Effects of interventions on the readiness for hospital discharge in elderly patients with chronic heart failure: A Randomized Controlled Trial

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Design: A randomized controlled trial was conducted. Methods A total of 92 participants admitted for heart failure were recruited from the cardiology departments of a public hospital in Qingdao.They were randomly allocated to the control group and the intervention group.All participants received the usual care. Participants in the intervention group received the discharge preparation interventions. Data were collected at baseline,1 month, 3 months from baseline. Results Compared to the control group, participants in the intervention group had significantly higher levels of discharge preparation( P <0.05) and the quality of discharge teaching at 1-month,3-month follow-ups( P <0.05).Patients in the intervention group experienced significantly lower the quality of living level than patients in the control group at 3-month follow-ups( P <0.05).The research showed that the result of 6-minute walk test was higher among participants in the intervention group than those in the control group at 3-month follow-ups( P <0.05).At 1-month and 3-month after intervention,the rates of unplanned readmissions were compared between the two groups.The rates of unplanned readmissions were 11.4% at 1-month,was 6.8% at 3-month in the intervention group, but it was 37.2% at 1-month and 32.6% at 3-month in the control group. Conclusion Discharge preparation interventions can effectively improve discharge preparation level and the quality of discharge teaching,improve the quality of life,and reduce the rate of unplanned readmission. Discharge preparation interventions Elderly patients Chronic heart failure SUMMARY STATEMENT OF IMPLICATIONS FOR PRACTICE What does this research add to existing knowledge in gerontology? What are the implications of this new knowledge for nursing care with older people? How could the findings be used to influence policy or practice or research or education? Introduction Chronic heart failure (CHF), a persistent HF state, is an important geriatric syndrome [ 1 , 2 ] .Epidemiological data indicates that the prevalence of HF is 1%ཞ2% globally, and the incidence rate of people over 70 in developed countries is up to 10% [ 3 ] . In terms of fatality rate, a study of 7319 hospitalized patients shows that the heart failure has a general population prevalence ranging from 2.1%ཞ16.9% in patients from 30 to 90 years of age [ 4 ] . Elderly patients with CHF need to return to family to continue rehabilitation after the acute phase, but patients are still affected by symptoms such as a difficulty falling or staying asleep, edema, depression, constipation [ 5 ] .Those seriously affect the quality of life and survival of patients with CHF. Previous studies have shown that reliable and effective discharge preparation service could reduce the rate of the unplanned readmission and reduce the length of hospital stay, and empower self-management ability [ 6 , 7 ] . However, as a result of inadequate discharge preparation, some patients with CHF experience significantly worsening symptoms and unplanned readmission.30% of patients may be readmitted after discharge from hospitalization because of low levels of self-management, poor adherence, which can cause a worsening of symptoms and an increase of the disease exacerbations. Patients transitioning from hospital to family and home rehabilitation are at the highest risk for experiencing adverse outcomes in the post-discharge period [ 8 ] .It is suggested that successful hospital-initiated transitional care programs include a bridging strategy with hospitalization and hospital postdischarge. Improving self-management ability and reducing the rate of unplanned readmission is an urgent problem to be solved among patients with CHF. Therefore, the discharge preparation of patients with CHF must be evaluated with great attention. The purpose of the trial was to investigate the potential benefits of discharge preparation interventions in patients with CHF. Methods Study design This study is a randomized controlled trial which was conducted with the approval of the Ethics committee of Qingdao Municipal Hospital(2023临审字第034号). Study participants Elderly patients with CHF who were admitted to the Department of Cardiology, between August 2021 and March 2022 were enrolled. Inclusion Criteria: (1)less than 60 years;(2)Meet the criteria for CHF: patients diagnosed with HF according to the diagnostic criteria of Chinese guidelines for the diagnosis and treatment of HF 2018;(3)The first hospitalization;(4)The cardiac function grade (New York Heart Association) of patients was grade II to III;(5)Volunteered to participate in this study and signed informed consent;(6)The participants have access to a smartphone and use software such as smartphone assisstants;(7)Able to understand the survey content. Exclusion criteria: (1)Patients complicated with severe hepatic and renal diseases;(2)Patients with the stroke sequelae patients and dementia;(3)Patients with delirium or an active serious mental illness;(4)Newly developed heart failure;(5)Patients with repeated admissions for acute heart failure. The sample size was calculated by the following formulas:n 1 =n 2 =2×[S(t a /2+t β )／δ] 2 .Significance testing was 2 side at an ɑ of 0.05 and 0.10 for interactions. Based on the result of the pre-test, S=85.43,δ=63.60, S/δ ≈ 1.343.Therefore, the minimum sample size would be 38 patients per group. Considering a 20% drop-out rate, the sample size was finally determined to be 46 patients per group. Randomization and masking Ninety-two patients who were admitted to our hospital were randomly selected and divided into the control group and intervention group by coin tossing, with 46 patients in each group. Positive contours were indicated in the control group and negative in the intervention group. To avoid possible contamination, members of the same group were allocated to the same ward as much as possible. Finally, Cardiology Department 1 was the intervention group and Cardiology Department 2 was control group. Intervention and control condition Control group The control group was given routine health guidance and publicity materials, such as the handbook of health education for heart failure within the first 48 hours after admission. Patients needed to pay attention to the hospital’s WeChat public account. Primary nurses guided patients through the admissions process to help them adapt to the hospital environment and refine evaluation after hospital admission as soon as possible. The specific health guidance is as follows.(1)Psychological guidance: patients were instructed to keep a stable mood and avoid emotional stress, such as anxiety, nervousness, depression, and excitement;(2)Diet nursing:patients were given low-calorie、high-protein、high-vitamin、low salt and easily digestible diet;(3)Daliy activity: the amount of activity depended on the impaired cardiac function;(4)Symptom nursing: patients were instructed to cough and discharge sputum correctly and turn over regularly to avoid lung infection;(5)Medical nursing: patients were guided to take medication that could improve cardiac function by physician orders;(6)Condition monitoring and complications management:if the patients present symptoms, such as the ankle developed puffiness,nocturia tenesmus,the body weight increased abnormally,anorexia and fullness,it will indicate an increased risk of recurrence discharge guidance and indicates an increased risk of recurrence in heart failure patients. Intervention group The intervention group consisted of care as usual plus the discharge preparation interventions protocol.The discharge preparation interventions protocol flow is depicted in Table 1. Table 1 Discharge preparation interventions protocol for elderly patients with chronic heart failure Time Theme Goal Content on the day of admission. I participate in smart life 1.understand the needs of patients comprehensively 2.Introduce the discharge preparation service ①Participants are informed of the targets and meaning：nurses assess the patients the status of patients ②Teach patients to master the smart assisstant and applet 2～3 days after admission I can manage heart faliure Building trust and relationship ①Teach patients recognize the symptoms and signs associated with heart faliure and master first-aid related knowledge ②Teach patients master volume management instrument like oxygen saturation and knownoledge related to Oxygen therapy and heart failure diet management 4～5 days after admission I’m good with self-care promote self- management ability ①Teach patients master the cardiopulmonary function training and exercise intensity Teach patients stay-home safety common sense,which helps patients arrange safe environments ②The device such as Xiaoai uses a set alarm to remind patients to take their medication、diet and defecation ③Help multimorbidity patients master the attention of disease Time Theme Goal Content 6～7 days after admission I feel relax because of the easy life Maintain a pleasant mood ①Teach patients keep relax and reduce the stress ②Teach patients the simple and understandable movement modality ③Teach patients use ride-hailing services,which make patients live simple and effective ④The patients and their family explore psychological burden after discharge,which helps patients overcome difficulties 8～10 days after admission Be released from the hospital and now back at home Go home and enjoy the old age ①Require considerable training and practice.The nurse demonstrates the skills that the patients would need once they go home ②Through the individual patient healthy education and multidisciplinary discussions,nurse makes a detailed list to address the rehabilitation concerns ③Provide patients with discharge process,discharge attention,regular visitation and regular re-examination ④All patients are given a follow-up plan to ensure they felt at ease ⑤Nurses help patients to contact relevant community agencies who can provide specialised support 1 day before discharge Health always accompany me Keep a healthy life Assist patients to complete the questionnaire Communicate with patients about the follow-up time and pathway after discharge Outcome measures The general questionnaire The questionnaire was developed by the research group,including demographic data of the patients and disease-related data. The demographic data consists of