The effects of a solution-focused model discharge readiness coaching intervention on the parents of Chinese pediatric liver transplantation patients: a single-center observational study

Abstract

Background: Liver transplantation (LT) is the only effective treatment for pediatric diseases such as cholestatic diseases, genetic metabolic diseases, acute liver failure, and liver malignancies. With the continuous improvement of LT technology, more and more children with end-stage liver disease are receiving this life-saving treatment. Parents of pediatric LT patients often face significant psychological challenges, including anxiety, depression, and a lack of confidence in their ability to provide postoperative care. This study aimed to evaluate the impact of a solution-focused based model discharge readiness coaching intervention on improving the discharge readiness and mental health status of parents of pediatric LT patients.

Methods: A convenience sampling method was used to select either the father or the mother of 110 pediatric LT patients hospitalized in the Organ Transplantation Department of The First Affiliated Hospital of Guangxi Medical University as study participants. The study was conducted over 2 years, with 55 parents of children who underwent LT in 2022 serving as the control group and 55 parents of children who underwent LT in 2023 serving as the experimental group. The experimental group received routine education plus tailored, solution-focused counseling sessions lasting approximately 20 to 30 minutes each, conducted every Tuesday and Friday. The control group received standard care. Discharge readiness scores before and after the intervention, as well as the quality scores for the discharge counseling provided, were assessed.

Results: The experimental group showed significantly higher discharge readiness scores (total and subscales: personal status, coping ability, anticipatory support) and discharge counseling quality compared to the control group (P<0.05). The effect size for the total discharge readiness score was 0.85, indicating a large effect. The intervention also reduced unplanned readmissions and improved postoperative quality of life. However, due to the limitations of the study design, including the single-center nature and small sample size, the findings should be interpreted with caution.

Conclusions: The solution-focused model intervention improved parents' discharge readiness and the quality of discharge counseling, thus improving the patients and caregivers postoperatively quality of life and reducing the unplanned readmission rate of pediatric LT patients. Future studies should address these limitations through multicenter trials with larger sample sizes.

Keywords: Pediatric liver transplantation (pediatric LT); discharge counseling quality; discharge readiness; solution-focused model.