Mediating effect of readiness for hospital discharge and self-efficacy on adherence to nutritional therapy in postoperative patients with gastric cancer: a structural equation modeling approach

Objective Adherence to nutritional therapy is important for recovery, nutritional status, and clinical outcomes after gastric cancer surgery. Discharge teaching, psychological resilience, readiness for hospital discharge, and self-efficacy may all influence whether patients follow nutritional recommendations at home. The purpose of this study was to examine how the quality of discharge teaching and psychological resilience relate to adherence to nutritional therapy among postoperative patients with gastric cancer, and to test whether readiness for hospital discharge and self-efficacy mediate these associations. Methods This short-term prospective observational study recruited postoperative patients with gastric cancer from a cancer hospital in China. Participants completed questionnaires assessing quality of discharge teaching, psychological resilience, readiness for hospital discharge, self-efficacy, and adherence to nutritional therapy. Structural equation modeling was used to examine direct and indirect relationships among these variables. Results Quality of discharge teaching and psychological resilience were directly associated with adherence to nutritional therapy. Significant indirect associations were identified through readiness for hospital discharge alone and through the sequential pathway from readiness for hospital discharge to self-efficacy, whereas the indirect pathways through self-efficacy alone were not statistically significant. Conclusion The associations of the quality of discharge teaching and psychological resilience with adherence to nutritional therapy were partly explained by indirect pathways through readiness for hospital discharge and self-efficacy. Early assessment and targeted strategies to strengthen discharge teaching, psychological resilience, readiness for discharge, and self-efficacy may support adherence to nutritional therapy among postoperative patients with gastric cancer.