age,sex and educational level et al. The Hospital Discharge Preparation Scale(PDPS) The primary outcome,hospital discharge preparation,is assessed by the Hospital Discharge Preparation Scale(PDPS) [9] .This scale contains three dimensions with a total of 12 entries.It has a content validity index of 0.88.The overall Cronbach’s alpha coefficient of the scale is 0.89. Each dimension ranges from 0.73 to 0.90.Each item is scored on a 0～10.A higher total score indicates a better hospital discharge preparation.Hospital discharge preparation will be considered high if it scores 7 and above and otherwise not well prepared. The Quality of Discharge Teaching Scale(QDTS) The Quality of Discharge Teaching Scale was developed by Weiss et al [8] . It includes 3 dimensions: content needed (6 items), content received (6 items), and instruction skills and effects(12 items).A scoring system of 0～10 points is adopted.A higher total score indicates better quality discharge teaching.The Chinese version of the scale is tested for its validity and reliability.The content validity index (CVI) is 0.98.The Cronbach’s alpha coefficient is 0.92 [10] . The Rates of Unplanned Readmissions Unplanned readmission refers to readmission of patients in a short duration due to the same or related illness after discharge.Typically, the 30-day unplanned readmission rate is counted. The Minnesota Living with Heart Failure Questionnaire The quality of life is assessed by completion of the Minnesota Living with Heart Failure Questionnaire [11] .The questionnaire contains 21 items, divided in three dimensions:5 items for affective dimension,8 items for physical dimension,8 items for the symptom dimension. Each item is scored from 0 as the lowest, to 5 as the highest, with a maximum total score of 105.Higher score indicates the poor quality of life. A 6-minute walk test According to the Chinese expert consensus [12] on the clinical application of 6-minute walk test in elderly patients,walking distance less than 100m indicates severe cardiac insufficiency;150m~300m indicates moderate cardiac insufficiency;301m ~ 450m indicates mild cardiac insufficiency. Formation of multi-disciplinary team Our research team comprised a researcher,a postgraduate supervisor in nursing, a cardiology physician, a chief nurse working in the Department of Cardiology,a rehabilitation specialist,a nutritionist, a psychologist, three nurses and two nursing post-graduate students.Postgraduate supervisor in nursing was responsible for guiding the project.The chief nurse of working in the Department of Cardiology was responsible for coordinating the cooperation between the team members.Three nurses were responsible for the knowledge and skills training,data collection and implementation of intervention procedures.The cardiology physician was in charge of the education and training of the team members.A nutritionist was responsible for dietary instruction.The psychologist was responsible for discovering the psychological problems of patients and their families.The rehabilitation specialist developped personalizing the therapy and assisted the patient as needed in performing rehabilitation treatment.The post-graduate students collected relevant data, managed the Wechat and setted up the smart device. Data collection Participants completed the general questionnaires before intervention.At one day before discharge,nurses assisted patients to complete the Quality of Discharge Teaching Scale,the Hospital Discharge Preparation Scale,the Minnesota Living with Heart Failure Questionnaire,a 6-minute walk test.After completing the questionnaire, the forms were collected on the spot, and the accuracy of the questionnaire was checked at the same time to ensure the quality of collected data.At 1 month,3 months after discharge,the rates of unplanned readmissions and the Minnesota Living with Heart Failure Questionaire were collected by the the research team at outpatient clinics. Data analysis All data were analyzed with SPSS26.0 statistical software.Counting data were represented by the number of cases and percentage, and the chi-square test was used for comparison between groups.Shapiro-Wilk normality test was applied to examine whether data samples fit a normal distribution.Continuous variables with a normal distribution were expressed as mean standard deviation,and group comparisons were made using the independent sample T test.The data that did not meet the normal distribution was represented by median (upper quartile and lower quartile).Differences with P ≤ 0.05 were considered significant. Ethical approval This research study was conducted with the approval of the Ethics Committee of Qingdao Municipal Hospital. Results In the intervention group,one patient died because of illness.One patient gave up participating in the research for various reasons.A total of forty-four patients in the intervention group completed the intervention.In the control group,one patient died because of illness.Two patients gave up participating in the research for various reasons.A total of forty-three patients in the control group completed the intervention. Baseline data The sociodemographic,clinical characteristics and the baseline outcome variables across the study groups were presented in Table 2. Table 2 Sociodemographic, clinical characteristics and outcome variables at baseline Intervention group （n=44） Control group （n=43） t/ c2 P Age 70.82±6.34 71.67±6.82 0.607 0.546 Gender Man 24 (53.5) 28(65.1) 1.011 0.315 Woman 20 (46.5) 15(34.9) BMI(kg/m2 ) 25.28±3.07 25.59±3.12 0.474 0.636 18.5～23.9 18 (40.9) 13 (30.2) 1.240 0.538 24～27.9 16 (36.4) 20 (46.5) >27.9 10 (22.7) 10(23.3) Highest education level primary school and below 22 (50.0) 19 (44.2) 0.296 0.863 Senior high school or Technical secondary school 10 (22.7) 11 (25.6) college and above 12 (27.3) 13 (30.2) Employment status, n(%) off-the-job 3 (6.8) 2 (4.7) 0.189 0.664 on-the-job 41 (93.2) 41 (95.3) Marital status Never married/widowed/ divorced 12 (27.3) 16 (37.2) 0.984 0.321 Married 32 (72.7) 27(62.8) Place of residence Rural and townships 27 (61.4) 25 (58.1) 0.094 0.759 Urban 17 (38.6) 18 (41.9) Live by himself or with others Yes 6 (13.6) 9 (20.9) 0.811 0.368 No 38 ( 86.4) 34 (79.1) Intervention group （n=44） Control group （n=43） t/ c2 P Monthly household income, n (%) 3000 18(40.9) 19 (44.2) Payment manner of the medical expenses Public fee 13(29.5) 15(34.9) 0.886 0.642 Medicare 18 (40.9) 19 (44.2) Self-paid 13 (29.5) 9 (20.9) EF value >50% 10 (22.7) 17(39.5) 5.373 0.068 40～50% 32 (72.7) 21(48.8) <40% 2 (4.5) 5(11.6) NYHA Functional Classification, n(%) Ⅱ 16 (36.4) 22 (51.2) 1.936 0.164 Ⅲ 28 (63.6) 21 (48.8) Number of complications 1 2(4.6) 6(14.0) 2.734 0.255 2 13(29.5) 9(20.9) 3 29(65.9) 28(65.1) Cause of disease Coronary heart disease 41(93.2) 37(86.0) 1.194 0.275 hypertension 32(72.7) 27(62.8) 0.984 0.321 Other 36(81.8) 37(86.0) 0.288 0.592 Intervention effect on the hospital discharge preparation The intervention group had significantly higher scores than the control group for a total score of the hospital discharge preparation,the score of adaptive capacity dimension and anticipating receiving support dimension( P <0.05).However,there was no significant difference in the scores of individual’s status dimension between the two groups( P = 0.065).Please see Table 3 for details. Table 3 Presents a comparison of the total score of hospital discharge preparation and the scores of each dimension between the two groups after the intervention Intervention group Control group T/Z P Mean difference Standard errors 95%CI individual’s status 22.23±5.03 20.37±4.18 1.868 0.065 1.855 0.993 -0.12~3.83 adaptive capacity 42.50 (37.00,47.00) 34.00 (31.00,41.00) 4.026 < 0.001 6.295 1.473 3.37~9.23 anticipating receiving support 30.91±6.07 27.81±5.56 2.479 0.015 3.095 1.249 0.61~5.58 Total score 94.43±9.72 83.19±10.51 5.182 < 0.001 11.246 2.170 6.93~15.56 Intervention effect on the quality of discharge teaching After intervention,the intervention group had a higher score of each dimension than those of the control group( P <0.05),as shown in Table 4. Table 4 Presents a comparison of the total score of the quality of discharge teaching of each dimension between the two groups after the intervention Intervention group(n=44) Control group(n=43) T/Z P Mean difference Standard errors 95%CI Content needed 51.50±5.51 46.23±5.48 4.470 < 0.001 5.267 1.178 2.92~7.61 Content received 47.00 (44.25,53.00) 43.00 (36.00, 46.00) 4.587 < 0.001 6.555 1.215 4.14~8.97 Instuction skills and effects 90.50±10.89 86.19±9.28 1.986 0.049 4.314 2.172 -0.01~8.63 Total score 194.50 (176.00,202.75) 178.00 (164.00, 185.00) 4.331 <0 .001 16.160 3.216 9.77~22.55 Intervention effect on the rates of unplanned readmissions The rates of unplanned readmissions of the two groups were compared by chi-square test at the 1 and 3 months after the intervention.The rates of unplanned readmissions in the intervention group at 1 month after the intervention were 11.4%,6.8% at 3 months after the intervention,while 37.2% 32.6%in the control group.The rates of unplanned readmissions in the intervention group were significantly lower than that in the control group, with a statistically significant difference( P =0.005、0.002),as shown in Table 5. Table 5 Comparison of the rates of unplanned readmissions between the two groups at different time points 1 month after intervention(%) 3 months after intervention(%) Intervention group(n=44) 5 (11.4) 3 (6.8) Control group 16 (37.2) 14 (32.6) χ 2 7.933 9.165 P 0.005 0.002 Intervention effect on the quality of life Repeated measures ANOVA showed there were statistically significant differences in the interaction effect of time with group in the two groups(F=3.69， P =0.027).Pairwise comparisons were made among the intervention group at three different time points by Bonferroni method.At 3 months after intervention, the quality of life scores in the intervention group were obviously lower than those before the intervention(38.59±18.48 to 24.25±9.77)( P <0.001).However,there were no significant differences across time points in the control group(36.65±15.59 to 34.09±8.53)( P = 0.569).The independent-samples t test was adopted for inter-group comparison.At 3-month after intervention, the quality of life scores in the intervention group were obviously lower than the control group( P =0.599,0.468,<0.001),as shown in Table 6. Table 6 Comparison of the quality of life between the two groups at different time points Before hospital discharge 1-month after