Exploring the interplay of stigma, family care, and discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous transhepatic cholangial drainage recovery

Abstract

Objective: To investigate the current status of stigma, family care, and discharge readiness in patients with malignant obstructive jaundice undergoing percutaneous transhepatic cholangial drainage (PTCD) and analyze its influencing factors.

Methods: A cross-sectional survey was conducted on 399 patients with malignant obstructive jaundice who underwent PTCD using a general information questionnaire, the readiness for hospital discharge scale (RHDS), the social impact scale (SIS), and the family APGAR index.

Results: The total average stigma score in patients with malignant obstructive jaundice who underwent PTCD was 59.1 ± 10.34, and the average scores of each dimension, from low to high, were: social exclusion, economic discrimination, intrinsic stigma, and social isolation. The overall average score of discharge readiness was 61.08 ± 17.94, and the average scores of each dimension from low to high were personal status, adaptability, and predictive support. The total score of the family care scale was 5.00 (4.00, 7.00). Patients with malignant obstructive jaundice undergoing PTCD had a negative correlation between their sense of stigma and discharge readiness, r = -0.748 (P < 0.01). There was a positive correlation between family care and discharge readiness, r = 0.904 (P < 0.01), and a negative correlation between sense of stigma and family care, r = -0.854 (P < 0.01). The results of multiple linear regression analysis showed that age, lifestyle, PTCD time, and hospitalization interval were all correlated with patients' sense of stigma, family care, and discharge readiness (P < 0.05).

Conclusions: Patients with malignant obstructive jaundice who underwent PTCD had a moderate level of stigma, family care, and discharge readiness. There were pairwise correlations among family care, discharge readiness, and sense of stigma. Clinical medical staff should attach importance to the quality of discharge guidance and the importance of family support, help patients establish good social support systems, and promote the safety management of patients after discharge.

Keywords: Family care; Influence factor; Malignant obstructive jaundice; Percutaneous transhepatic cholangial drainage; Readiness for discharge; Sick stigma.