Readiness for hospital discharge is a key determinant of postoperative rehabilitation and recovery. Traditional discharge education often does not address individualized needs for patients undergoing laryngeal cancer surgery, who may face complex functional, psychosocial, and self-care challenges. The Cox Interaction Model of Client Health Behavior (IMCHB) is a patient-centered framework that emphasizes interaction, individualized assessment, and empowerment. The IMCHB has been applied in various settings but is infrequently reported in patients after laryngeal cancer surgery. This study evaluated whether an IMCHB-based discharge preparation program, delivered in addition to routine nursing care, was associated with improved readiness for discharge, better self-management ability, and changes in anxiety and depression.
This was a quasi-experimental, non-randomized controlled study using convenience sampling at a tertiary hospital. Sixty-five patients undergoing laryngeal cancer surgery were enrolled and assigned by admission order: 33 patients to the intervention group and 32 patients to the control group. The control group received routine nursing care. The intervention group received an IMCHB-based discharge preparation intervention in addition to routine care. Assessments were performed before the intervention, at discharge, and at 1 month after discharge.
The discharge program was explicitly based on the Cox Interaction Model of Client Health Behavior (IMCHB). The intervention complemented routine nursing care and focused on patient-centered interaction and empowerment, aiming to tailor education and preparation to individual needs before discharge. The PubMed abstract reports that this IMCHB-based preparation was the distinguishing element between the intervention and control groups; specific intervention components and delivery details were not reported in the abstract.
Groups were compared on three primary domains: readiness for hospital discharge, self-management ability, and anxiety/depression. Measurements were taken at three timepoints: baseline (before the intervention), at discharge, and 1 month after discharge. Effect sizes and 95% confidence intervals were calculated for key between-group comparisons as reported in the abstract.
At the time of discharge, the intervention group showed significantly higher readiness-for-discharge scores compared with controls (99.97 ± 6.31 vs 88.09 ± 6.14). The mean difference (MD) was 11.88 (95% CI: 8.65–14.71), with a large effect size (Cohen’s d = 1.91).
Self-management ability at discharge was also higher in the intervention group (174.73 ± 9.35 vs 152.13 ± 12.78), with MD = 22.60 (95% CI: 17.05–28.15) and a large effect size (Cohen’s d = 2.02).
Anxiety scores at discharge were lower in the intervention group (41.48 ± 2.89 vs 43.19 ± 3.70), MD = −1.71 (95% CI: −3.36 to −0.06), corresponding to a moderate effect (Cohen’s d = 0.51).
At 1 month after discharge, the between-group difference in self-management ability persisted: median values were 189.00 (interquartile range 186.00–191.50) for the intervention group versus 144.00 (133.00–154.50) for controls (Mann-Whitney r = 0.86).
Depression scores at 1 month were lower in the intervention group (40.73 ± 3.18 vs 46.75 ± 3.09), with MD = −6.02 (95% CI: −7.57 to −4.47) and a large effect size (Cohen’s d = 1.92).
In this non-randomized study, an IMCHB-based discharge preparation program was associated with higher readiness for discharge and substantially higher self-management ability at discharge and at 1 month. The intervention was also associated with reductions in anxiety at discharge and lower depression scores at 1 month. The reported effect sizes for readiness for discharge and self-management were large, indicating clinically meaningful differences in this sample.
These findings suggest that applying a structured, patient-centered model such as the IMCHB to discharge preparation may improve psychological and self-care outcomes in patients after laryngeal cancer surgery. Enhanced readiness for discharge and stronger self-management ability may support recovery and reduce the risk of post-discharge complications or unmet care needs, although the study did not report downstream clinical events.
Key limitations reported in the abstract include the study design and sample selection: this was a quasi-experimental, non-randomized trial using convenience sampling and assignment by admission order, which can introduce selection bias and limit causal inference. The abstract does not detail the specific components or fidelity of the IMCHB-based intervention, nor does it report longer-term clinical outcomes beyond 1 month. Authors explicitly advise cautious interpretation of the results and call for randomized controlled trials to confirm effectiveness and clinical utility.
Clinicians and program designers interested in discharge planning for laryngeal cancer surgery patients may consider the IMCHB as a theoretical framework for individualized, interaction-focused preparation, but should await randomized evidence or examine implementation and evaluation locally with rigorous methods.