intervention 3-month after intervention F P Intervention group(n=44) 38.59±18.48 31.25±14.89 24.25±9.77 10.18 <0.001 Control group(n=43) 36.65±15.59 33.7±16.42 34.09±8.53 0.57 0.569 t/Z 0.528 -0.729 -5.001 P 0.599 0.468 < 0.001 Intervention effect on the result of the 6-minute walk test Repeated measures ANOVA showed there were statistically significant differences in the interaction effect of time with group of the 6-minute walk test in the two groups(F=5.12, P =0.007).Bonferroni pairwise comparisons for intervention group data at three time points showed the results of 6-minute walk test of 1 month and 3 months after discharge were significantly higher than those before discharge(218.31±25.05 to 264.4±42.17)( P <0.001).However,there were no significant differences found across time points in the control group(211.24±20.57 to 221.92±33.34)( P =0.117). The results of independent samples t-test indicate that the results of 6-minute walk test of intervention group were significantly higher than the control group at 1 month and 3 months after discharge,and the differences are statistically significant( P =0.005,<0.001),as shown in Table 7. Table 7 Comparison of the result of the 6-minute walk test between the two groups at different time points Before hospital discharge 1-month after intervention 3-month after intervention F P Intervention group(n=44) 218.31±25.05 252.27±40.99 264.4±42.17 16.99 <0.001 Control group(n=43) 211.24±20.57 226.41±42.25 221.92±33.34 2.21 0.117 t/Z 1.436 2.898 5.205 P 0.155 0.005 <0 .001 Discussion The hospital discharge preparation intervention may improve the hospital discharge preparation and the quality of discharge teaching In this study, hospital discharge preparation score in the intervention group was significantly better than in the control group.The reason could be that education duration was maximized,which also alleviated the problems of inadequate preparation in patients.Then, it solved the problems of the elderly with poorer ability to comprehend to some extent by introducing advanced technology and tools.In terms of the education designing,the research carried out a scientific and reasonable nursing work under the guidance of discharge preparation model.It is evident from data that the quality of discharge teaching of intervention is significantly better than the control group( P <0.05).To analyze the reason,verbal discharge instructions was common in routine predischarge guidance.In the face of the medical knowledge,the elderly exhibited difficulty in remembering the content of medical knowledge.Eight healthy education modules linked the smart assistant,which helps patients master disease knowledge and skills,so as to ensure the continued care of patients after discharge from the hospital and improve the quality of discharge teaching.Patients began to know the importance of self-care,which can stimulate their self-responsibility to actively obtain relevant health knowledge and nursing skills from passive acceptance to active participation [13] .Patients progressed onto practice after mastering fundamental knowledge,reinforcing the understanding of theoretical knowledge.Also,researchers provided certain rewards to motivate patients to form the behavioral conditioning. The hospital discharge preparation intervention may improve the quality of life From the research data it was evident that the quality of life for the two groups of patients showed no significant difference at 1 month post-intervention( P =0.468).At 3 months after the intervention, the intervention group indicated significantly lower score of the quality of life than that in the control group.Conclusion from this study, the time of discharge had a positive correlation to the quality of life of patients.In the process of discharge preparation intervention,using tasks lists prompted patients to targeted self-monitoring.The complex knowledge was presented in older patients in a relatively easy way to interpret and understand.It could help patients face their disease more actively.It prevented deterioration of disease and avoided the changes in the patient’s condition to some extent. The hospital discharge preparation intervention can reduce the rates of unplanned readmissions From the present study, it was evident that the rates of unplanned readmissions was 11.4% at one month,6.8% at three months.The result was lower than in the control group (37.2% at one month,32.6% at three months),which was also consistent with the conclusion of Mabire’s meta-analysis [14] .Therefore,this difference was statistically significant( P =0.005,0.002).The results demonstrated that the hospital discharge preparation intervention could reduce the rates of unplanned readmissions.Unplanned readmission was often related to inadequate preparation before discharge. And there were lots of predisposing factors and uncertainties.Patients might not be able to address these issues on their own when an emergency happens,which increases the rates of unplanned readmissions. Nurse in the intervention group systematically assessed patient’s needs in the discharge transition processes,and through multidisciplinary teamwork, our researcher makes full use of out-of-hospital and intrahospital resources to establish a long-term mechanism of discharge preparation.These interventions could improve the self-management ability of the patient,ensuring their health and quality of life eventually.Furthermore, the symptoms of HF cannot be initially recognized by patients because of its insidious onset compared to the acute onset of symptoms in myocardial infarction or stroke. After intervention,patients could be quick to master the skills of the identification method of acute onset of heart failure.This improved the patient’s ability to predict and deal with the stressful future event and reduced the rate of unplanned readmission [15] .This intervention provided patients with the training about heart failure knowledge and skills,which improved the patient’s ability of self-care. Declarations Financial Support There are currently no funding sources. Clinical trial number not applicable. The Consent of Participate declaration All authors of this paper agreed to participate in the writing and publication of this paper. Author Contribution Yaoyao Ding design of the work, Min Shan and Yaoyao Ding wrote the main manuscript text, Guangdi Xi prepared table 1-7, Yaxi Wang and Yan Xu and Guangdi Xi collected and analysed the research dates. All authors reviewed the manuscript. References Heidenreich PA, Trogdon JG, Khavjou OA, et al. 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The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument[J]. Eur J Heart Fail. 2014;11(1):99–105. Society CG. Chinese expert consensus on the clinical application of 6 Minute Walk Test in elderly patients[J]. Chin J Geriatr. 2020;39(11):1241–50. 10.3760/cma.j.issn.0254-9026.2020.11.001 . Lili Gao Y, Z M L. Research progress of intervention strategies for patient discharge readiness at home and abroad[J]. J Nurs (China). 2020;27(10):28–31. 10.16460/j.issn1008-9969.2020.10.028 . A C M, B S B, C D A B, et al. Patient readiness for hospital discharge and its relationship to discharge preparation and structural factors: A cross-sectional study - ScienceDirect[J]. Int J Nurs Stud. 2019;90:13–20. Weeks K, Kile D, Garber J. Implementing a Nurse Discharge Navigator: Reducing 30-Day Readmissions for Heart Failure and Sepsis Populations[J]. Prof Case Manage, 2020,25. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6126299","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":441124274,"identity":"6b5b5131-f3bf-49c0-9479-9095069dd864","order_by":0,"name":"Min Shan","email":"","orcid":"","institution":"Qingdao Municipal Hospital","correspondingAuthor":false,"prefix":"","firstName":"Min","middleName":"","lastName":"Shan","suffix":""},{"id":441124275,"identity":"c3cfd6c4-da76-4c78-92c0-6cd9b1edfabd","order_by":1,"name":"Guangdi Xi","email":"","orcid":"","institution":"Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Guangdi","middleName":"","lastName":"Xi","suffix":""},{"id":441124276,"identity":"2ffa859f-f309-4029-a1b5-5f054f2c448f","order_by":2,"name":"Yan Xu","email":"","orcid":"","institution":"Affiliated Hospital of Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Yan","middleName":"","lastName":"Xu","suffix":""},{"id":441124277,"identity":"8cf56601-2bd7-4d8d-9806-8b0435758654","order_by":3,"name":"Yaxi Wang","email":"","orcid":"","institution":"Affiliated Hospital of Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Yaxi","middleName":"","lastName":"Wang","suffix":""},{"id":441124278,"identity":"b47b9218-a27d-40ca-86f1-b894f37fa103","order_by":4,"name":"Yaoyao Ding","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyUlEQVRIiWNgGAWjYBACfvnHBx9+qGCr72dvIFKLZENasrHEGT7GmT0HiNRicCBHTYK3TY5xw40EYl124AyzgWSbGbPBzccbbzDU2EQT1MHY2HvwQcG5NDbJ22nFFgzH0nIbCGlhZuZLNpAoO8bDdzvHTIKx4TBhLWxsPGYSPGz/JRhuniFSCw8PSEsbm4HADR4itUhIsIECmS1BsgfolwRi/GJ/gxkclQn87Ic33vhQY0NYCzIwkEggRTlEC6k6RsEoGAWjYGQAACOWPuAdqWSyAAAAAElFTkSuQmCC","orcid":"","institution":"Affiliated Hospital of Qingdao University","correspondingAuthor":true,"prefix":"","firstName":"Yaoyao","middleName":"","lastName":"Ding","suffix":""}],"badges":[],"createdAt":"2025-02-28 07:38:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6126299/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6126299/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-025-03715-4","type":"published","date":"2025-08-12T15:57:13+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":89310591,"identity":"df892d14-aee0-494d-8adb-57de22cd4c3f","added_by":"auto","created_at":"2025-08-18 16:08:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1064902,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6126299/v1/b6ee3ce6-6802-480f-8f3e-1a7457e5733f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effects of interventions on the readiness for hospital discharge in elderly patients with chronic heart failure: A Randomized Controlled Trial","fulltext":[{"header":"SUMMARY STATEMENT OF IMPLICATIONS FOR PRACTICE","content":"\u003cp\u003e\u003cstrong\u003eWhat does this research add to existing knowledge in gerontology?\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWhat are the implications of this new knowledge for nursing care with older people?\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHow could the findings be used to influence policy or practice or research or education?