Mixed-methods study examining patients’ perceptions of the relationship between Discharge Teaching, Social Support, and Patient Readiness for Discharge

Mixed-methods study examining patients’ perceptions of the relationship between Discharge Teaching, Social Support, and Patient Readiness for Discharge | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Mixed-methods study examining patients’ perceptions of the relationship between Discharge Teaching, Social Support, and Patient Readiness for Discharge Qiongyan GAI, Jin Sun, Yajuan Weng, Jie Xu, Ping Li, Zhihong Wei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8972570/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Safe hospital-to-home transitions are critical for older patients undergoing robot-assisted radical prostatectomy (RARP), yet many face post-discharge self-management challenges. While discharge education and social support are vital, their specific contributions to readiness for hospital discharge (RHD) in this population remain under-explored. Methods An explanatory sequential mixed-methods design was employed at Nanjing Drum Tower Hospital, China. First, a cross-sectional survey (December 2022–April 2023) assessed sociodemographic characteristics, discharge teaching quality, and RHD in older men (aged 60–80) following RARP. Quantitative data were analyzed using descriptive statistics, multiple linear regression, and Importance-Performance Analysis (IPA). Subsequently, a qualitative descriptive phase (August 2023–January 2024) involved semi-structured interviews with 20 purposively selected patients (10 inpatients, 10 outpatients) to explain quantitative findings. Interviews were analyzed using inductive content analysis via NVivo 11. Results A total of 129 patients completed the survey (response rate: 84.9%; mean age 70.5 ± 5.1 years). Participants reported high RHD (mean 8.34 ± 0.63) and discharge teaching quality (mean 8.47 ± 0.45). IPA indicated that five key areas, including medical handling, fell into the “high importance–high performance” quadrant. Regression analysis identified discharge teaching quality (β = 0.599, p < 0.001) and social support (β = 0.210, p = 0.002) as significant predictors of RHD (adjusted R² = 0.449). Qualitative analysis of 20 interviews revealed two central themes: (1) “Personal support provided for gaining a sense of control,” highlighting the critical role of spousal care, economic security, and continuity of professional care in managing physical recovery; and (2) “Social support provided for personal growth,” emphasizing the need for peer interaction to reduce isolation and restore self-esteem and normalcy. Conclusions Older RARP patients generally exhibit high discharge readiness, significantly driven by discharge teaching quality and social support. While technical and tangible support from staff and spouses ensures physical safety and control, psychological adaptation requires broader social support, including peer validation and dignity preservation. Interventions should integrate structured education with enhanced social systems—such as peer groups and continuity of care models—to optimize recovery. Health sciences/Health care Health sciences/Urology Robot-assisted radical prostatectomy Readiness for hospital discharge Mixed methods Older adults Social support Figures Figure 1 Background Prostate cancer represents a significant and growing health burden for men worldwide, particularly among the aging population. In recent years, there emerges an annual increase of prostate cancer incidence in China, and its incidence rate ranks the 7th and mortality rate ranks the 10th among malignant tumors in Chinese men [ 1 – 3 ]. Robot-assisted radical prostatectomy (RARP) has emerged as the gold-standard surgical treatment for localized prostate cancer, offering benefits such as reduced blood loss and shorter hospital stays [ 4 – 5 ]. Following RARP, a critical aspect of postoperative management is the mandatory use of an indwelling urinary catheter, typically for one to two weeks, to ensure the integrity of the urethral-bladder anastomosis and prevent complications like urinary fistulas [ 6 ]. However, the catheter itself is a significant source of patient morbidity. It is not only a primary driver of postoperative pain [ 7 ] but also predisposes patients to a constellation of catheter-related complications, such as urinary tract infection, urinary catheter displacement, bladder spasms, hemorrhage, obstruction, peri-catheter leakage, and incontinence, etc. All of them affect patients' postoperative recovery process, together with negative effects on their physical and mental health, sense of self-efficacy, and quality of life [ 8 ]. The transition from the structured hospital environment to home-based self-management is a period of heightened vulnerability for these patients. The responsibility for a range of complex care tasks—from surgical site care and pelvic floor muscle training to managing the psychological impact of the disease and its treatment—shifts abruptly to the patients and their families, who often feel overwhelmed by these high supportive care needs [ 9 – 12 ]. Ensuring a successful transition hinges on the patient's Readiness for Hospital Discharge (RHD), defined as a patient's subjective assessment of their ability to manage their care outside the hospital [ 13 ]. High RHD is a critical patient-centered outcome, consistently linked to fewer adverse events, reduced readmission rates, and improved quality of life post-discharge [ 14 ]. While literature consistently identifies quality of discharge teaching and social support as two key modifiable determinants of RHD [ 15 – 17 ], their interplay and specific relevance for the post-RARP population are poorly understood, presenting critical knowledge gaps. Consequently, a significant disjuncture has emerged between the clinical imperative to prepare these patients, and the empirical foundation required to guide evidence-based practice. First, while the benefits of discharge teaching are known, the specific educational topics that are most important to older RARP patients versus how well they are being delivered have not been systematically evaluated. Second, the relative contribution of discharge teaching versus social support in predicting RHD within this specific, high-risk surgical population remains unclear. Furthermore, quantitative surveys alone are insufficient to fully capture the complexities of the transition experience. They may reveal that patients feel unsupported or unprepared, but they cannot explain why these gaps exist or describe the lived reality of coping with catheter care and psychological stress at home [ 18 ]. A mixed-methods approach is therefore necessary to bridge the gap between statistical trends and the patients' detailed perspectives. Therefore, this study employed an explanatory sequential mixed-methods design to: (1) investigate the levels of discharge readiness, quality of discharge teaching, and social support in older patients after RARP; (2) determine the relationship between these variables and identify the key predictors of discharge readiness; (3) use Importance-Performance Analysis (IPA) to pinpoint specific areas for educational improvement; and (4) deepen the understanding of these gaps by exploring patients’ in-depth experiences and unmet needs during the transition from hospital to home. Materials and Methods Study Design An explanatory sequential mixed-methods design was adopted to investigate readiness for hospital discharge (RHD) among older patients following RARP. The study began with a quantitative cross-sectional survey to identify general trends and predictors of discharge readiness. Based on the quantitative findings, a qualitative descriptive study was subsequently conducted to explore the underlying reasons for the statistical results and gain deeper insights into patients’ lived experiences. Participants and Recruitment The study was conducted at the Department of Urology, Nanjing Drum Tower Hospital in Nanjing, China. For the quantitative survey (December 2022 to April 2023), convenience sampling was used to recruit older adult patients. Inclusion criteria were: (1) male patients aged 60 to 80 years; (2) able to comprehend and respond to the questionnaire items; and (3) aware of their diagnosis and willing to participate. Patients were excluded if they: (1) exhibited unstable vital signs or severe postoperative complications that precluded participation; (2) had significant cognitive impairment; or (3) had a family request for non-disclosure of the diagnosis. For the qualitative interview (August 2023 to January 2024), purposive sampling was used to select 20 participants (10 inpatients and 10 from the follow-up clinic). The inclusion and exclusion criteria were consistent with those of the quantitative study. Based on the rule of thumb of 5-10 subjects per item for multivariate analysis, the sample size of 129 was considered sufficient for the regression model involving three main variables. Ethical Considerations This study was approved by the Institutional Review Board (IRB) of Nanjing Drum Tower Hospital (Approval No. 2022-533-02) and was conducted in accordance with the principles of the Declaration of Helsinki. All participants provided written informed consent for the survey and, where applicable, the audio-recorded interviews. They were assured of the confidentiality of their responses and their right to withdraw at any time. Measures Readiness for Hospital Discharge The Readiness for Hospital Discharge Scale (RHDS), developed by Weiss and Piacentine [13], was used to assess patients' perception of their preparedness for discharge. This 23-item scale comprises four subscales: Personal Status, Knowledge, Coping Ability, and Expected Support. Items are rated on an 11-point numerical scale ranging from 0 (not ready) to 10 (totally ready), with higher scores indicating greater readiness. In the current study, the scale demonstrated excellent reliability with a Cronbach’s alpha coefficient of 0.93, and the coefficients for the subscales ranged from 0.85 to 0.93. The content validity index of the scale was 0.85. Quality of Discharge Teaching The Quality of Discharge Teaching Scale (QDTS), developed by Weiss et al. [26], was employed to evaluate patients' perceptions of the education provided by nurses. The scale consists of 24 items divided into two dimensions: Content Received (what was taught) and Delivery and Effectiveness (how it was taught and its impact). The first 12 items form 6 paired sets that allow for a comparison between “needed content” and “received content” to identify gaps for improvement. In this study, the overall Cronbach’s alpha coefficient for the QDTS was 0.92. The coefficients for the “Content Received” and “Delivery and Effectiveness” subscales were 0.85 and 0.93, respectively, indicating high internal consistency comparable to the original English version. Social Support Social support was evaluated using the Social Support Rating Scale (SSRS) developed by Xiao [27], a widely validated instrument in China. The scale consists of 10 items across three dimensions: Subjective Support, Objective Support, and Utilization of Support. The items include a mix of single-choice (7 items) and multiple-choice (3 items) formats. The total score ranges up to 66, with higher scores indicating a higher level of social support. In this study, the overall Cronbach’s alpha coefficient for the SSRS was 0.708, with subscale coefficients ranging from 0.492 to 0.702. Data Collection Procedure Quantitative data were collected using a paper-based questionnaire booklet. A trained researcher approached eligible patients to provide a comprehensive explanation of the study, including its purpose, procedures, the voluntary nature of participation, and the estimated time for completion. After obtaining written informed consent, the questionnaires were distributed. Patients were asked to complete the questionnaire independently. For those with physical limitations that precluded independent completion (e.g., visual impairment or physical incapacity), the researcher read the items aloud and recorded their verbal responses verbatim to ensure data accuracy and completeness. Qualitative data were collected through semi-structured interviews. The time and location were arranged in advance with participants to ensure a quiet, comfortable, and suitable environment. Prior to the interview, the researcher explained the study's purpose and significance in detail, and audio recording was conducted only after obtaining the participant's consent. Interviews lasted between 20 and 30 minutes. Sampling and interviewing continued until data saturation was reached, defined