Complex determinants of hospital discharge readiness among patients with acute myocardial infarction: a fuzzy-set qualitative comparative analysis
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Accepted Version
Date
2025-07-21
Authors
Chen, Dandan
Xu, Li
Lee, Geraldine
Wang, Xiyi
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Published Version
Abstract
Background
Hospital discharge readiness is a crucial concept, influenced by various individual, interpersonal, and institutional factors in populations experiencing acute myocardial infarction. However, there is a gap in the exploration of these interactive variables, particularly regarding integrated configurations that facilitate readiness for hospital discharge.
Objective
This study aimed to explore the complex determinants affecting hospital discharge readiness from an integrated perspective, based on the Middle-Range Theory of Adaptation to Chronic Illness.
Methods
A cross-sectional observational study was conducted from July 2021 to March 2024 at a tertiary hospital in Shanghai, China. The study assessed individual demographics, family dynamics, quality of discharge teaching, adaptive capacity, and hospital discharge readiness among post-acute myocardial infarction patients. Fuzzy-set qualitative comparative analysis was employed by performing necessity and sufficiency analyses of discharge readiness.
Results
A total of 240 patients participated in this study. The findings indicated that no single determinant independently achieved hospital discharge readiness. Six configurations or pathways leading to high readiness were identified, classified into three patient types: (i) hospital-driven, (ii) family-hospital-driven, and (iii) individual-family-hospital joint-driven. Among these, the most significant configuration involved high family dynamics, high quality of teaching prior to discharge, high adaptive capacity, and low-income levels. Substitutability was observed between income levels and family functions across two configurations.
Conclusion
Hospital discharge readiness among post-acute myocardial infarction patients arises from interactions of multiple determinants spanning individual, interpersonal, and institutional levels. These insights can inform healthcare providers to prioritize identifying these factors and developing personalized interventions that enhance adaptive capacity, family dynamics, and teaching quality during transitional care.
Description
Keywords
Hospital discharge readiness , Acute myocardial infarction , Fuzzy-set qualitative comparative analysis , Theory of adaptation to chronic illness
Citation
Chen, D., Xu, L., Lee, G. and Wang, X. (2025) 'Complex determinants of hospital discharge readiness among patients with acute myocardial infarction: a fuzzy-set qualitative comparative analysis', International Journal of Nursing Studies, 170, 105172 (12pp). https://doi.org/10.1016/j.ijnurstu.2025.105172