\u003c/strong\u003e\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003eChronic heart failure (CHF), a persistent HF state, is an important geriatric syndrome\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e.Epidemiological data indicates that the prevalence of HF is 1%ཞ2% globally, and the incidence rate of people over 70 in developed countries is up to 10%\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn terms of fatality rate, a study of 7319 hospitalized patients shows that the heart failure has a general population prevalence ranging from 2.1%ཞ16.9% in patients from 30 to 90 years of age\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eElderly patients with CHF need to return to family to continue rehabilitation after the acute phase, but patients are still affected by symptoms such as a difficulty falling or staying asleep, edema, depression, constipation\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.Those seriously affect the quality of life and survival of patients with CHF. Previous studies have shown that reliable and effective discharge preparation service could reduce the rate of the unplanned readmission and reduce the length of hospital stay, and empower self-management ability\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHowever, as a result of inadequate discharge preparation, some patients with CHF experience significantly worsening symptoms and unplanned readmission.30% of patients may be readmitted after discharge from hospitalization because of low levels of self-management, poor adherence, which can cause a worsening of symptoms and an increase of the disease exacerbations. Patients transitioning from hospital to family and home rehabilitation are at the highest risk for experiencing adverse outcomes in the post-discharge period\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.It is suggested that successful hospital-initiated transitional care programs include a bridging strategy with hospitalization and hospital postdischarge.\u003c/p\u003e \u003cp\u003eImproving self-management ability and reducing the rate of unplanned readmission is an urgent problem to be solved among patients with CHF. Therefore, the discharge preparation of patients with CHF must be evaluated with great attention. The purpose of the trial was to investigate the potential benefits of discharge preparation interventions in patients with CHF.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a randomized controlled trial which was conducted with the approval of the Ethics committee of Qingdao Municipal Hospital(2023临审字第034号).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStudy participants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eElderly patients with CHF who were admitted to the Department of Cardiology, between August 2021 and March 2022 were enrolled. Inclusion Criteria: (1)less than 60 years;(2)Meet the criteria for CHF: patients diagnosed with HF according to the diagnostic criteria of Chinese guidelines for the diagnosis and treatment of HF 2018;(3)The first hospitalization;(4)The cardiac function grade (New York Heart Association) of patients was grade II to III;(5)Volunteered to participate in this study and signed informed consent;(6)The participants have access to a smartphone and use software such as smartphone assisstants;(7)Able to understand the survey content. Exclusion criteria: (1)Patients complicated with severe hepatic and renal diseases;(2)Patients with the stroke sequelae patients and dementia;(3)Patients with delirium or an active serious mental illness;(4)Newly developed heart failure;(5)Patients with repeated admissions for acute heart failure. The sample size was calculated by the following formulas:n\u003csub\u003e1\u003c/sub\u003e=n\u003csub\u003e2\u003c/sub\u003e=2\u0026times;[S(t\u003csub\u003ea\u003c/sub\u003e/2+t\u003csub\u003e\u0026beta;\u003c/sub\u003e)／\u0026delta;]\u003csup\u003e2\u003c/sup\u003e.Significance testing was 2 side at an ɑ of 0.05 and 0.10 for interactions. Based on the result of the pre-test, S=85.43,\u0026delta;=63.60,\u0026nbsp;S/\u0026delta; \u0026asymp; 1.343.Therefore, the minimum sample size would be 38 patients per group. Considering a 20% drop-out rate, the sample size was finally determined to be 46 patients per group.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRandomization and masking\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNinety-two patients who were admitted to our hospital were randomly selected and divided into the control group and\u0026nbsp;intervention\u0026nbsp;group by coin tossing, with 46 patients in each group. Positive contours were indicated in the control group and negative in the\u0026nbsp;intervention\u0026nbsp;group. To avoid possible contamination, members of the same group were allocated to the same ward as much as possible. Finally, Cardiology Department 1 was the intervention group and Cardiology Department 2 was control group.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIntervention and control condition\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eControl group\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe control group was given routine health guidance and publicity materials, such as the handbook of health education for\u0026nbsp;heart failure\u0026nbsp;within the first 48\u0026thinsp;hours after admission. Patients needed to pay attention to the hospital\u0026rsquo;s WeChat public account. Primary nurses guided patients through the admissions process to help them adapt to the hospital environment and refine evaluation after hospital admission as soon as possible.\u003c/p\u003e\n\u003cp\u003eThe specific health guidance is as follows.(1)Psychological guidance: patients were instructed to keep a stable mood and avoid emotional stress, such as anxiety, nervousness, depression, and excitement;(2)Diet nursing:patients were given low-calorie、high-protein、high-vitamin、low salt and easily digestible diet;(3)Daliy activity: the amount of activity depended on the impaired cardiac function;(4)Symptom nursing: patients were instructed to cough and discharge sputum correctly and turn over regularly to avoid lung infection;(5)Medical nursing: patients were guided to take medication that could improve cardiac function by physician orders;(6)Condition monitoring and complications management:if the patients present symptoms, such as the ankle developed puffiness,nocturia tenesmus,the body weight increased abnormally,anorexia and fullness,it will indicate an increased risk of recurrence discharge guidance and indicates an increased risk of recurrence in heart failure patients.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIntervention group\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe intervention group consisted of care as usual plus the discharge preparation interventions\u0026nbsp;protocol.The discharge\u0026nbsp;preparation interventions\u0026nbsp;protocol flow is depicted in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDischarge preparation interventions\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eprotocol\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;for elderly patients with chronic heart failure\u003c/strong\u003e\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"556\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Theme\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGoal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003eon the day of admission.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003eI participate in smart life\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e1.understand the needs of patients comprehensively\u003c/p\u003e\n \u003cp\u003e2.Introduce the discharge preparation service\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e①Participants are informed of the targets and meaning：nurses assess the patients the status of patients\u003c/p\u003e\n \u003cp\u003e②Teach patients to master the smart assisstant and applet\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2～3 days after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eI can manage\u003c/p\u003e\n \u003cp\u003eheart faliure\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eBuilding trust and relationship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e①Teach patients recognize the symptoms and signs associated with heart faliure and master first-aid related knowledge\u003c/p\u003e\n \u003cp\u003e②Teach patients master volume management instrument like oxygen saturation and knownoledge related to Oxygen therapy and heart failure diet management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4～5 days after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eI\u0026rsquo;m good with self-care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003epromote self-\u003c/p\u003e\n \u003cp\u003emanagement ability\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e①Teach patients master the cardiopulmonary function training and exercise intensity\u003c/p\u003e\n \u003cp\u003eTeach patients stay-home safety common sense,which helps patients arrange safe environments\u003c/p\u003e\n \u003cp\u003e②The device such as Xiaoai uses a set alarm to remind patients to take their medication、diet and defecation\u003c/p\u003e\n \u003cp\u003e③Help multimorbidity patients master the attention of disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Theme\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGoal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6～7 days after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eI feel relax because of the easy life\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMaintain a pleasant mood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e①Teach patients keep relax and reduce the stress\u003c/p\u003e\n \u003cp\u003e②Teach patients the simple and understandable movement modality\u003c/p\u003e\n \u003cp\u003e③Teach patients use ride-hailing services,which make patients live simple and effective\u003c/p\u003e\n \u003cp\u003e④The patients and their family explore psychological burden after discharge,which helps patients overcome difficulties\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8～10 days after admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eBe released from the hospital and \u0026nbsp;now back at home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGo home and enjoy the old age \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003e①Require considerable training and practice.The nurse demonstrates the skills that the patients would need once they go home\u003c/p\u003e\n \u003cp\u003e②Through the individual patient healthy education and multidisciplinary discussions,nurse makes a detailed list to address the rehabilitation concerns\u003c/p\u003e\n \u003cp\u003e③Provide patients with discharge process,discharge attention,regular visitation and regular re-examination\u003c/p\u003e\n \u003cp\u003e④All patients are given a follow-up plan to ensure they felt at ease\u003c/p\u003e\n \u003cp\u003e⑤Nurses help patients to contact relevant community agencies who can provide specialised support\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 11.6697%;\"\u003e\n \u003cp\u003e1 day before discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.5422%;\"\u003e\n \u003cp\u003eHealth always accompany me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.9031%;\"\u003e\n \u003cp\u003eKeep a healthy life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51.8851%;\"\u003e\n \u003cp\u003eAssist patients to complete the questionnaire\u003c/p\u003e\n \u003cp\u003eCommunicate with patients about the follow-up time and pathway after discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003eOutcome measures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe general questionnaire\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire was developed by the research group,including demographic data of the patients and disease-related data. The demographic data consists of age,sex and educational level et al.