as the point where no new themes emerged. Upon completion of the interview, each participant was asked to complete a general demographic questionnaire. Data Analysis Quantitative data analysis Statistical analyses were performed using SPSS software (version 27.0). Descriptive statistics, including frequencies and percentages for categorical variables, and means with standard deviations (Mean ± SD) for continuous variables, were calculated to summarize sociodemographic characteristics, discharge teaching quality, and discharge readiness scores. One-way Analysis of Variance (ANOVA) was employed to examine differences in discharge readiness, teaching quality, and social support across various demographic groups. Pearson’s correlation analysis was conducted to assess the relationships between discharge teaching quality, social support, and discharge readiness. To identify independent predictors of discharge readiness, a multiple linear regression model was constructed. Additionally, Importance-Performance Analysis (IPA) was utilized to evaluate discrepancies between patient expectations and the actual information received, with paired samples t-tests used to compare the differences between importance and satisfaction scores for specific topics. A two-tailed p-value < 0.05 was considered statistically significant. Qualitative data analysis All interviews were audio-recorded and transcribed verbatim within 24 hours to ensure accuracy and completeness. Data management was facilitated using NVivo 11 software (QSR International). We employed an inductive content analysis approach involving a three-phase coding process: preparation, organizing, and reporting. First, the researchers achieved data immersion by reading the transcripts repeatedly to obtain a holistic understanding of the participants’ experiences. Second, meaning units—sentences or paragraphs relevant to the study objectives—were extracted and assigned initial codes. Third, codes with similar patterns were grouped into categories (sub-themes). Finally, through an iterative process of abstraction, these categories were synthesized into central themes. Representative quotes were selected to substantiate the findings and ensure the results were grounded in the data. Results Participant Characteristics Quantitative Survey Participants Characteristics A total of 152 questionnaires were distributed, of which 129 were returned as valid and included in the final analysis, yielding an effective response rate of 84.9%. These participants were older men with a mean age of 70.5 ± 5.1 years, predominantly in the 70–74 age group (41.1%). Participants were predominantly of Han ethnicity (99.2%) and mainly from urban environments (79.1%), with a significant concentration residing in Nanjing, Jiangsu Province (64.3%). Regarding family structure and support, 97.7% of the participants were married. The majority (62.0%) lived in two-person households (living with spouse only), and spouses assumed the primary caregiving role for nearly all patients (93.8%). Socioeconomically, the majority were retired (87.6%) and had attained secondary education (junior/senior high or vocational school, 63.6%). Most reported an annual household income between 10,000 and 100,000 RMB (69.8%), and public medical insurance coverage was nearly universal (96.9%). Clinically, the most frequently observed Gleason score was 7 (55.8%). Detailed sociodemographic and clinical characteristics are presented in Table 1. Table 1 Quantitative Survey Participants Characteristics (n=129) Characteristics n (%) Age (years) 60-64 21 (16.3) 65-69 27 (20.9) 70-74 53 (41.1) 75-80 28 (21.7) Residency Rural 27 (20.9) Urban 102 (79.1) Location Nanjing (Local) 83 (64.3) Outside Nanjing 46 (35.7) Education Level Graduate students and above 3 (2.3) Undergraduate 8 (6.2) Junior college 14 (10.9) Senior high schools (Technical secondary schools) 40 (31.0) Junior high schools 42 (32.6) Primary school 20 (15.5) No or very little literacy 2 (1.6) Employment Status Retired 113 (87.6) Farmer 12 (9.3) Employed 4 (3.1) Annual Household Income (RMB) ≤ 10,000 16 (12.4) 10,001-100,000 90 (69.8) 100,001-200,000 17 (13.2) ≥ 200,000 6 (4.7) Residential situation Spouse cohabitation 80 (62.0) Live alone 4 (3.1) Others 45 (34.9) Caregiver availability spouse 121 (93.8) children 3 (2.3) None (Self-care) 5 (3.9) Gleason score 6 38 (29.5) 7 72 (55.8) 8 19 (14.7) Qualitative Interview Participants Characteristics Purposive sampling was used to select 20 participants for semi-structured interviews. Participants were stratified into two groups: The pre-discharge group (n=10) had a mean age of 69.9 ± 6.5 years (range: 60–83). Five participants resided in Nanjing, while the remaining five were from other cities. All were married, and most (n=9) lived exclusively with their spouses. Care was primarily provided by wives, with supplemental support from children (n=5) or siblings (n=1). The majority were retired (n=8), and the most prevalent Gleason score was 7 (n=5). The mean total length of stay (LOS) was 7.6 ± 1.3 days, with a mean postoperative stay of 4.1 ± 0.9 days (Table 2). Table 2. Characteristics of Pre-discharge Participants (n=10) ID Age Residency Occupation Insurance Caregivers Living Arrangement Gleason Score Total LOS (d) Post-op LOS (d) F1 66 Local Retired UEBMI Spouse Spouse only 6 7 4 F2 69 Local Retired UEBMI Spouse Spouse only 6 7 3 F3 74 Local Retired UEBMI Spouse Spouse only 7 8 5 F4 64 Local Retired UEBMI Spouse Spouse only 7 9 5 F5 69 Non-local Farmer URBMI Spouse & Children Extended family † 6 8 4 F6 72 Non-local Retired UEBMI Spouse & Children Spouse only 8 7 4 F7 60 Non-local Retired UEBMI Spouse & Children Spouse only ‡ 7 9 5 F8 67 Non-local Retired UEBMI Spouse Spouse only 6 9 5 F9 83 Local Freelance URBMI Spouse & Children Spouse only 7 5 3 F10 75 Non-local Retired UEBMI Spouse & Family Spouse only 7 7 3 Note: Abbreviations: LOS = Length of Stay; UEBMI = Urban Employee Basic Medical Insurance; URBMI = Urban Resident Basic Medical Insurance. Residency: "Local" refers to residents of Nanjing; "Non-local" refers to residents outside of Nanjing. † Participant lives with spouse, son, and daughter-in-law (extended family). ‡ Participant lives with spouse; children reside in the same residential community. The post-discharge group (n=10) comprised patients interviewed during outpatient follow-up, 10 to 14 days after surgery. The mean age was 69.6 ± 4.6 years (range: 62–75). As with the pre-discharge group, the majority were residents of Nanjing (n=9). Most participants primarily were married (n=9) and lived in two-person households with their spouses (n=7). Care was primarily provided by spouses, with assistance from children (n=3) or siblings (n=1). The most prevalent Gleason score was 6 (n=5). The mean duration of indwelling catheterization was 13.8 ± 0.8 days (Table 3). Table 3. Characteristics of Post-discharge Participants (n=10) ID Age Residency Occupation Insurance Caregivers Living Arrangement Gleason Score Total LOS (d) Catheter Days H1 71 Local Retired UEBMI Spouse Spouse only 8 6 14 H2 67 Local Retired UEBMI Spouse Spouse only 7 7 14 H3 75 Non-local Retired UEBMI Spouse Spouse only 6 6 12 H4 74 Local Retired UEBMI Spouse Spouse only 7 5 14 H5 62 Local Retired UEBMI Spouse Spouse only 6 8 14 H6 73 Local Retired UEBMI Spouse & Children Extended family † 6 6 14 H7 63 Local Retired UEBMI Spouse Spouse only 6 9 15 H8 71 Local Retired UEBMI Spouse & Siblings Spouse only ‡ 6 5 14 H9 67 Local Retired UEBMI Children With children 8 9 13 H10 73 Local Retired UEBMI Children Living alone § 7 9 14 Note: Abbreviations: LOS = Length of Stay; UEBMI = Urban Employee Basic Medical Insurance. Residency: "Local" refers to residents of Nanjing; "Non-local" refers to residents outside of Nanjing. † Participant lives with spouse and children. ‡ Participant lives with spouse; siblings provide care but reside elsewhere. § Participant lives alone, with children residing in the same building. Quantitative results Discharge Readiness and Teaching Patients in the study sample reported a high level of readiness for hospital discharge, evidenced by a mean score of 8.34 (SD = 0.63). The overall perceived quality of discharge teaching was also rated favorably (mean = 8.47, SD = 0.45). Within this domain, the delivery dimension (mean = 8.77, SD = 0.44) scored higher than the received content dimension (mean = 7.86, SD = 0.64). Importance-Performance Analysis (IPA) revealed that five of six items—including home assistance, medical handling, treatment information, family care, and self-care—were rated in the “high importance–high performance” quadrant (Figure 1). Figure 1 Four-quadrant plot of IPA Social Support The mean total score on the Social Support Rating Scale was 41.62 (SD = 5.38). The mean scores for the subscales were 22.19 (SD = 2.70) for subjective support, 11.43 (SD = 1.77) for objective support, and 7.99 (SD = 2.29) for utilization of support. Univariate analysis revealed that social support scores differed significantly across groups based on education, occupation, income, and marital status (all p < 0.05). Post-hoc tests further clarified these differences. For instance, patients with a bachelor’s degree or above reported significantly higher total support scores compared to those with a junior high/vocational school education (MD = 4.90, p < 0.05), a middle school education (MD = 5.70, p < 0.01), or an elementary school education (MD = 7.08, p < 0.01). Similarly, farmers reported significantly lower total support scores than retirees (MD = -3.48, p < 0.05) and enterprise employees (MD = -7.67, p < 0.01). Significant differences were also observed in support utilization scores across these groups. Relationship Between Discharge Readiness, Teaching, and Social Support Correlation analysis showed that discharge readiness was positively correlated with both discharge teaching ( r = 0.645, p < 0.01) and social support ( r = 0.340, p < 0.01). Discharge teaching and social support were also positively correlated ( r = 0.217, p < 0.05). Multiple linear regression (Table 4) identified discharge teaching and social support as significant predictors of discharge readiness (adjusted R ² = 0.449, p < 0.001). Among them, discharge teaching exerted the strongest effect ( β = 0.599), followed by social support ( β = 0.210). Table 4 Multiple regression analysis on influencing factors of discharge readiness Independent Variables B SE β t P VIF (Constant) 0.193 0.796 — 0.242 0.809 — Total Social Support Score 0.025 0.008 0.21 3.12 0.002 1.05 Discharge Teaching Quality 0.841 0.094 0.599 8.917 0.001 1.05 Model Summary Adjusted R² 0.449 F-value 53.188 Durbin-Watson 1.888 Note: Dependent Variable: Discharge Readiness. VIF = Variance Inflation Factor. Qualitative results Based on the analysis of the semi-structured interviews, the supportive care needs and experiences of patients were categorized into six sub-categories, which were further synthesized into two central themes: (1) Personal support provided for gaining a sense of control (addressing physiological and safety needs); and (2) Social support provided for personal growth (addressing belongingness and esteem needs). The thematic framework is presented in Table 5. Table 5. Thematic Framework of Post-discharge Support Needs Central Themes Sub-categories Key Elements Theme 1: Personal support provided for gaining a sense of control Tangible & Financial Support Spousal caregiving; assistance with ADLs; impact of insurance coverage; financial burden on retirees. Information & Continuity Specificity of discharge instructions; direct access to surgeons; distrust of fragmented primary care. Trust & Professionalism Empathy from staff; need for "one-on-one" communication; safety in established medical relationships. Theme 2: Social support provided for personal growth Belonging & Peer Support Shared understanding in patient groups; emotional validation from peers; reducing isolation. Self-Esteem & Normalcy Preserving dignity; privacy regarding medical devices (e.g., catheter bags); finding purpose in hobbies. Theme 1: Personal Support for Gaining a Sense of Control This theme highlights the fundamental requirements for patients to manage their physical recovery and navigate the healthcare system safely. Tangible and Economic Security Spouses, particularly wives, were identified as the cornerstone of daily support, managing household chores and nursing tasks. This tangible support allowed patients to focus on recovery without domestic worries. However, economic stability was a major determinant of psychological burden. While patients with comprehensive insurance and pensions felt secure, those with limited coverage expressed significant anxiety regarding the high costs of