Construction and Evaluation of a Flipped Discharge Model for Stomates With Colorectal Cancer

The occurrence of complications related to the intestinal stoma and the surrounding skin will be assessed using a standardized Stoma Complication Assessment Form. This form evaluates six major items: changes in peristomal skin, degree of stoma prolapse, presence of parastomal hernia, degree of stoma stenosis, degree of stoma retraction, and degree of stoma mucocutaneous separation. Each item has specific criteria and a scoring system, with a higher total score indicating a greater number and severity of complications.

Measured using the Chinese version of the Ostomy Adjustment Scale (OAS) . The scale consists of 34 items rated on a 6-point Likert scale, with total scores ranging from 34 to 204. A higher total score indicates better psychological and social adaptation to living with a stoma.

Measured using the Chinese version of the Stoma Self-Efficacy Scale (SSES) . This 22-item scale assesses patients' confidence in managing their stoma (stoma efficacy) and in social situations (social self-efficacy) using a 5-point Likert scale. Total scores range from 22 to 110. A higher score indicates greater self-efficacy.

Measured using the Chinese version of the Readiness for Hospital Discharge Scale (RHDS) . This 12-item scale assesses a patient's self-perceived preparedness for discharge across three dimensions: personal status, coping ability, and expected support. Each item is scored on a 0-10 scale, with total scores ranging from 0 to 120. A higher total score indicates better readiness for discharge.

Measured using the Chinese version of the Stoma Quality of Life Scale (Stoma-QOL-C) . This 20-item scale evaluates the impact of the stoma on various life domains over the past month across four dimensions (e.g., sleep, social relationships). Each item is scored on a 4-point Likert scale (1 = always, 4 = never), with total scores ranging from 20 to 80. A higher total score indicates better stoma-specific quality of life.

Measured using the Chinese version of the Stoma Self-Care Scale - Early Stage version (SSCS-early) . This 10-item scale specifically assesses a patient's skill in independently changing the stoma appliance. Each item is scored on a 5-point Likert scale (1 = very unskilled, 5 = very skilled), with total scores ranging from 10 to 50. A higher score indicates greater self-care ability.

Measured as the average length of the index hospital admission in days.

Includes total medical costs during the study period, covering Western and traditional Chinese medicine, stoma center fees, and supplies. Measured in RMB.

The direct costs of implementing the "Flipped Discharge" intervention (e.g., provider travel expenses, personnel time) will be quantified separately. Measured in RMB.

The rate of hospital readmission during the follow-up period. Measured as a percentage (%) .

Assessed using a self-developed questionnaire evaluating the nurse-patient relationship. The tool includes two subscales: Trust subscale: Scores range from X to Y, with higher scores indicating greater patient trust in the nurse-patient relationship. Support subscale: Scores range from X to Y, with higher scores indicating greater perceived support from the stoma nurse. Each item is rated on a Likert scale (e.g., 1 = not at all to 5 = completely), and subscale scores are calculated by summing the individual item scores.