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe Hospital Discharge Preparation Scale(PDPS)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe primary outcome,hospital discharge preparation,is assessed by the Hospital Discharge Preparation Scale(PDPS)\u003csup\u003e[9]\u003c/sup\u003e.This scale contains three dimensions with a total of 12 entries.It has a content validity index of 0.88.The overall Cronbach\u0026rsquo;s alpha coefficient of the scale is 0.89. Each dimension ranges from 0.73 to 0.90.Each item is scored on a 0～10.A higher total score indicates a better hospital discharge preparation.Hospital discharge preparation will be considered high if it scores 7 and above and otherwise not well prepared.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe Quality of Discharge Teaching Scale(QDTS)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Quality of Discharge Teaching Scale was developed by Weiss et al\u003csup\u003e[8]\u003c/sup\u003e. It includes 3 dimensions: content needed (6 items), content received (6 items), and instruction skills and effects(12 items).A scoring system of 0～10 points is adopted.A higher total score indicates better quality discharge teaching.The Chinese version of the scale is tested for its validity and reliability.The content validity index (CVI) is 0.98.The Cronbach\u0026rsquo;s alpha coefficient is 0.92\u003csup\u003e[10]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe Rates of Unplanned Readmissions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eUnplanned readmission refers to readmission of patients in a short duration due to the same or related illness after discharge.Typically, the 30-day unplanned readmission rate is counted.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe Minnesota Living with Heart Failure Questionnaire\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe quality of life is assessed by completion of the Minnesota Living with Heart Failure Questionnaire\u003csup\u003e[11]\u003c/sup\u003e.The questionnaire contains 21 items, divided in three dimensions:5 items for affective dimension,8 items for physical dimension,8 items for the symptom dimension. Each item is scored from 0 as the lowest, to 5 as the highest, with a maximum total score of 105.Higher score indicates the poor quality of life.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eA 6-minute walk test\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the Chinese expert consensus\u003csup\u003e[12]\u003c/sup\u003e on the clinical application of 6-minute walk test in elderly patients,walking distance less than 100m indicates severe cardiac insufficiency;150m~300m indicates moderate cardiac insufficiency;301m ~ 450m indicates mild cardiac insufficiency.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFormation of multi-disciplinary team\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOur research team comprised a researcher,a postgraduate supervisor in nursing, a cardiology physician, a chief nurse working in the Department of Cardiology,a rehabilitation specialist,a nutritionist, a psychologist, three nurses and two nursing post-graduate students.Postgraduate supervisor in nursing was responsible for guiding the project.The chief nurse of working in the Department of Cardiology was responsible for coordinating the cooperation between the team members.Three nurses were responsible for the knowledge and skills training,data collection and implementation of intervention procedures.The cardiology physician was in charge of the education and training of the team members.A nutritionist was responsible for dietary instruction.The psychologist was responsible for discovering the psychological problems of patients and their families.The rehabilitation specialist developped personalizing the therapy and assisted the patient as needed in performing rehabilitation treatment.The post-graduate students collected relevant data, managed the Wechat and setted up the smart device.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData collection\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants completed the general questionnaires before intervention.At one day before discharge,nurses assisted patients to complete the Quality of Discharge Teaching Scale,the Hospital Discharge Preparation Scale,the Minnesota Living with Heart Failure Questionnaire,a 6-minute walk test.After completing the questionnaire, the forms were collected on the spot, and the accuracy of the questionnaire was checked at the same time to ensure the quality of collected data.At 1 month,3 months after discharge,the rates of unplanned readmissions and the Minnesota Living with Heart Failure Questionaire were collected by the the research team at outpatient clinics.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll data were analyzed with SPSS26.0 statistical software.Counting data were represented by the number of cases and percentage, and the chi-square test was used for comparison between groups.Shapiro-Wilk normality test was applied to examine whether data samples fit a normal distribution.Continuous variables with a normal distribution were expressed as mean standard deviation,and group comparisons were made using the independent sample T test.The data that did not meet the normal distribution was represented by median (upper quartile and lower quartile).Differences with\u003cem\u003e\u0026nbsp;P\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.05 were considered significant.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEthical approval\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis research study was conducted with the approval of the Ethics Committee of Qingdao Municipal Hospital.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn the intervention group,one patient died because of illness.One patient gave up participating in the research for various reasons.A total of forty-four patients in the intervention group completed the intervention.In the control group,one patient died because of illness.Two patients gave up participating in the research for various reasons.A total of forty-three patients in the control group completed the intervention.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBaseline data\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe sociodemographic,clinical characteristics and the baseline outcome variables across the study groups were presented in Table 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Sociodemographic, clinical characteristics and outcome variables at baseline\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"596\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003eIntervention group\u003c/p\u003e\n \u003cp\u003e（n=44）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003cp\u003e（n=43）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003et/ c2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e70.82\u0026plusmn;6.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e71.67\u0026plusmn;6.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.546\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eMan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e24 (53.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e28(65.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eWoman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e20 (46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e15(34.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 94px;\"\u003e\n \u003cp\u003eBMI(kg/m2 )\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e25.28\u0026plusmn;3.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e25.59\u0026plusmn;3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.474\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.636\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e18.5～23.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e18 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e13 (30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e24～27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e16 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e20 (46.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026gt;27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e10 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e10(23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003eHighest education level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eprimary school and below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e22 (50.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e19 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eSenior high school or Technical secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e10 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e11 (25.