prostate cancer treatment. “For us retired enterprise workers, it is a big burden. But there is no other way; to save my life, I must treat it... even if my family's finances were poor, we had to find a way to pay.” (Participant F1) Continuity of Care and Trust Patients prioritized professional authority and continuity. They expressed a strong preference for follow-up care provided by their original surgical team rather than rotating doctors or community clinics. Trust was built on the surgeon's familiarity with their specific case and the perceived professional competence of the nursing staff. The lack of a unified referral system made patients reluctant to use community health centers for catheter maintenance. “I prefer coming here [the tertiary hospital] because the chief surgeon knows my condition firsthand... If the community hospital were linked to the big hospital in a unified system, that would be convenient, but otherwise, I don't trust private clinics.” (Participant F6/H1) “When I see the clear discharge instructions... knowing exactly when to remove the catheter and when to review the pathology report, I feel confident. ” (Participant F4) Theme 2: Social Support for Personal Growth Beyond physical safety, patients sought support that fostered psychological adaptation, belonging, and a return to normalcy. Empowerment through Shared Experience Interacting with peers who shared similar medical histories provided a unique form of emotional validation that family members could not offer. Whether through online groups or offline interactions, witnessing the recovery of others reduced feelings of isolation and fear. “My colleague had the same disease... but he looks great. [I realized] this is not a death sentence.” (Participant F2) “We are like a group; everyone has experienced the same thing. I think chatting with them is also a form of rehabilitation.” (Participant H3) Restoring Self-Esteem and Normalcy Patients strove to maintain their identity beyond being a "patient." They expressed a strong desire for privacy, often hiding visible signs of illness (such as drainage bags) to avoid pity or public scrutiny. Engaging in meaningful hobbies (e.g., music, outdoor activities) served as a critical coping mechanism, helping them regain a sense of inner peace and control over their lives. “I try to hide the drainage bag as much as possible when I go out. Otherwise, people know you are a patient and stare at you. I want to be normal.” (Participant F1) “I play the piano at home. As soon as the music starts, my spirits lift immediately because I feel this is part of my life.” (Participant F2) Discussion This study employed a mixed-methods approach to comprehensively evaluate the discharge readiness and supportive care needs of older patients undergoing RARP. The quantitative results indicated high levels of discharge readiness, strongly driven by the quality of discharge teaching and social support. The high level of discharge readiness observed in this cohort appears favorable when compared to levels reported for patients undergoing more invasive open surgeries [ 18 – 21 ]. This difference may be attributable to the minimally invasive nature of RARP, which facilitates faster physical recovery and greater postoperative independence [ 22 ]. The qualitative findings further contextualized these results, revealing that while patients felt physically prepared, they navigated complex psychological needs involving dignity, privacy, and a desire for continuity of care. The Pivotal Role of Tailored Discharge Teaching Discharge teaching emerged as the most influential determinant of discharge readiness (β = 0.599). The correlation and regression findings support previous research emphasizing the pivotal role of discharge education in promoting adherence to medical advice, improving rehabilitation outcomes, and supporting successful community reintegration [ 23 – 25 ]. Effective discharge teaching provides both patients and caregivers with essential knowledge and skills, thereby enhancing patients’ confidence and self-care capacity. While the quantitative survey showed high satisfaction with the delivery of teaching, the qualitative interviews uncovered a nuanced gap: patients desired more specific, actionable information. Although the "high importance–high performance" rating in the IPA suggests general satisfaction, the qualitative theme of Information & Continuity highlighted that patients often felt insecure when severed from their original surgical team. This suggests that trust is a critical component of discharge readiness, and while nurses teach well, the specific content may need to be more personalized to maintain that trust post-discharge. Social Support: Beyond Family Care to Peer Empowerment Social support also significantly influenced discharge readiness, though to a lesser extent than discharge teaching. This aligns with prior evidence showing that strong interpersonal support buffers stress and improves recovery trajectories [ 18 ]. In this study, most patients relied on female partners as primary caregivers (93.8%), underscoring the critical role of family involvement. However, the qualitative results extended this understanding by identifying a unique role for peer support—a dimension often overlooked in standard scales. While spouses provided essential physical care (physiological/safety needs), they often could not fully empathize with the patient's internal experience. As revealed in the Empowerment through Shared Experience theme, interaction with fellow patients provided emotional validation and reduced isolation, addressing higher-level belongingness needs that family alone could not fulfill. Socioeconomic Disparities and Vulnerability The univariate analysis highlighted significant disparities: patients with lower education, lower income, and those from farming backgrounds reported significantly weaker social support. The qualitative interviews provided a vivid explanation for this statistical trend. Participants with limited financial means expressed profound anxiety about the economic burden of treatment (“even if my family's finances were poor, we had to find a way to pay”). This financial stress likely erodes their perceived social support and psychological readiness. These findings emphasize the need for targeted interventions, integrating professional social workers and multidisciplinary teams to ensure equitable care and mitigate social disparities. Psychological Adaptation: Dignity and Normalcy A key contribution of the qualitative component was uncovering the tension between the need for care and the desire for dignity—a facet not captured by the quantitative survey. The theme Restoring Self-Esteem and Normalcy revealed that patients actively managed their public image by concealing medical devices (e.g., drainage bags) to avoid the “patient” label. This aligns with Maslow’s esteem needs. While the quantitative data showed high readiness scores, the qualitative narratives suggest this “readiness” might partially stem from a stoic desire to return to normalcy and hide their vulnerability from the public eye. Therefore, healthcare providers should address these psychosocial barriers by teaching discrete catheter management strategies and encouraging resumption of meaningful hobbies to facilitate psychological reintegration. Limitations Several limitations should be noted. First, the single-center design and convenience sampling may limit the generalizability of findings to other regions with different healthcare resources. Second, the study relied on self-reported data, which may be subject to recall bias or social desirability bias, particularly regarding sensitive topics like incontinence. Third, while the mixed-methods design provides depth, the cross-sectional nature of the quantitative phase precludes causal inferences. Future longitudinal studies are needed to track how discharge readiness translates into long-term quality of life and readmission rates. Conclusion Older RARP patients demonstrate high discharge readiness, primarily driven by effective discharge teaching and social support. However, this readiness is not merely physical; qualitative findings highlight critical unmet needs regarding psychological dignity, peer connection, and continuity of care. Vulnerable groups, particularly those with lower socioeconomic status, face greater challenges due to financial anxiety and weaker support systems. To improve outcomes, clinical practice should move beyond standard education to include: (1) continuity-focused follow-up to maintain patient trust; (2) peer support mechanisms to address emotional isolation; and (3) targeted interventions for economically vulnerable patients. Addressing these logistical and humanistic needs is essential for a holistic recovery. Abbreviations ADL: Activities of Daily Living ANOVA: Analysis of Variance IPA: Importance-Performance Analysis IRB: Institutional Review Board LOS: Length of Stay QDTS: Quality of Discharge Teaching Scale RARP: Robot-assisted radical prostatectomy RHD: Readiness for hospital discharge RMB: Renminbi (Chinese currency) SD: Standard Deviation SPSS: Statistical Package for the Social Sciences SSRS : Social Support Rating Scale UEBMI: Urban Employee Basic Medical Insurance URBMI: Urban Resident Basic Medical Insurance VIF: Variance Inflation Factor Declarations Ethics approval and consent to participate This study was performed in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board (IRB) of Nanjing Drum Tower Hospital (Approval No. 2022-533-02). Informed consent was obtained from all subjects involved in the study. Written informed consent was obtained from participants for the survey and, where applicable, the audio-recorded interviews. Consent for publication Not applicable. Availability of data and materials The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Competing interests The authors declare that they have no competing interests Funding statement This research was supported by fundings for Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University(2022-LCYJ-MS-10), Research Topic on Hospital Management Innovation of Jiangsu Provincial Hospital Association (JSYGY-3-2023-615), and Project of the Institute of Modern Hospital Management and Development at Nanjing University (NDYG2022077). Authors' contributions Q G: Methodology, Statistical analysis, Writing-Original Draft; J S: Writing-Original Draft, Editing the draft, Review; J X: Methodology, Investigation, Statistical analysis; Y W & Z W: Editing the draft, Review; P L: Opinion-Review. All authors have read and approved the manuscript. Acknowledgements All authors thank the participants of the Department of Urology of Nanjing Drum Tower Hospital for their strong support, which has effectively helped the data collection. References He Jie, Chen WanQing, Li Ni, et al. Guidelines for screening and early diagnosis and treatment of prostate cancer in China. China Cancer, 2022;31(1):1-30. [in Chinese] Groeben C, Wirth M P. Prostate cancer: Basics on clinical appearance, diagnostics and treatment. Medizinische Monatsschrift für Pharmazeuten. 2017;40(5):192-201. Morita T, Yamamoto K, Ozaki A, et al. The oldest-old in China. Lancet. 2017;390(10097):846-7. Yuan Jianlin, Meng Ping, Yang Xiaojian, et al. Clinical experience of robot assisted laparoscopic surgery for high-risk prostate cancer. Journal of Clinical Urology. 2016;31(1):15-8. [in Chinese] Li Lijun, Liu Jing, Ma Zhiwei. Comparison of laparoscopic and robot assisted laparoscopic radical prostatectomy for prostate cancer. Guangdong Medical Journal. 2017;38(4):563-6. [in Chinese] Lepor H. Practical considerations in radical retropubic prostatectomy. Urol Clin North Am. 2003;30(2):363-8. Morgan MS, Ozayar A, Friedlander JI, et al. An assessment of patient comfort and morbidity after robot-assisted radical prostatectomy with suprapublic tube urethral catheter drainage. Endourol. 2016;30(3):300-5. Zhou Ping, Tian Aiqin. The effect of traditional Chinese medicine perineal care on bacterial colonization and patient comfort after radical prostatectomy for prostate cancer. Nursing Research. 2019;33(9):1608-10. [in Chinese] Li Haiyan, Zhao Jinwei, Jiang Haihong, et al. Investigation on the demand of continuing nursing service for patients after radical prostatectomy. Nursing and Rehabilitation. 2020;19(03):80-3. [in Chinese] Paterson C, Robertson A, Smith A, Nabi G. Identifying the unmet supportive care needs of men living with and beyond prostate cancer: A systematic review. European journal of oncology nursing: the official journal of European Oncology Nursing Society. 