Construction and verification of discharge preparation and guidance checklist for patients requiring home enteral nutrition: A randomized control trial

To develop, implement, and evaluate a structured discharge preparation and guidance checklist for patients requiring home enteral nutrition (HEN).

The HEN discharge preparation and guidance checklist was developed through a multiphase process by literature review, qualitative interview, and Delphi consultation. A randomized controlled trial was conducted with 90 patients (45 intervention, 45 control) requiring HEN at a tertiary hospital in China. The intervention group received checklist-assisted discharge education, whereas the control group received conventional verbal instructions. Outcomes were assessed using validated tools: Quality of Discharge Teaching Scale (QDTS), Readiness for Hospital Discharge Scale (RHDS), Patient Satisfaction Questionnaire-18 (PSQ-18), NutriQoL, Self-Rating Anxiety Scale (SAS), 30-day unplanned readmission rates, and patient-initiated inquiries.

The intervention group demonstrated significant improvements in QDTS total scores (P < 0.001), content received (P < 0.001), and delivery skills and effects (P = 0.007). RHDS scores for personal status, knowledge, perceived coping ability, and expected support were significantly higher in the intervention group (all P < 0.05). PSQ-18 (P < 0.001) and daily life and social activity domains of NutriQoL (P = 0.036) also improved. However, no significant differences were observed in physical functioning domains of NutriQoL (P = 0.217), SAS (P = 0.160), or unplanned readmission rates (P = 0.343). The intervention group reported fewer online searches for HEN management (P = 0.035).

The HEN discharge preparation and guidance checklist effectively standardized discharge education, enhanced patient preparedness, and improved satisfaction. Although short-term physiological and psychological outcomes showed limited effects, the tool addresses critical gaps in transitional care. Future studies should explore long-term impacts and integrate financial/psychosocial support.