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003ecollege and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e12 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e13 (30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003eEmployment status, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eoff-the-job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e3 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e2 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.664\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eon-the-job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e41 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e41 (95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eNever married/widowed/\u003c/p\u003e\n \u003cp\u003edivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e12 (27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e16 (37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.984\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e32 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e27(62.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003ePlace of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eRural and townships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e27 (61.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e25 (58.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e17 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e18 (41.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003eLive by himself or with others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e6 (13.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e9 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.368\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e38 ( 86.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e34 (79.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003eIntervention group\u003c/p\u003e\n \u003cp\u003e（n=44）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003cp\u003e（n=43）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003et/\u0026nbsp;c2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003eMonthly household income, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026lt;1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e7 (15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e5 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.840\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1000～3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e19(43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e19 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026gt;3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e18(40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e19 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003ePayment manner of the medical expenses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003ePublic fee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e13(29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e15(34.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.886\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e18 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e19 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eSelf-paid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e13 (29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e9 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003eEF value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026gt;50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e10 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e17(39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 61px;\"\u003e\n \u003cp\u003e5.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e40～50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e32 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e21(48.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026lt;40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e2 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e5(11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNYHA Functional Classification, n(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eⅡ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e16 (36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e22 (51.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 61px;\"\u003e\n \u003cp\u003e1.936\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eⅢ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e28 (63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e21 (48.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNumber of complications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e2(4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e6(14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 61px;\"\u003e\n \u003cp\u003e2.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.255\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e13(29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e9(20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e29(65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e28(65.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 94px;\"\u003e\n \u003cp\u003eCause of disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eCoronary heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e41(93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e37(86.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.194\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.275\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003ehypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e32(72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e27(62.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.984\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e36(81.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e37(86.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eIntervention effect on the hospital discharge preparation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe intervention group had significantly higher scores than the control group for a total score of the hospital discharge preparation,the score of adaptive capacity dimension and anticipating receiving support dimension(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).However,there was no significant difference in the scores of individual\u0026rsquo;s status dimension between the two groups(\u003cem\u003eP\u003c/em\u003e\u003cstrong\u003e=\u003c/strong\u003e0.065).Please see Table 3 for details.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 \u0026nbsp;Presents a comparison of the total score of hospital discharge preparation and the scores of each dimension between the two groups after the intervention\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"650\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eIntervention group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003eT/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eMean difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003eStandard errors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eindividual\u0026rsquo;s status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e22.23\u0026plusmn;5.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e20.37\u0026plusmn;4.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e1.868\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e1.855\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e0.993\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e-0.12~3.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eadaptive capacity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e42.50\u003c/p\u003e\n \u003cp\u003e(37.00,47.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e34.00\u003c/p\u003e\n \u003cp\u003e(31.00,41.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e4.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e6.295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e1.473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e3.37~9.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eanticipating receiving support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e30.91\u0026plusmn;6.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e27.81\u0026plusmn;5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e2.479\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e3.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e1.249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e0.61~5.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eTotal score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e94.43\u0026plusmn;9.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e83.19\u0026plusmn;10.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e5.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e11.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e2.170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e6.93~15.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eIntervention effect on the quality of discharge teaching\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAfter intervention,the intervention group had a higher score of each dimension than those of the control group(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05),as shown in Table 4.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 Presents a comparison of the total score of the quality of discharge teaching of each dimension between the two groups after the intervention\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"667\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003eIntervention group(n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003eControl group(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003eT/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003eMean difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003eStandard errors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003eContent needed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e51.50\u0026plusmn;5.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e46.23\u0026plusmn;5.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e4.470\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e5.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e1.178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.92~7.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003eContent received\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e47.00\u003c/p\u003e\n \u003cp\u003e(44.25,53.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e43.00\u003c/p\u003e\n \u003cp\u003e(36.00, 46.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e4.587\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e6.555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e1.