2015;19(4):405-18. Bo Haixin, Chen Jie, Fan Guorong, et al. Effect of continuous nursing model in home treatment of pelvic floor muscle rehabilitation in patients with stress urinary incontinence. Chinese Journal of Modern Nursing. 2017;23(14):1896-9. [in Chinese] Wu Chunyan, Li Ping, Li Haiyan, et al. Effects of multi-form continuous nursing on anxiety and quality of life of patients undergoing radical prostatectomy. Nursing Research. 2019;34(17):76-8. [in Chinese] Weiss, M, Piacentine L. Psychometric properties of the Readiness for Hospital Discharge Scale. Journal of Nursing Measurement. 2006;14(3):163-80. Kang, E, Gillespie BM, Tobiano G, Chaboyer W. Discharge education delivered to general surgical patients in their management of recovery post discharge: A systematic mixed studies review. International Journal of Nursing Studies. 2018; 87:1-13. Knier, S., Stichler, J. F., Ferber, L., & Catterall, K. Patients’ perceptions of the quality of discharge teaching and readiness for discharge. Rehabilitation Nursing. 2015;40(1):30-9. Koelling TM, Johnson ML, Cody RJ, et al. Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005; 111:179-85. Nman D M, Jacobson T M, Maxson P M, et al. Effects of urinary catheter education for patients undergoing prostatectomy. Urol Nurs. 2013;33(6):289-98. Zhao Liyan, Ma Xueling, Wang Yujue. Analysis of the correlation between discharge readiness, discharge teaching, and social support in patients with colorectal cancer undergoing colostomy. Qilu Journal of Nursing. 2022;28(04):31-4. [in Chinese] Zhang Qi, Zheng Donglian, Ma Fuzhen, et al. Analysis of the current status and influencing factors of discharge readiness in elderly patients with coronary artery bypass grafting. Nursing Practice and Research. 2022;19(24):3675-81. [in Chinese] Yang Na. Discharge readiness level and related influencing factors of patients after radical resection of hilar cholangiocarcinoma. Medical Equipment. 2023;36(07):147-50. [in Chinese] Liu Huijing, Liu Wei, Dong Jianqing, Tao Xiaofeng, Wang Xiaoxi. Path analysis of the current status and influencing factors of discharge readiness in elderly patients with prostate cancer after surgery. Chinese Journal of Andrology. 2018;24(09):857-60. [in Chinese] Palma-Zamora I, Abdollah F, Rogers C, Jeong W. Robot-assisted radical prostatectomy: Advancements in surgical technique and perioperative care. Front Surg. 2022;27(9): 944561. Pazar B, Iyigun E. The effects of preoperative education of cardiac patients on haemodynamic parameters, comfort, anxiety and patient-ventilator synchrony: A randomised controlled trial. Intensive Crit Care Nurs. 2020;6(58):102799. Bobay KL, Jerofke TA, Weiss ME, Yakusheva O. Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge. Geriatr Nurs. 2010;31(3):178-87. Zhao Huiling, Feng Xianqiong, Yu Rong et al. Research progress on patient discharge readiness nursing. Chinese Journal of Nursing Management. 2013;13(6):81-3. [in Chinese] Weiss ME, Piacentine LB, Lokken L, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec. 2007;21(1):31-42. Xiao SY. The theoretical basis and research application of the Social Support Rating Scale. Journal of Clinical Psychiatry. 1994;4(2):98-100. [in Chinese] Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 14 May, 2026 Reviewers invited by journal 13 May, 2026 Editor assigned by journal 04 Mar, 2026 Editor invited by journal 04 Mar, 2026 Submission checks completed at journal 01 Mar, 2026 First submitted to journal 01 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-8972570","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":600588538,"identity":"5e8ec1b8-8e47-40e0-a5c7-3cea80078a9b","order_by":0,"name":"Qiongyan GAI","email":"","orcid":"","institution":"Nanjing University","correspondingAuthor":false,"prefix":"","firstName":"Qiongyan","middleName":"","lastName":"GAI","suffix":""},{"id":600588541,"identity":"bcb08cd1-b6ce-4192-9b47-b8010114782d","order_by":1,"name":"Jin Sun","email":"","orcid":"","institution":"Nanjing University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jin","middleName":"","lastName":"Sun","suffix":""},{"id":600588542,"identity":"d8741495-f9f7-459a-9b5a-811f88f1e2f6","order_by":2,"name":"Yajuan Weng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxklEQVRIiWNgGAWjYBACfvn3zz8kGEjI2bc3EKlFsiGHjeFDgY2xAc8BIrUYHMhhY5zxIS3RQCKBaC1njz3mMTicYC75eOMNhhqbaMIOO9iXbgzUkmc5O63YguFYWm4DIS18hxkMpIFaihlu55hJMDYcJqyF4RhES2LDzTNEahE4w2MmOcMgLXHDDR4itUjOYEs2+GBgYyzZA/RLAjF+4ZdgPvgg4Y+EHD/74Y03PtTYEOEXJEB81CBpIVXHKBgFo2AUjAwAAA/HQcB/O8nbAAAAAElFTkSuQmCC","orcid":"","institution":"Nanjing University","correspondingAuthor":true,"prefix":"","firstName":"Yajuan","middleName":"","lastName":"Weng","suffix":""},{"id":600588543,"identity":"c6e1db8e-d6a1-41a4-a224-7e2057f2a1ad","order_by":3,"name":"Jie Xu","email":"","orcid":"","institution":"Changsha Children's Welfare Institute","correspondingAuthor":false,"prefix":"","firstName":"Jie","middleName":"","lastName":"Xu","suffix":""},{"id":600588545,"identity":"df2d1b31-0725-4f8e-bf86-a269fc806b38","order_by":4,"name":"Ping Li","email":"","orcid":"","institution":"Nanjing University","correspondingAuthor":false,"prefix":"","firstName":"Ping","middleName":"","lastName":"Li","suffix":""},{"id":600588547,"identity":"5705e409-66c7-4cd8-b346-fcdeb7a28091","order_by":5,"name":"Zhihong Wei","email":"","orcid":"","institution":"the Second Hospital of Lanzhou University","correspondingAuthor":false,"prefix":"","firstName":"Zhihong","middleName":"","lastName":"Wei","suffix":""}],"badges":[],"createdAt":"2026-02-26 02:53:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8972570/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8972570/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104179337,"identity":"c9559ecc-f415-4a12-8987-2b41b7395982","added_by":"auto","created_at":"2026-03-08 17:04:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":33576,"visible":true,"origin":"","legend":"\u003cp\u003eFour-quadrant plot of IPA\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-8972570/v1/78a5a0b3bfa4e6f4a468cd02.png"},{"id":104404986,"identity":"51eb1f67-4b3f-43ed-a40c-f3643252228f","added_by":"auto","created_at":"2026-03-11 12:21:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1306321,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8972570/v1/14b19d77-8b45-4286-ae34-d39cfec3a0af.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mixed-methods study examining patients’ perceptions of the relationship between Discharge Teaching, Social Support, and Patient Readiness for Discharge","fulltext":[{"header":"Background","content":"\u003cp\u003eProstate cancer represents a significant and growing health burden for men worldwide, particularly among the aging population. In recent years, there emerges an annual increase of prostate cancer incidence in China, and its incidence rate ranks the 7th and mortality rate ranks the 10th among malignant tumors in Chinese men [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Robot-assisted radical prostatectomy (RARP) has emerged as the gold-standard surgical treatment for localized prostate cancer, offering benefits such as reduced blood loss and shorter hospital stays [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Following RARP, a critical aspect of postoperative management is the mandatory use of an indwelling urinary catheter, typically for one to two weeks, to ensure the integrity of the urethral-bladder anastomosis and prevent complications like urinary fistulas [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, the catheter itself is a significant source of patient morbidity. It is not only a primary driver of postoperative pain [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] but also predisposes patients to a constellation of catheter-related complications, such as urinary tract infection, urinary catheter displacement, bladder spasms, hemorrhage, obstruction, peri-catheter leakage, and incontinence, etc. All of them affect patients' postoperative recovery process, together with negative effects on their physical and mental health, sense of self-efficacy, and quality of life [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe transition from the structured hospital environment to home-based self-management is a period of heightened vulnerability for these patients. The responsibility for a range of complex care tasks\u0026mdash;from surgical site care and pelvic floor muscle training to managing the psychological impact of the disease and its treatment\u0026mdash;shifts abruptly to the patients and their families, who often feel overwhelmed by these high supportive care needs [\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEnsuring a successful transition hinges on the patient's Readiness for Hospital Discharge (RHD), defined as a patient's subjective assessment of their ability to manage their care outside the hospital [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. High RHD is a critical patient-centered outcome, consistently linked to fewer adverse events, reduced readmission rates, and improved quality of life post-discharge [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. While literature consistently identifies quality of discharge teaching and social support as two key modifiable determinants of RHD [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], their interplay and specific relevance for the post-RARP population are poorly understood, presenting critical knowledge gaps.\u003c/p\u003e \u003cp\u003eConsequently, a significant disjuncture has emerged between the clinical imperative to prepare these patients, and the empirical foundation required to guide evidence-based practice. First, while the benefits of discharge teaching are known, the specific educational topics that are most important to older RARP patients versus how well they are being delivered have not been systematically evaluated. Second, the relative contribution of discharge teaching versus social support in predicting RHD within this specific, high-risk surgical population remains unclear. Furthermore, quantitative surveys alone are insufficient to fully capture the complexities of the transition experience. They may reveal that patients feel unsupported or unprepared, but they cannot explain why these gaps exist or describe the lived reality of coping with catheter care and psychological stress at home [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. A mixed-methods approach is therefore necessary to bridge the gap between statistical trends and the patients' detailed perspectives.\u003c/p\u003e \u003cp\u003eTherefore, this study employed an explanatory sequential mixed-methods design to: (1) investigate the levels of discharge readiness, quality of discharge teaching, and social support in older patients after RARP; (2) determine the relationship between these variables and identify the key predictors of discharge readiness; (3) use Importance-Performance Analysis (IPA) to pinpoint specific areas for educational improvement; and (4) deepen the understanding of these gaps by exploring patients\u0026rsquo; in-depth experiences and unmet needs during the transition from hospital to home.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn explanatory sequential mixed-methods design was adopted to investigate readiness for hospital discharge (RHD) among older patients following RARP.\u0026nbsp;The study began with a quantitative cross-sectional survey to identify general trends and predictors of discharge readiness. Based on the quantitative findings, a qualitative descriptive study was subsequently conducted to explore the underlying reasons for the statistical results and gain deeper insights into patients\u0026rsquo; lived experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants and Recruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted at the Department of Urology, Nanjing Drum Tower Hospital in Nanjing, China.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFor the quantitative survey (December 2022 to April 2023), convenience sampling was used to recruit older adult patients. Inclusion criteria were: (1) male patients aged 60 to 80 years; (2) able to comprehend and respond to the questionnaire items; and (3) aware of their diagnosis and willing to participate. Patients were excluded if they: (1) exhibited unstable vital signs or severe postoperative complications that precluded participation; (2) had significant cognitive impairment; or (3) had a family request for non-disclosure of the diagnosis.