised the project: Y. L.; Acquired funding and administered the project: L.C.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This research was funded by the Key Research and Development Program of Chengdu Science and Technology Bureau (Grant number 2024-YF05-00947-SN).

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Zhang J, Xia L, Zhang X, Liu J, Tang J, Xia J, et al. Development and validation of a predictive model for vertebral fracture risk in osteoporosis patients. Eur Spine J 2024;33:3242-3260. DOI: 10.1007/s00586-024-08235-4.
  2. Tang L, Zhang H, Yang Y, Huang HQ. Hidden blood loss of percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Jt Dis Relat Surg 2025;36:240-7. DOI: 10.52312/jdrs.2025.2201.
  3. Ballane G, Cauley JA, Luckey MM, El-Hajj Fuleihan G. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 2017;28:1531-42. DOI: 10.1007/s00198-017-3909-3.
  4. O'Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ. The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 1996;11:1010-8. DOI: 10.1002/jbmr.5650110719.PMID:8797123.
  5. Longo UG, Loppini M, Denaro L, Maffulli N, Denaro V. Osteoporotic vertebral fractures: Current concepts of conservative care. Br Med Bull 2012;102:171-89. DOI: 10.1093/bmb/ldr048.
  6. Lavelle W, Carl A, Lavelle ED, Khaleel MA. Vertebroplasty and kyphoplasty. Anesthesiol Clin 2007;25:913-28. DOI: 10.1016/j.anclin.2007.07.011.
  7. Chen Z, Chen Z, Wu Y, Wu Y, Ning S, Ning S, et al. Risk factors of secondary vertebral compression fracture after percutaneous vertebroplasty or kyphoplasty: A retrospective study of 650 patients. Med Sci Monit 2019;25:9255-61. DOI: 10.12659/MSM.915312.
  8. Lindsay R, Burge RT, Strauss DM. One year outcomes and costs following a vertebral fracture. Osteoporos Int 2005;16:78-85. DOI: 10.1007/s00198-004-1646-x.
  9. Voormolen MH, Lohle PN, Juttmann JR, van der Graaf Y, Fransen H, Lampmann LE. The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 2006;17:71-6. DOI: 10.1097/01.RVI.0000190910.43602.3C.
  10. Gledhill K, Hanna L, Nicks R, Lannin NA. Defining discharge-readiness from subacute care from all stakeholders' perspectives: A systematic review. Disabil Rehabil 2021;43:3127-34. DOI: 10.1080/09638288.2020.1733107.
  11. Fenwick AM. An interdisciplinary tool for assessing patients’ readiness for discharge in the rehabilitation setting. J Adv Nurs 1979;4:9-21. DOI: 10.1111/j.1365-2648.1979.tb02984.x.
  12. Kaya S, Sain Guven G, Aydan S, Kar A, Teleş M, Yıldız A, et al. Patients’ readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death. J Nurs Manag 2018;26:707-16. DOI: 10.1111/jonm.12605.
  13. Ni P, JL Chen, N Liu. The sample size estimation in quantitative nursing research. Chin J Nurs 2010;45:378-80.
  14. Weiss ME, Piacentine LB. Psychometric properties of the readiness for hospital discharge scale. J Nurs Meas 2006;14:163-80. DOI: 10.1891/jnm-v14i3a002.
  15. Lin YH, Kao CC, Huang AM, Chi MT, Chou FH. Psychometric testing of the chinese version of the readiness for hospital discharge scale. Hu Li Za Zhi 2014;61:56-65. DOI: 10.6224/JN.61.4.56.
  16. Weiss M, Yakusheva O, Bobay K. Nurse and patient perceptions of discharge readiness in relation to postdischarge utilization. Med Care 2010;48:482-6. DOI: 10.1097/MLR.0b013e3181d5feae.
  17. Weiss ME, Piacentine LB, Lokken L, Ancona J, Archer J, Gresser S, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec 2007;21:31- 42. DOI: 10.1097/00002800-200701000-00008.
  18. Wang BH, Wang H, Yang CZ. Reliability and validity of the chinese version of the quality of discharge teaching scale. Zhonghua hu li za zhi 2016;51:752-5.
  19. Parker SG, Peet SM, McPherson A, Cannaby AM, Abrams K, Baker R, et al. A systematic review of discharge arrangements for older people. Health Technol Assess 2002;6:1-183. DOI: 10.3310/hta6040.
  20. Kornburger C, Gibson C, Sadowski S, Maletta K, Klingbeil C. Using “teach-back” to promote a safe transition from hospital to home: An evidence-based approach to improving the discharge process. J Pediatr Nurs 2013;28:282-91. DOI: 10.1016/j.pedn.2012.10.007.