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.14~8.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003eInstuction skills and effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e90.50\u0026plusmn;10.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e86.19\u0026plusmn;9.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e1.986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e4.314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e2.172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e-0.01~8.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003eTotal score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e194.50\u003c/p\u003e\n \u003cp\u003e(176.00,202.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e178.00\u003c/p\u003e\n \u003cp\u003e(164.00, 185.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e4.331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u0026lt;0\u0026thinsp;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e16.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e3.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e9.77~22.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eIntervention effect on the rates of unplanned readmissions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe rates of unplanned readmissions of the two groups were compared by chi-square test at the 1 and 3 months after the intervention.The rates of unplanned readmissions in the intervention group at 1 month after the intervention were 11.4%,6.8% at 3 months after the intervention,while 37.2% 32.6%in the control group.The rates of unplanned readmissions in the intervention group were significantly lower than that in the control group, with a statistically significant difference(\u003cem\u003eP\u003c/em\u003e=0.005、0.002),as shown in Table 5.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5 Comparison of the rates of unplanned readmissions between the two groups at different time points\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 186px;\"\u003e\n \u003cp\u003e1 month after intervention(%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e3 months after intervention(%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eIntervention group(n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 186px;\"\u003e\n \u003cp\u003e5 (11.4)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e3 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eControl group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 186px;\"\u003e\n \u003cp\u003e16 (37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e14 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003e\u0026chi; 2\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 186px;\"\u003e\n \u003cp\u003e7.933\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e9.165\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eP\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 186px;\"\u003e\n \u003cp\u003e0.005\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eIntervention effect on the quality of life\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRepeated measures ANOVA showed there were statistically significant differences in the interaction effect of time with group in the two groups(F=3.69，\u003cem\u003eP\u003c/em\u003e=0.027).Pairwise comparisons were made among the intervention group at three different time points by Bonferroni method.At 3 months after intervention, the quality of life scores in the intervention group were obviously lower than those before the intervention(38.59\u0026plusmn;18.48 to 24.25\u0026plusmn;9.77)(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001).However,there were no significant differences across time points in the control group(36.65\u0026plusmn;15.59 to 34.09\u0026plusmn;8.53)(\u003cem\u003eP\u003c/em\u003e=\u003c/p\u003e\n\u003cp\u003e0.569).The independent-samples t test was adopted for inter-group comparison.At 3-month after intervention, the quality of life scores in the intervention group were obviously lower than the control group( \u003cem\u003eP\u003c/em\u003e=0.599,0.468,\u0026lt;0.001),as shown in Table 6.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6 Comparison of the quality of life between the two groups at different time points\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003eBefore hospital discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e1-month after intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e3-month after intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eIntervention group(n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e38.59\u0026plusmn;18.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e31.25\u0026plusmn;14.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e24.25\u0026plusmn;9.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e10.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003eControl group(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e36.65\u0026plusmn;15.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e33.7\u0026plusmn;16.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e34.09\u0026plusmn;8.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.569\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003et/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e-0.729\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e-5.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e0.599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eIntervention effect on the result of the 6-minute walk test\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRepeated measures ANOVA showed there were statistically significant differences in the interaction effect of time with group of the 6-minute walk test in the two groups(F=5.12,\u003cem\u003eP\u003c/em\u003e=0.007).Bonferroni pairwise comparisons for intervention group data at three time points showed the results of 6-minute walk test of 1 month and 3 months after discharge were significantly higher than those before discharge(218.31\u0026plusmn;25.05 to 264.4\u0026plusmn;42.17)(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001).However,there were no significant differences found across time points in the control group(211.24\u0026plusmn;20.57 to 221.92\u0026plusmn;33.34)(\u003cem\u003eP\u003c/em\u003e=0.117). The results of independent samples t-test indicate that the results of 6-minute walk test of intervention group were significantly higher than the control group at 1 month and 3 months after discharge,and the differences are statistically significant(\u003cem\u003eP\u003c/em\u003e=0.005,\u0026lt;0.001),as shown in Table 7.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7 Comparison of the result of the 6-minute walk test between the two groups at different time points\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003eBefore hospital discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e1-month after intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e3-month after intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eIntervention group(n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e218.31\u0026plusmn;25.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e252.27\u0026plusmn;40.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e264.4\u0026plusmn;42.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e16.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eControl group(n=43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e211.24\u0026plusmn;20.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e226.41\u0026plusmn;42.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e221.92\u0026plusmn;33.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.117\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003et/Z\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e1.436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e2.898\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e5.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026lt;0\u0026thinsp;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cem\u003eThe hospital discharge preparation intervention may improve the hospital discharge preparation and the quality of discharge teaching\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, hospital discharge preparation score in the intervention group was significantly better than in the control group.The reason could be that education duration was maximized,which also alleviated the problems of inadequate preparation in patients.Then, it solved the problems of the elderly with poorer ability to comprehend to some extent by introducing advanced technology and tools.In terms of the education designing,the research carried out a scientific and reasonable nursing work under the guidance of discharge preparation model.It is evident from data that the quality of discharge teaching of intervention is significantly better than the control group(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).To analyze the reason,verbal discharge instructions was common in routine predischarge guidance.In the face of the medical knowledge,the elderly exhibited difficulty in remembering the content of medical knowledge.Eight healthy education modules linked the smart assistant,which helps patients master disease knowledge and skills,so as to ensure the continued care of patients after discharge from the hospital and improve the quality of discharge teaching.Patients began to know the importance of self-care,which can stimulate their self-responsibility to actively obtain relevant health knowledge and nursing skills from passive acceptance to active participation\u003csup\u003e[13]\u003c/sup\u003e.Patients progressed onto practice after mastering fundamental knowledge,reinforcing the understanding of theoretical knowledge.Also,researchers provided certain rewards to motivate patients to form the behavioral conditioning.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe hospital discharge preparation intervention may improve the quality of life\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFrom the research data it was evident that the quality of life for the two groups of patients showed no significant difference at 1 month post-intervention(\u003cem\u003eP\u003c/em\u003e=0.468).At 3 months after the intervention, the intervention group indicated significantly lower score of the quality of life than that in the control group.Conclusion from this study, the time of discharge had a positive correlation to the quality of life of patients.In the process of discharge preparation intervention,using tasks lists prompted patients to targeted self-monitoring.The complex knowledge was presented in older patients in a relatively easy way to interpret and understand.It could help patients face their disease more actively.It prevented deterioration of disease and avoided the changes in the patient\u0026rsquo;s condition to some extent.