Abstract:

Objective: To explore the application effects of a discharge preparation service program based on King’s theory of goal attainment in patients with pulmonary tuberculosis (PTB). Methods: Using purposive sampling, sixty-five patients with PTB from the TB department of Shanghai Public Health Clinical Center were enrolled as the control group (receiving routine discharge preparation) between August 2024 and October 2025. Another sixty-five PTB patients from the department of respiratory and critical care medicine were enrolled as the experimental group (receiving a discharge preparation service program based on King’s theory of goal attainment). During the study period, one patient dropped out from the experimental group and two from the control group, yielding a final sample of sixty-four patients in the experimental group and sixty-three in the control group. The two groups were compared on discharge readiness, length of hospital stay, self-management behaviors (pre- and post-intervention), unplanned readmission rates within two months after discharge, and the sputum negative conversion rate at the end of the second month after discharge. Results: After the intervention, the total score on the readiness for hospital discharge scale, as well as the scores on its personal status, adaptive ability, and anticipated support subscales, were significantly higher in the experimental group (89.82±9.69, 23.00 (20.00, 25.75), 37.75 (33.00, 40.50), 30.00 (25.25, 33.00)) than in the control group (79.62±11.03, 20.00 (18.00, 23.00), 34.50 (31.33, 37.00), 25.00 (22.00, 28.17)), with statistically significant differences (t=5.537, P<0.001; Z=-3.608, P<0.001; Z=-3.215, P=0.001; Z=-4.035, P<0.001). At two months after discharge, the total score on the self-management behavior scale, as well as the scores on its treatment adherence, treatment support, and transmission prevention subscales, were significantly higher in the experimental group (82.48±2.30, 23.31±1.77, 29.53±1.01, 29.64±0.76) than in the control group (78.05±4.27, 21.63±2.76, 27.78±1.87, 28.63±1.73), with statistically significant differences (t=7.271, P<0.001; t=4.068, P<0.001; t=6.563, P<0.001; t=4.236, P<0.001). The unplanned readmission rate within two months after discharge in the experimental group (14.06% (9/64)) was significantly lower than that in the control group (28.57% (18/63)), with a statistically significant difference (χ²=3.992, P=0.046). There was no statistically significant difference (Z=-0.230, P=0.818) in length of hospital stay between the experimental group (11.00 (9.00, 14.00) d) and the control group (11.50 (9.50, 14.00) d). At the end of the second month after discharge, the sputum negative conversion rate in the experimental group (91.67% (33/36)) showed no statistically significant difference (Fisher’s exact test,P=0.702) compared with the control group (87.88% (29/33)). Conclusion: The discharge preparation service based on King’s theory of goal attainment can effectively improve discharge readiness and self-management behavior, and reduce unplanned readmission rates within two months after discharge in patients with PTB, but has no significant effect on the length of hospital stay and sputum negative conversion rate at the end of the second month after discharge.

Key words: Tuberculosis, pulmonary, Patient discharge, Health education, Nursing theory