  21. Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, et al. Closing the loop: Physician communication with diabetic patients who have low health literacy. Arch Intern Med 2003;163:83-90. DOI: 10.1001/archinte.163.1.83.
  22. Wong J, Wong S, Brooks E, Yabsley RH. Home readiness and recov-ery pattern after total hip replacement. J Orthop Nurs 1999;3:210-9.
  23. Zileli M, Fornari M, Costa F, Anania CD, Parthiban J, Sharif S. Epidemiology, natural course, and preventive measures of osteoporotic vertebral fractures: WFNS Spine Committee Recommendations. J Neurosurg Sci 2022;66:282-90. DOI: 10.23736/S0390-5616.22.05643-0.
  24. Manolagas SC, O'Brien CA, Almeida M. The role of estrogen and androgen receptors in bone health and disease. Nat Rev Endocrinol 2013;9:699-712. DOI: 10.1038/nrendo.2013.179.
  25. Riggs BL, Khosla S, Melton LJ 3rd. A unitary model for involutional osteoporosis: Estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res 1998;13:763-73. DOI: 10.1359/jbmr.1998.13.5.763.
  26. Yoo JH, Moon SH, Ha YC, Lee DY, Gong HS, Park SY, et al. Osteoporotic fracture: 2015 Position Statement of the Korean Society for Bone and Mineral Research. J Bone Metab 2015;22:175-81. DOI: 10.11005/jbm.2015.22.4.175.
  27. Sherbourne CD, Hays RD. Marital status, social support, and health transitions in chronic disease patients. J Health Soc Behav 1990;31:328-43.
  28. Hakami KM, Alhazmi AH, Zaalah S, Shubayli S, Darraj H, Hamdi S, et al. The impact of heart attack and sudden cardiac death risk perception on lifestyle modification intention among adults in Jazan Province. Patient Prefer Adherence 2023;17:3353-65. DOI: 10.2147/PPA.S427202.
  29. Wu DL, Luo CL, Du X, Li PP, Jiang M, Liu T, et al. Current status and influencing factors of readiness for discharge of elderly patients with chronic obstructive pulmonary disease. Patient Prefer Adherence 2023;17:1323-33. DOI: 10.2147/PPA.S410725.
  30. Nurhayati N, Songwathana P, Vachprasit R. Surgical patients’ experiences of readiness for hospital discharge and perceived quality of discharge teaching in acute care hospitals. J Clin Nurs 2019;28:1728-36. DOI: 10.1111/jocn.14764.
  31. Weiss M, Ryan P, Lokken L, Nelson M. Length of stay after vaginal birth: Sociodemographic and readiness-fordischarge factors. Birth 2004;31:93-101. DOI: 10.1111/j.0730-7659.2004.00286.x.
  32. Daynes J, Roth MF, Zekaj M, Hudson I, Pearson C, Vaidya R. Adult native septic arthritis in an inner city hospital: Effects on length of stay. Orthopedics 2016;39:e674-9. DOI: 10.3928/01477447-20160419-01.
  33. Yiu HY, Chien WT, Lui MH, Qin B. Information needs of Chinese surgical patients on discharge: A comparison of patients' and nurses' perceptions. J Adv Nurs 2011;67:1041- 52. DOI: 10.1111/j.1365-2648.2010.05528.x.
  34. Xiao S, Tourangeau A, Widger K, Berta W. Discharge planning in mental healthcare settings: A review and concept analysis. Int J Ment Health Nurs 2019;28:816-32. DOI: 10.1111/inm.12599.
  35. Mabire C, Büla C, Morin D, Goulet C. Nursing discharge planning for older medical inpatients in Switzerland: A cross-sectional study. Geriatr Nurs 2015;36:451-7. DOI: 10.1016/j.gerinurse.2015.07.002.
  36. Balvardi S, Pecorelli N, Castelino T, Niculiseanu P, Liberman AS, Charlebois P, et al. Measuring in-hospital recovery after colorectal surgery within a well-established enhanced recovery pathway: A comparison between hospital length of stay and time to readiness for discharge. Dis Colon Rectum 2018;61:854-60. DOI: 10.1097/DCR.0000000000001061.
  37. Mitchell JP. Association of provider communication and discharge instructions on lower readmissions. J Healthc Qual 2015;37:33-40. DOI: 10.1097/01.JHQ.0000460126.88382.13.
  38. Ashbrook L, Mourad M, Sehgal N. Communicating discharge instructions to patients: A survey of nurse, intern, and hospitalist practices. J Hosp Med 2013;8:36-41. DOI: 10.1002/jhm.1986.