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe hospital discharge preparation intervention can reduce the rates of unplanned readmissions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFrom the present study, it was evident that the rates of unplanned readmissions was 11.4% at one month,6.8% at three months.The result was lower than in the control group (37.2% at one month,32.6% at three months),which was also consistent with the conclusion of Mabire\u0026rsquo;s meta-analysis\u003csup\u003e[14]\u003c/sup\u003e.Therefore,this difference was statistically significant(\u003cem\u003eP\u003c/em\u003e=0.005,0.002).The results demonstrated that the hospital discharge preparation intervention could reduce the rates of unplanned readmissions.Unplanned readmission was often related to inadequate preparation before discharge.\u003c/p\u003e\n\u003cp\u003eAnd there were lots of predisposing factors and uncertainties.Patients might not be able to address these issues on their own when an emergency happens,which increases the rates of unplanned readmissions. Nurse in the intervention group systematically assessed patient\u0026rsquo;s needs in the discharge transition processes,and through multidisciplinary teamwork, our researcher makes full use of out-of-hospital and intrahospital resources to establish a long-term mechanism of discharge preparation.These interventions could improve the self-management ability of the patient,ensuring their health and quality of life eventually.Furthermore, the symptoms of HF cannot be initially recognized by patients because of its insidious onset compared to the acute onset of symptoms in myocardial infarction or stroke.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAfter intervention,patients could be quick to master the skills of the identification method of acute onset of heart failure.This improved the patient\u0026rsquo;s ability to predict and deal with the stressful future event and reduced the rate of unplanned readmission\u003csup\u003e[15]\u003c/sup\u003e.This intervention provided patients with the training about heart failure knowledge and skills,which improved the patient\u0026rsquo;s ability of self-care.\u003c/p\u003e"},{"header":"Declarations","content":" \u003c/p\u003e\u003cp\u003e \u003ch2\u003eFinancial Support\u003c/h2\u003e \u003cp\u003eThere are currently no funding sources.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eClinical trial number\u003c/strong\u003e \u003cp\u003enot applicable.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eThe Consent of Participate declaration\u003c/strong\u003e \u003cp\u003eAll authors of this paper agreed to participate in the writing and publication of this paper.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eYaoyao Ding design of the work, Min Shan and Yaoyao Ding wrote the main manuscript text, Guangdi Xi prepared table 1-7, Yaxi Wang and Yan Xu and Guangdi Xi collected and analysed the research dates. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHeidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the. Am Heart Association [J] Circulation. 2011;123(8):933\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReyes EB, Ha JW, Firdaus I, et al. Heart failure across Asia: Same healthcare burden but differences in organization of care[J]. Int J Cardiol. 2016;223:163\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCardiovascular Group G, B C M, Elderly H F I. T. Chinese experts consensus on the diagnosis and treatment of chronic heart failure in the elderly[J]. Chin J Geriatr. 2021;40(5):550\u0026ndash;61. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.issn.0254-9026.2021.05.002\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.issn.0254-9026.2021.05.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eColeman EA, Boult C. Improving the Quality of Transitional Care for Persons with Complex Care Needs: Position Statement of The American Geriatrics Society Health Care Systems Committee[J]. Journal of the American Geriatrics Society; 2003.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan Harriette. Spall. Transition care with telemonitoring did not reduce readmission after hospitalization for heart failure.[J]. Annals of internal medicine; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYongqiong Hu YD. Assessment of the application and impact of discharge planning for patients with Chronic Heart Failure[J]. Chin Nurs Manage. 2016;16(04):531\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu QM, Liu J, Hu HY, et al. Effectiveness of nurse-led early discharge planning programmes for hospital inpatients with chronic disease or rehabilitation needs: a systematic review and meta-analysis[J]. J Clin Nurs. 2015;24(19\u0026ndash;20):2993.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeiss ME, Bobay KL, Bahr SJ et al. A Model for Hospital Discharge Preparation[J]. J Nurs Adm, 2015,45(12).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin YH, Kao CC, Huang AM, et al. [Psychometric testing of the chinese version of the readiness for hospital discharge scale].[J]. Hu LI Za Zhi. 2014;61(4):56\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBing-hua W, Hui W, Chun-zi Y. Reliability and validity of the Chinese version of the Quality of Discharge Teaching Scale[J]. Chin J Nurs. 2016;51(6):752\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3761/j.issn.0254-1769.2016.06.025\u003c/span\u003e\u003cspan address=\"10.3761/j.issn.0254-1769.2016.06.025\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJaarsma T, Restedt KF, Rtensson M. The European Heart Failure Self-care Behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument[J]. Eur J Heart Fail. 2014;11(1):99\u0026ndash;105.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSociety CG. Chinese expert consensus on the clinical application of 6 Minute Walk Test in elderly patients[J]. Chin J Geriatr. 2020;39(11):1241\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3760/cma.j.issn.0254-9026.2020.11.001\u003c/span\u003e\u003cspan address=\"10.3760/cma.j.issn.0254-9026.2020.11.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLili Gao Y, Z M L. Research progress of intervention strategies for patient discharge readiness at home and abroad[J]. J Nurs (China). 2020;27(10):28\u0026ndash;31. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.16460/j.issn1008-9969.2020.10.028\u003c/span\u003e\u003cspan address=\"10.16460/j.issn1008-9969.2020.10.028\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eA C M, B S B, C D A B, et al. Patient readiness for hospital discharge and its relationship to discharge preparation and structural factors: A cross-sectional study - ScienceDirect[J]. Int J Nurs Stud. 2019;90:13\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeeks K, Kile D, Garber J. Implementing a Nurse Discharge Navigator: Reducing 30-Day Readmissions for Heart Failure and Sepsis Populations[J]. Prof Case Manage, 2020,25.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Discharge preparation interventions, Elderly patients, Chronic heart failure","lastPublishedDoi":"10.21203/rs.3.rs-6126299/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6126299/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study aimed to evaluate the effects of the interventions on the readiness for hospital discharge in elderly patients with chronic heart failure.The primary outcome was the readiness for hospital discharge.The secondary outcomes were the quality of discharge teaching,and the rates of unplanned readmissions and the quality of living.The clinical outcome includes the 6-minute walk test.\u003c/p\u003e\u003ch2\u003eDesign:\u003c/h2\u003e \u003cp\u003eA randomized controlled trial was conducted.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 92 participants admitted for heart failure were recruited from the cardiology departments of a public hospital in Qingdao.They were randomly allocated to the control group and the intervention group.All participants received the usual care. Participants in the intervention group received the discharge preparation interventions. Data were collected at baseline,1 month, 3 months from baseline.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eCompared to the control group, participants in the intervention group had significantly higher levels of discharge preparation(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05) and the quality of discharge teaching at 1-month,3-month follow-ups(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).Patients in the intervention group experienced significantly lower the quality of living level than patients in the control group at 3-month follow-ups(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).The research showed that the result of 6-minute walk test was higher among participants in the intervention group than those in the control group at 3-month follow-ups(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).At 1-month and 3-month after intervention,the rates of unplanned readmissions were compared between the two groups.The rates of unplanned readmissions were 11.4% at 1-month,was 6.8% at 3-month in the intervention group, but it was 37.2% at 1-month and 32.6% at 3-month in the control group.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDischarge preparation interventions can effectively improve discharge preparation level and the quality of discharge teaching,improve the quality of life,and reduce the rate of unplanned readmission.\u003c/p\u003e","manuscriptTitle":"Effects of interventions on the readiness for hospital discharge in elderly patients with chronic heart failure: A Randomized Controlled Trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-22 10:51:20","doi":"10.21203/rs.3.rs-6126299/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision 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Nursing","date":"2025-03-20T14:39:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"63297c43-ab6d-413d-9e2c-5c15ae4f2605","owner":[],"postedDate":"April 22nd, 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