\u003c/p\u003e\n\u003cp\u003eFor the qualitative interview (August 2023 to January 2024), purposive sampling was used to select 20 participants (10 inpatients and 10 from the follow-up clinic). The inclusion and exclusion criteria were consistent with those of the quantitative study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBased on the rule of thumb of 5-10 subjects per item for multivariate analysis, the sample size of 129 was considered sufficient for the regression model involving three main variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB) of Nanjing Drum Tower Hospital (Approval No. 2022-533-02) and was conducted in accordance with the principles of the Declaration of Helsinki. All participants provided written informed consent for the survey and, where applicable, the audio-recorded interviews. They were assured of the confidentiality of their responses and their right to withdraw at any time.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasures\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReadiness for Hospital Discharge\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Readiness for Hospital Discharge Scale (RHDS), developed by Weiss and Piacentine [13], was used to assess patients\u0026apos; perception of their preparedness for discharge. This 23-item scale comprises four subscales: Personal Status, Knowledge, Coping Ability, and Expected Support. Items are rated on an 11-point numerical scale ranging from 0 (not ready) to 10 (totally ready), with higher scores indicating greater readiness. In the current study, the scale demonstrated excellent reliability with a Cronbach\u0026rsquo;s alpha coefficient of 0.93, and the coefficients for the subscales ranged from 0.85 to 0.93. The content validity index of the scale was 0.85.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuality of Discharge Teaching\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Quality of Discharge Teaching Scale (QDTS), developed by Weiss et al. [26], was employed to evaluate patients\u0026apos; perceptions of the education provided by nurses. The scale consists of 24 items divided into two dimensions: Content Received (what was taught) and Delivery and Effectiveness (how it was taught and its impact). The first 12 items form 6 paired sets that allow for a comparison between \u0026ldquo;needed content\u0026rdquo; and \u0026ldquo;received content\u0026rdquo; to identify gaps for improvement. In this study, the overall Cronbach\u0026rsquo;s alpha coefficient for the QDTS was 0.92. The coefficients for the \u0026ldquo;Content Received\u0026rdquo; and \u0026ldquo;Delivery and Effectiveness\u0026rdquo; subscales were 0.85 and 0.93, respectively, indicating high internal consistency comparable to the original English version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocial Support\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSocial support was evaluated using the Social Support Rating Scale (SSRS) developed by Xiao [27], a widely validated instrument in China. The scale consists of 10 items across three dimensions: Subjective Support, Objective Support, and Utilization of Support. The items include a mix of single-choice (7 items) and multiple-choice (3 items) formats. The total score ranges up to 66, with higher scores indicating a higher level of social support. In this study, the overall Cronbach\u0026rsquo;s alpha coefficient for the SSRS was 0.708, with subscale coefficients ranging from 0.492 to 0.702.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQuantitative data were collected using a paper-based questionnaire\u0026nbsp;booklet. A trained researcher approached eligible patients to provide a comprehensive explanation of the study, including its purpose, procedures, the voluntary nature of participation, and the estimated time for completion. After obtaining written informed consent, the questionnaires were distributed.\u0026nbsp;Patients were asked to complete the questionnaire independently.\u0026nbsp;For those with physical limitations that precluded independent completion (e.g., visual impairment or physical incapacity), the researcher read the items aloud and recorded their verbal responses verbatim to ensure data accuracy and completeness.\u003c/p\u003e\n\u003cp\u003eQualitative data were collected through semi-structured interviews. The time and location were arranged in advance with participants to ensure a quiet, comfortable, and suitable environment. Prior to the interview, the researcher explained the study\u0026apos;s purpose and significance in detail, and audio recording was conducted only after obtaining the participant\u0026apos;s consent. Interviews lasted between 20 and 30 minutes. Sampling and interviewing continued until data saturation was reached, defined as the point where no new themes emerged. Upon completion of the interview, each participant was asked to complete a general demographic questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuantitative data analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analyses were performed using SPSS software (version 27.0). Descriptive statistics, including frequencies and percentages for categorical variables, and means with standard deviations (Mean \u0026plusmn; SD) for continuous variables, were calculated to summarize sociodemographic characteristics, discharge teaching quality, and discharge readiness scores. One-way Analysis of Variance (ANOVA) was employed to examine differences in discharge readiness, teaching quality, and social support across various demographic groups. Pearson\u0026rsquo;s correlation analysis was conducted to assess the relationships between discharge teaching quality, social support, and discharge readiness. To identify independent predictors of discharge readiness, a multiple linear regression model was constructed. Additionally, Importance-Performance Analysis (IPA) was utilized to evaluate discrepancies between patient expectations and the actual information received, with paired samples t-tests used to compare the differences between importance and satisfaction scores for specific topics. A two-tailed p-value \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative data analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll interviews were audio-recorded and transcribed verbatim within 24 hours to ensure accuracy and completeness. Data management was facilitated using NVivo 11 software (QSR International). We employed an inductive content analysis approach involving a three-phase coding process: preparation, organizing, and reporting.\u003c/p\u003e\n\u003cp\u003eFirst, the researchers achieved data immersion by reading the transcripts repeatedly to obtain a holistic understanding of the participants\u0026rsquo; experiences. Second, meaning units\u0026mdash;sentences or paragraphs relevant to the study objectives\u0026mdash;were extracted and assigned initial codes. Third, codes with similar patterns were grouped into categories (sub-themes). Finally, through an iterative process of abstraction, these categories were synthesized into central themes. Representative quotes were selected to substantiate the findings and ensure the results were grounded in the data.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eParticipant Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuantitative Survey\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eParticipants Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 152 questionnaires were distributed, of which 129 were returned as valid and included in the final analysis, yielding an effective response rate of 84.9%. These participants were older men with a mean age of 70.5 \u0026plusmn; 5.1 years, predominantly in the 70\u0026ndash;74 age group (41.1%). Participants were predominantly of Han ethnicity (99.2%) and mainly from urban environments (79.1%), with a significant concentration residing in Nanjing, Jiangsu Province (64.3%). Regarding family structure and support, 97.7% of the participants were married. The majority (62.0%) lived in two-person households (living with spouse only), and spouses assumed the primary caregiving role for nearly all patients (93.8%). Socioeconomically, the majority were retired (87.6%) and had attained secondary education (junior/senior high or vocational school, 63.6%). Most reported an annual household income between 10,000 and 100,000 RMB (69.8%), and public medical insurance coverage was nearly universal (96.9%). Clinically, the most frequently observed Gleason score was 7 (55.8%). Detailed sociodemographic and clinical characteristics are presented in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u0026nbsp;\u003c/strong\u003eQuantitative Survey Participants Characteristics (n=129)\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e60-64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e21 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e65-69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e27 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e70-74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e53 (41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e75-80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e28 (21.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eResidency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e27 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e102 (79.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eNanjing (Local)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e83 (64.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eOutside Nanjing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e46 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eGraduate students and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e3 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e8 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eJunior college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e14 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eSenior high schools (Technical secondary schools)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e40 (31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eJunior high schools\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e42 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e20 (15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eNo or very little literacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e2 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eEmployment Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e113 (87.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e12 (9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e4 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eAnnual Household Income (RMB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e\u0026le; 10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e16 (12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e10,001-100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e90 (69.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e100,001-200,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e17 (13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e\u0026ge; 200,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e6 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eResidential situation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eSpouse cohabitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e80 (62.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eLive alone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e4 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e45 (34.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eCaregiver availability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003espouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e121 (93.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003echildren\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e3 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eNone (Self-care)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e5 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003eGleason score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e38 (29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e72 (55.