Effect on the readiness for discharge of determining the learning requirements before discharge in patients with stoma

Aim: The aim of this study was to determine the effect of identifying the learning needs of patients with stomas prior to discharge on their readiness for discharge. Methods: This study, conducted as part of a master's thesis, employed a pre-test–post-test uncontrolled quasi-experimental design. It was carried out between April 2024 and April 2025 where in the general surgery clinics of two training and research hospital in İstanbul with 81 patients that met the inclusion criteria. Patients that met the eligibility criteria signed the Voluntary Informed Consent Form. Demographic data were collected using a Descriptive Information Form. Before the educational intervention, patients with stomas completed the Patient Learning Needs Scale and the Readiness for Hospital Discharge Scale (Patient Self-Assessment Form). Additionally, the researcher nurse completed the Readiness for Hospital Discharge Scale for Adult Patients (Nurse Assessment Form). Education was provided to patients according to learning needs. Efforts were made to deliver the education sessions between 10:00 and 11:00 a.m.; however, the timing was adjusted according to patients' willingness and attention. The education was delivered face-to-face, lasted no longer than 30 minutes and was followed by the distribution of booklets prepared by the researcher. One day after the training, patients again completed the Patient Learning Needs Scale and the Readiness for Hospital Discharge Scale (Patient Self-Assessment Form), and the researcher nurse repeated the completion of the Readiness for Hospital Discharge Scale (Nurse Assessment Form). Statistical analyses were conducted using SPSS version 26 (IBM Corp., Armonk, NY, USA). Results: Except for employment status, no statistically significant differences were found in discharge readiness levels according to patients' demographic characteristics prior to education (p>0.05). Both nurse and patient assessments revealed an increase in discharge readiness following the educational intervention. Discharge readiness was found to be lower among patients hospitalized for fewer than 5 days and those who had their stoma created within the past month. In contrast, discharge readiness was higher among patients who could independently use stoma equipment, had previously received disease-related education, were able to perform stoma care independently, and had hospital stays of 11 days or longer. A statistically significant positive correlation was found between nurse and patient assessments of discharge readiness both before and after education [(pre-education: r=0.758; p<0.001), (post-education: r=0.625; p<0.001)]. Furthermore, a statistically significant negative correlation was found between discharge readiness levels (as assessed by both nurses and patients) and learning needs, both before and after education [(pre-education: r=-0.357 and r=-0.251; p=0.001 and p=0.025); (post-education: r=-0.402 and r=-0.320; p<0.001 and p=0.004)]. Conclusion: The findings indicate that as the learning needs of patients with stomas decrease, their readiness for discharge increases. The study suggests that a single-session educational intervention and booklet may not be sufficient to fully meet patients' learning needs. To enhance knowledge retention, it is recommended that educational interventions incorporate different methods. Education should be provided not only before surgery but also in the postoperative, pre-discharge, and post-discharge periods. Moreover, the frequency of educational sessions should be increased at regular intervals, and stoma care training should be delivered by a multidisciplinary team that includes specialized stoma nurses.