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 78.8991%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.1009%;\"\u003e\n \u003cp\u003e19 (14.7)\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\u003cstrong\u003eQualitative Interview Participants Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePurposive sampling was used to select 20 participants for semi-structured interviews. Participants were stratified into two groups:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe pre-discharge group\u003c/strong\u003e (n=10) had a mean age of 69.9 \u0026plusmn; 6.5 years (range: 60\u0026ndash;83). Five participants resided in Nanjing, while the remaining five were from other cities. All were married, and most (n=9) lived exclusively with their spouses. Care was primarily provided by wives, with supplemental support from children (n=5) or siblings (n=1). The majority were retired (n=8), and the most prevalent Gleason score was 7 (n=5). The mean total length of stay (LOS) was 7.6 \u0026plusmn; 1.3 days, with a mean postoperative stay of 4.1 \u0026plusmn; 0.9 days (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Characteristics of Pre-discharge Participants (n=10)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"676\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 5.613%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eID\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.613%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.226%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5554%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.226%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInsurance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.5554%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregivers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.3619%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving Arrangement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGleason Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal LOS (d)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-op LOS (d)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eURBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eExtended family\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003csup\u003e\u0026Dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eFreelance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eURBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003eF10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.613%;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.226%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5554%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3619%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.74889%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.94239%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.15805%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003cstrong\u003eAbbreviations:\u003c/strong\u003e LOS = Length of Stay; UEBMI = Urban Employee Basic Medical Insurance; URBMI = Urban Resident Basic Medical Insurance. \u003cstrong\u003eResidency:\u003c/strong\u003e \u0026quot;Local\u0026quot; refers to residents of Nanjing; \u0026quot;Non-local\u0026quot; refers to residents outside of Nanjing.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e\u0026dagger;\u0026nbsp;\u003c/sup\u003eParticipant lives with spouse, son, and daughter-in-law (extended family).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e\u0026Dagger;\u0026nbsp;\u003c/sup\u003eParticipant lives with spouse; children reside in the same residential community.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe post-discharge group\u0026nbsp;\u003c/strong\u003e(n=10) comprised patients interviewed during outpatient follow-up, 10 to 14 days after surgery. The mean age was 69.6 \u0026plusmn; 4.6 years (range: 62\u0026ndash;75). As with the pre-discharge group, the majority were residents of Nanjing (n=9). Most participants primarily were married (n=9) and lived in two-person households with their spouses (n=7). Care was primarily provided by spouses, with assistance from children (n=3) or siblings (n=1). The most prevalent Gleason score was 6 (n=5). The mean duration of indwelling catheterization was 13.8 \u0026plusmn; 0.8 days (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Characteristics of Post-discharge Participants (n=10)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"699\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eID\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.8571%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1429%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.8571%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInsurance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1429%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregivers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.8571%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving Arrangement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGleason Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal LOS (d)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCatheter Days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eNon-local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eExtended family\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eSpouse \u0026amp; Siblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eSpouse only\u003csup\u003e\u0026Dagger;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eChildren\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eWith children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6.85714%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.42857%;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eLocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.8571%;\"\u003e\n \u003cp\u003eUEBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1429%;\"\u003e\n \u003cp\u003eChildren\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.8571%;\"\u003e\n \u003cp\u003eLiving alone\u003csup\u003e\u0026sect;\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.42857%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.71429%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.7143%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: \u003cstrong\u003eAbbreviations:\u003c/strong\u003e LOS = Length of Stay; UEBMI = Urban Employee Basic Medical Insurance. \u003cstrong\u003eResidency:\u003c/strong\u003e \u0026quot;Local\u0026quot; refers to residents of Nanjing; \u0026quot;Non-local\u0026quot; refers to residents outside of Nanjing. \u003csup\u003e\u0026dagger;\u003c/sup\u003eParticipant lives with spouse and children. \u003csup\u003e\u0026Dagger;\u003c/sup\u003eParticipant lives with spouse; siblings provide care but reside elsewhere.\u003csup\u003e\u0026nbsp;\u0026sect;\u003c/sup\u003eParticipant lives alone, with children residing in the same building.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuantitative results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDischarge Readiness and Teaching\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients in the study sample\u0026nbsp;reported\u0026nbsp;a high level of readiness for hospital discharge, evidenced by a mean score of 8.34 (SD = 0.63). The overall perceived quality of discharge teaching was also rated favorably (mean = 8.47, SD = 0.45). Within this domain, the delivery dimension (mean = 8.77, SD = 0.44) scored higher than the received content dimension (mean = 7.86, SD = 0.64).\u003c/p\u003e\n\u003cp\u003eImportance-Performance Analysis (IPA) revealed that five of six items\u0026mdash;including home assistance, medical handling, treatment\u0026nbsp;information, family care, and self-care\u0026mdash;were rated in the \u0026ldquo;high importance\u0026ndash;high performance\u0026rdquo; quadrant (Figure 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure 1\u003c/strong\u003e Four-quadrant plot of IPA\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocial Support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean total score on the\u0026nbsp;Social\u0026nbsp;Support Rating Scale was 41.62 (SD = 5.38). The mean scores for the subscales were 22.19 (SD = 2.70) for subjective support, 11.43 (SD = 1.77) for objective support, and 7.99 (SD = 2.29) for utilization of support.\u003c/p\u003e\n\u003cp\u003eUnivariate analysis revealed that social support scores differed significantly across groups based on education, occupation, income, and marital status (all \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05). Post-hoc tests further clarified these differences. For instance, patients with a bachelor\u0026rsquo;s degree or above reported significantly higher total support scores compared to those with a junior high/vocational school education (MD\u0026nbsp;= 4.90, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05), a middle school education (MD\u0026nbsp;= 5.70, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01), or an elementary school education (MD\u0026nbsp;= 7.08, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01). Similarly, farmers reported significantly lower total support scores than retirees (MD\u0026nbsp;= -3.48, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05) and enterprise employees (MD\u0026nbsp;= -7.67, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01). Significant differences were also observed in support utilization scores across these groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRelationship Between Discharge Readiness, Teaching, and Social Support\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrelation analysis showed that discharge readiness was positively correlated with both discharge teaching (\u003cem\u003er\u003c/em\u003e = 0.645, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01) and social support (\u003cem\u003er\u003c/em\u003e = 0.340, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01). Discharge teaching and social support were also positively correlated (\u003cem\u003er\u003c/em\u003e = 0.217, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eMultiple linear regression (Table\u0026nbsp;4) identified discharge teaching and social support as significant predictors of\u0026nbsp;discharge\u0026nbsp;readiness (adjusted \u003cem\u003eR\u003c/em\u003e\u0026sup2; = 0.449, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). Among them, discharge teaching exerted the strongest effect (\u003cem\u003e\u0026beta;\u003c/em\u003e = 0.599), followed by social support (\u003cem\u003e\u0026beta;\u003c/em\u003e = 0.210).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;4\u003c/strong\u003e Multiple regression analysis on influencing factors of discharge readiness\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026beta;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVIF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e(Constant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.796\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003eTotal Social Support Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003eDischarge Teaching Quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.841\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.599\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e8.917\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel Summary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e\u003cem\u003eAdjusted R\u0026sup2;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e0.449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e\u003cem\u003eF-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e53.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0018%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 37.3429%;\"\u003e\n \u003cp\u003e\u003cem\u003eDurbin-Watson\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e1.888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.1311%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0018%;\"\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\u003eNote: Dependent Variable: Discharge Readiness. VIF = Variance Inflation Factor.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the analysis of the semi-structured interviews, the supportive care needs and experiences of patients were categorized into six sub-categories, which were further synthesized into two central themes: (1) Personal support provided for gaining a sense of control (addressing physiological and safety needs); and (2) Social support provided for personal growth (addressing belongingness and esteem needs). The thematic framework is presented in Table 5.\u003c/p\u003e\n\u003cp\u003eTable 5. Thematic Framework of Post-discharge Support Needs\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"655\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eCentral Themes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eSub-categories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 333px;\"\u003e\n \u003cp\u003eKey Elements\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eTheme 1: Personal support provided for gaining a sense of control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eTangible \u0026amp; Financial Support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 333px;\"\u003e\n \u003cp\u003eSpousal caregiving; assistance with ADLs; impact of insurance coverage; financial burden on retirees.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eInformation \u0026amp; Continuity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 333px;\"\u003e\n \u003cp\u003eSpecificity of discharge instructions; direct access to surgeons; distrust of fragmented primary care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eTrust \u0026amp; Professionalism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 333px;\"\u003e\n \u003cp\u003eEmpathy from staff; need for \u0026quot;one-on-one\u0026quot; communication; safety in established medical relationships.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eTheme 2: Social support provided for personal growth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eBelonging \u0026amp; Peer Support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 333px;\"\u003e\n \u003cp\u003eShared understanding in patient groups; emotional validation from peers; reducing isolation.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 185px;\"\u003e\n \u003cp\u003eSelf-Esteem \u0026amp; Normalcy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 333px;\"\u003e\n \u003cp\u003ePreserving dignity; privacy regarding medical devices (e.g., catheter bags); finding purpose in hobbies.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 1: Personal Support for Gaining a Sense of Control\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis theme highlights the fundamental requirements for patients to manage their physical recovery and navigate the healthcare system safely.\u003c/p\u003e\n\u003cp\u003eTangible and Economic Security Spouses, particularly wives, were identified as the cornerstone of daily support, managing household chores and nursing tasks. This tangible support allowed patients to focus on recovery without domestic worries. However, economic stability was a major determinant of psychological burden. While patients with comprehensive insurance and pensions felt secure, those with limited coverage expressed significant anxiety regarding the high costs of prostate cancer treatment.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;For us retired enterprise workers, it is a big burden. But there is no other way; to save my life, I must treat it... even if my family\u0026apos;s finances were poor, we had to find a way to pay.\u0026rdquo;\u003c/em\u003e (Participant F1)\u003c/p\u003e\n\u003cp\u003eContinuity of Care and Trust Patients prioritized professional authority and continuity. They expressed a strong preference for follow-up care provided by their original surgical team rather than rotating doctors or community clinics. Trust was built on the surgeon\u0026apos;s familiarity with their specific case and the perceived professional competence of the nursing staff. The lack of a unified referral system made patients reluctant to use community health centers for catheter maintenance.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I prefer coming here [the tertiary hospital] because the chief surgeon knows my condition firsthand... If the community hospital were linked to the big hospital in a unified system, that would be convenient, but otherwise, I don\u0026apos;t trust private clinics.\u0026rdquo;\u003c/em\u003e (Participant F6/H1) \u003cem\u003e\u0026ldquo;When I see the clear discharge instructions... knowing exactly when to remove the catheter and when to review the pathology report, I feel confident.\u003c/em\u003e\u003cem\u003e\u0026rdquo;\u003c/em\u003e (Participant F4)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 2: Social Support for Personal Growth\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBeyond physical safety, patients sought support that fostered psychological adaptation, belonging, and a return to normalcy.\u003c/p\u003e\n\u003cp\u003eEmpowerment through Shared Experience Interacting with peers who shared similar medical histories provided a unique form of emotional validation that family members could not offer. Whether through online groups or offline interactions, witnessing the recovery of others reduced feelings of isolation and fear.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;My colleague had the same disease... but he looks great. [I realized] this is not a death sentence.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(Participant F2)\u003cem\u003e\u0026nbsp;\u0026ldquo;We are like a group; everyone has experienced the same thing. I think chatting with them is also a form of rehabilitation.\u0026rdquo;\u003c/em\u003e (Participant H3)\u003c/p\u003e\n\u003cp\u003eRestoring Self-Esteem and Normalcy Patients strove to maintain their identity beyond being a \u0026quot;patient.\u0026quot; They expressed a strong desire for privacy, often hiding visible signs of illness (such as drainage bags) to avoid pity or public scrutiny. Engaging in meaningful hobbies (e.g., music, outdoor activities) served as a critical coping mechanism, helping them regain a sense of inner peace and control over their lives.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I try to hide the drainage bag as much as possible when I go out. Otherwise, people know you are a patient and stare at you. I want to be normal.\u0026rdquo;\u003c/em\u003e (Participant F1) \u003cem\u003e\u0026ldquo;I play the piano at home. As soon as the music starts, my spirits lift immediately because I feel this is part of my life.\u0026rdquo;\u0026nbsp;\u003c/em\u003e(Participant F2)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study employed a mixed-methods approach to comprehensively evaluate the discharge readiness and supportive care needs of older patients undergoing RARP. The quantitative results indicated high levels of discharge readiness, strongly driven by the quality of discharge teaching and social support. The high level of discharge readiness observed in this cohort appears favorable when compared to levels reported for patients undergoing more invasive open surgeries [\u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This difference may be attributable to the minimally invasive nature of RARP, which facilitates faster physical recovery and greater postoperative independence [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The qualitative findings further contextualized these results, revealing that while patients felt physically prepared, they navigated complex psychological needs involving dignity, privacy, and a desire for continuity of care.\u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section2\"\u003e \u003ch2\u003eThe Pivotal Role of Tailored Discharge Teaching\u003c/h2\u003e \u003cp\u003eDischarge teaching emerged as the most influential determinant of discharge readiness (β\u0026thinsp;=\u0026thinsp;0.599). The correlation and regression findings support previous research emphasizing the pivotal role of discharge education in promoting adherence to medical advice, improving rehabilitation outcomes, and supporting successful community reintegration [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Effective discharge teaching provides both patients and caregivers with essential knowledge and skills, thereby enhancing patients\u0026rsquo; confidence and self-care capacity. While the quantitative survey showed high satisfaction with the delivery of teaching, the qualitative interviews uncovered a nuanced gap: patients desired more specific, actionable information. Although the \"high importance\u0026ndash;high performance\" rating in the IPA suggests general satisfaction, the qualitative theme of Information \u0026amp; Continuity highlighted that patients often felt insecure when severed from their original surgical team. This suggests that trust is a critical component of discharge readiness, and while nurses teach well, the specific content may need to be more personalized to maintain that trust post-discharge.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003eSocial Support: Beyond Family Care to Peer Empowerment\u003c/h2\u003e \u003cp\u003eSocial support also significantly influenced discharge readiness, though to a lesser extent than discharge teaching. This aligns with prior evidence showing that strong interpersonal support buffers stress and improves recovery trajectories [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In this study, most patients relied on female partners as primary caregivers (93.8%), underscoring the critical role of family involvement. However, the qualitative results extended this understanding by identifying a unique role for peer support\u0026mdash;a dimension often overlooked in standard scales. While spouses provided essential physical care (physiological/safety needs), they often could not fully empathize with the patient's internal experience. As revealed in the Empowerment through Shared Experience theme, interaction with fellow patients provided emotional validation and reduced isolation, addressing higher-level belongingness needs that family alone could not fulfill.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eSocioeconomic Disparities and Vulnerability\u003c/h2\u003e \u003cp\u003eThe univariate analysis highlighted significant disparities: patients with lower education, lower income, and those from farming backgrounds reported significantly weaker social support. The qualitative interviews provided a vivid explanation for this statistical trend. Participants with limited financial means expressed profound anxiety about the economic burden of treatment (\u0026ldquo;even if my family's finances were poor, we had to find a way to pay\u0026rdquo;). This financial stress likely erodes their perceived social support and psychological readiness. These findings emphasize the need for targeted interventions, integrating professional social workers and multidisciplinary teams to ensure equitable care and mitigate social disparities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003ePsychological Adaptation: Dignity and Normalcy\u003c/h2\u003e \u003cp\u003eA key contribution of the qualitative component was uncovering the tension between the need for care and the desire for dignity\u0026mdash;a facet not captured by the quantitative survey. The theme Restoring Self-Esteem and Normalcy revealed that patients actively managed their public image by concealing medical devices (e.g., drainage bags) to avoid the \u0026ldquo;patient\u0026rdquo; label. This aligns with Maslow\u0026rsquo;s esteem needs. While the quantitative data showed high readiness scores, the qualitative narratives suggest this \u0026ldquo;readiness\u0026rdquo; might partially stem from a stoic desire to return to normalcy and hide their vulnerability from the public eye. Therefore, healthcare providers should address these psychosocial barriers by teaching discrete catheter management strategies and encouraging resumption of meaningful hobbies to facilitate psychological reintegration.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eSeveral limitations should be noted. First, the single-center design and convenience sampling may limit the generalizability of findings to other regions with different healthcare resources. Second, the study relied on self-reported data, which may be subject to recall bias or social desirability bias, particularly regarding sensitive topics like incontinence. Third, while the mixed-methods design provides depth, the cross-sectional nature of the quantitative phase precludes causal inferences. Future longitudinal studies are needed to track how discharge readiness translates into long-term quality of life and readmission rates.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOlder RARP patients demonstrate high discharge readiness, primarily driven by effective discharge teaching and social support. However, this readiness is not merely physical; qualitative findings highlight critical unmet needs regarding psychological dignity, peer connection, and continuity of care. Vulnerable groups, particularly those with lower socioeconomic status, face greater challenges due to financial anxiety and weaker support systems.\u003c/p\u003e \u003cp\u003eTo improve outcomes, clinical practice should move beyond standard education to include: (1) continuity-focused follow-up to maintain patient trust; (2) peer support mechanisms to address emotional isolation; and (3) targeted interventions for economically vulnerable patients. Addressing these logistical and humanistic needs is essential for a holistic recovery.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eADL:\u003c/strong\u003e Activities of Daily Living \u003cstrong\u003eANOVA:\u003c/strong\u003e Analysis of Variance \u003cstrong\u003eIPA:\u003c/strong\u003e Importance-Performance Analysis \u003cstrong\u003eIRB:\u003c/strong\u003e Institutional Review Board \u003cstrong\u003eLOS:\u003c/strong\u003e Length of Stay \u003cstrong\u003eQDTS:\u003c/strong\u003e Quality of Discharge Teaching Scale \u003cstrong\u003eRARP:\u003c/strong\u003e Robot-assisted radical prostatectomy \u003cstrong\u003eRHD:\u0026nbsp;\u003c/strong\u003eReadiness for hospital discharge \u003cstrong\u003eRMB:\u003c/strong\u003e Renminbi (Chinese currency) \u003cstrong\u003eSD:\u0026nbsp;\u003c/strong\u003eStandard Deviation \u003cstrong\u003eSPSS:\u003c/strong\u003e Statistical Package for the Social Sciences \u003cstrong\u003eSSRS\u003c/strong\u003e: Social Support Rating Scale \u003cstrong\u003eUEBMI:\u003c/strong\u003e Urban Employee Basic Medical Insurance \u003cstrong\u003eURBMI:\u0026nbsp;\u003c/strong\u003eUrban Resident Basic Medical Insurance \u003cstrong\u003eVIF:\u0026nbsp;\u003c/strong\u003eVariance Inflation Factor\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board (IRB) of Nanjing Drum Tower Hospital (Approval No. 2022-533-02). Informed consent was obtained from all subjects involved in the study. Written informed consent was obtained from participants for the survey and, where applicable, the audio-recorded interviews.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by fundings for Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University(2022-LCYJ-MS-10), Research Topic on Hospital Management Innovation of Jiangsu Provincial Hospital Association (JSYGY-3-2023-615), and Project of the Institute of Modern Hospital Management and Development at Nanjing University (NDYG2022077).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQ G: Methodology, Statistical analysis, Writing-Original Draft; J S: Writing-Original Draft,\u0026nbsp;Editing the draft, Review;\u0026nbsp;J X: Methodology, Investigation, Statistical analysis; Y\u0026nbsp;W \u0026amp;\u0026nbsp;Z W: Editing\u0026nbsp;the draft, Review; P L: Opinion-Review. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors thank the participants of the Department of Urology of Nanjing Drum Tower Hospital for their strong support, which has effectively helped the data collection.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHe Jie, Chen WanQing, Li Ni, et al. Guidelines for screening and early diagnosis and treatment of prostate cancer in China. China Cancer, 2022;31(1):1-30. [in Chinese]\u003c/li\u003e\n\u003cli\u003eGroeben C, Wirth M P. Prostate cancer: Basics on clinical appearance, diagnostics and treatment. Medizinische Monatsschrift f\u0026uuml;r Pharmazeuten. 2017;40(5):192-201.\u003c/li\u003e\n\u003cli\u003eMorita T, Yamamoto K, Ozaki A, et al. The oldest-old in China. Lancet. 2017;390(10097):846-7.\u003c/li\u003e\n\u003cli\u003eYuan Jianlin, Meng Ping, Yang Xiaojian, et al. Clinical experience of robot assisted laparoscopic surgery for high-risk prostate cancer. Journal of Clinical Urology. 2016;31(1):15-8. [in Chinese]\u003c/li\u003e\n\u003cli\u003eLi Lijun, Liu Jing, Ma Zhiwei. Comparison of laparoscopic and robot assisted laparoscopic radical prostatectomy for prostate cancer. Guangdong Medical Journal. 2017;38(4):563-6. [in Chinese]\u003c/li\u003e\n\u003cli\u003eLepor H. Practical considerations in radical retropubic prostatectomy. Urol Clin North Am. 2003;30(2):363-8.\u003c/li\u003e\n\u003cli\u003eMorgan MS, Ozayar A, Friedlander JI, et al. An assessment of patient comfort and morbidity after robot-assisted radical prostatectomy with suprapublic tube urethral catheter drainage. Endourol. 2016;30(3):300-5.\u003c/li\u003e\n\u003cli\u003eZhou Ping, Tian Aiqin. The effect of traditional Chinese medicine perineal care on bacterial colonization and patient comfort after radical prostatectomy for prostate cancer. Nursing Research. 2019;33(9):1608-10. [in Chinese]\u003c/li\u003e\n\u003cli\u003eLi Haiyan, Zhao Jinwei, Jiang Haihong, et al. Investigation on the demand of continuing nursing service for patients after radical prostatectomy. Nursing and Rehabilitation. 2020;19(03):80-3. [in Chinese]\u003c/li\u003e\n\u003cli\u003ePaterson C, Robertson A, Smith A, Nabi G. Identifying the unmet supportive care needs of men living with and beyond prostate cancer: A systematic review. European journal of oncology nursing: the official journal of European Oncology Nursing Society. 2015;19(4):405-18.\u003c/li\u003e\n\u003cli\u003eBo Haixin, Chen Jie, Fan Guorong, et al. Effect of continuous nursing model in home treatment of pelvic floor muscle rehabilitation in patients with stress urinary incontinence. Chinese Journal of Modern Nursing. 2017;23(14):1896-9. [in Chinese]\u003c/li\u003e\n\u003cli\u003eWu Chunyan, Li Ping, Li Haiyan, et al. Effects of multi-form continuous nursing on anxiety and quality of life of patients undergoing radical prostatectomy. Nursing Research. 2019;34(17):76-8. [in Chinese]\u003c/li\u003e\n\u003cli\u003eWeiss, M, Piacentine L. Psychometric properties of the Readiness for Hospital Discharge Scale. Journal of Nursing Measurement. 2006;14(3):163-80.\u003c/li\u003e\n\u003cli\u003eKang, E, Gillespie BM, Tobiano G, Chaboyer W. Discharge education delivered to general surgical patients in their management of recovery post discharge: A systematic mixed studies review. International Journal of Nursing Studies. 2018; 87:1-13.\u003c/li\u003e\n\u003cli\u003eKnier, S., Stichler, J. F., Ferber, L., \u0026amp; Catterall, K. Patients\u0026rsquo; perceptions of the quality of discharge teaching and readiness for discharge. Rehabilitation Nursing. 2015;40(1):30-9. \u003c/li\u003e\n\u003cli\u003eKoelling TM, Johnson ML, Cody RJ, et al. Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005; 111:179-85.\u003c/li\u003e\n\u003cli\u003eNman D M, Jacobson T M, Maxson P M, et al. Effects of urinary catheter education for patients undergoing prostatectomy. Urol Nurs. 2013;33(6):289-98.\u003c/li\u003e\n\u003cli\u003eZhao Liyan, Ma Xueling, Wang Yujue. Analysis of the correlation between discharge readiness, discharge teaching, and social support in patients with colorectal cancer undergoing colostomy. Qilu Journal of Nursing. 2022;28(04):31-4. [in Chinese]\u003c/li\u003e\n\u003cli\u003eZhang Qi, Zheng Donglian, Ma Fuzhen, et al. Analysis of the current status and influencing factors of discharge readiness in elderly patients with coronary artery bypass grafting. Nursing Practice and Research. 2022;19(24):3675-81. [in Chinese]\u003c/li\u003e\n\u003cli\u003eYang Na. Discharge readiness level and related influencing factors of patients after radical resection of hilar cholangiocarcinoma. Medical Equipment. 2023;36(07):147-50. [in Chinese]\u003c/li\u003e\n\u003cli\u003eLiu Huijing, Liu Wei, Dong Jianqing, Tao Xiaofeng, Wang Xiaoxi. Path analysis of the current status and influencing factors of discharge readiness in elderly patients with prostate cancer after surgery. Chinese Journal of Andrology. 2018;24(09):857-60. [in Chinese]\u003c/li\u003e\n\u003cli\u003ePalma-Zamora I, Abdollah F, Rogers C, Jeong W. Robot-assisted radical prostatectomy: Advancements in surgical technique and perioperative care. Front Surg. 2022;27(9): 944561.\u003c/li\u003e\n\u003cli\u003ePazar B, Iyigun E. The effects of preoperative education of cardiac patients on haemodynamic parameters, comfort, anxiety and patient-ventilator synchrony: A randomised controlled trial. Intensive Crit Care Nurs. 2020;6(58):102799.\u003c/li\u003e\n\u003cli\u003eBobay KL, Jerofke TA, Weiss ME, Yakusheva O. Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge. Geriatr Nurs. 2010;31(3):178-87.\u003c/li\u003e\n\u003cli\u003eZhao Huiling, Feng Xianqiong, Yu Rong et al. Research progress on patient discharge readiness nursing. Chinese Journal of Nursing Management. 2013;13(6):81-3. [in Chinese]\u003c/li\u003e\n\u003cli\u003eWeiss ME, Piacentine LB, Lokken L, et al. Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurse Spec. 2007;21(1):31-42. \u003c/li\u003e\n\u003cli\u003eXiao SY. The theoretical basis and research application of the Social Support Rating Scale. Journal of Clinical Psychiatry. 1994;4(2):98-100. [in Chinese]\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Robot-assisted radical prostatectomy, Readiness for hospital discharge, Mixed methods, Older adults, Social support","lastPublishedDoi":"10.21203/rs.3.rs-8972570/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8972570/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSafe hospital-to-home transitions are critical for older patients undergoing robot-assisted radical prostatectomy (RARP), yet many face post-discharge self-management challenges. While discharge education and social support are vital, their specific contributions to readiness for hospital discharge (RHD) in this population remain under-explored.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn explanatory sequential mixed-methods design was employed at Nanjing Drum Tower Hospital, China. First, a cross-sectional survey (December 2022\u0026ndash;April 2023) assessed sociodemographic characteristics, discharge teaching quality, and RHD in older men (aged 60\u0026ndash;80) following RARP. Quantitative data were analyzed using descriptive statistics, multiple linear regression, and Importance-Performance Analysis (IPA). Subsequently, a qualitative descriptive phase (August 2023\u0026ndash;January 2024) involved semi-structured interviews with 20 purposively selected patients (10 inpatients, 10 outpatients) to explain quantitative findings. Interviews were analyzed using inductive content analysis via NVivo 11.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 129 patients completed the survey (response rate: 84.9%; mean age 70.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.1 years). Participants reported high RHD (mean 8.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63) and discharge teaching quality (mean 8.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45). IPA indicated that five key areas, including medical handling, fell into the \u0026ldquo;high importance\u0026ndash;high performance\u0026rdquo; quadrant. Regression analysis identified discharge teaching quality (β\u0026thinsp;=\u0026thinsp;0.599, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and social support (β\u0026thinsp;=\u0026thinsp;0.210, p\u0026thinsp;=\u0026thinsp;0.002) as significant predictors of RHD (adjusted R\u0026sup2; = 0.449). Qualitative analysis of 20 interviews revealed two central themes: (1) \u0026ldquo;Personal support provided for gaining a sense of control,\u0026rdquo; highlighting the critical role of spousal care, economic security, and continuity of professional care in managing physical recovery; and (2) \u0026ldquo;Social support provided for personal growth,\u0026rdquo; emphasizing the need for peer interaction to reduce isolation and restore self-esteem and normalcy.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eOlder RARP patients generally exhibit high discharge readiness, significantly driven by discharge teaching quality and social support. While technical and tangible support from staff and spouses ensures physical safety and control, psychological adaptation requires broader social support, including peer validation and dignity preservation. Interventions should integrate structured education with enhanced social systems\u0026mdash;such as peer groups and continuity of care models\u0026mdash;to optimize recovery.\u003c/p\u003e","manuscriptTitle":"Mixed-methods study examining patients’ perceptions of the relationship between Discharge Teaching, Social Support, and Patient Readiness for Discharge","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-08 17:04:03","doi":"10.21203/rs.3.rs-8972570/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"176804751468510863730760759482240838511","date":"2026-05-14T16:56:01+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-13T13:17:18+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-04T11:30:41+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-04T11:03:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-02T02:23:04+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-03-02T02:17:33+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3aa3ea28-5c15-46f6-94f3-63f1a8a8a6fe","owner":[],"postedDate":"March 8th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"176804751468510863730760759482240838511","date":"2026-05-14T16:56:01+00:00","index":88,"fulltext":""},{"type":"reviewersInvited","content":"2","date":"2026-05-13T13:17:18+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":63911860,"name":"Health sciences/Health care"},{"id":63911861,"name":"Health sciences/Urology"}],"tags":[],"updatedAt":"2026-05-13T13:23:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-08 17:04:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8972570","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8972570","identity":"rs-8972570","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}