Associations between perceived discharge planning quality, patient capability, self-management, and quality of life in maintenance haemodialysis: a cross-sectional PLS-SEM study

Background Maintenance haemodialysis requires patients to sustain complex self-management beyond hospital care. Although perceived discharge planning quality is an essential component of transitional care, evidence regarding its associations with patient capability-related outcomes and quality of life remains limited. This study examined associations between perceived discharge planning quality, patient capability-related constructs and quality of life. Methods The study included 370 adults receiving maintenance haemodialysis in Kendari, Indonesia. Validated questionnaires measured discharge planning quality, dialysis health literacy, transition readiness, self-care self-efficacy, self-management behaviour, family support and kidney disease-specific quality of life. Data were analysed using partial least squares structural equation modelling. Results The model explained 51% of the variance in kidney disease-specific quality of life (R² = 0.51). Perceived discharge planning quality was positively associated with transition readiness (β = 0.52, P < 0.001) and self-care self-efficacy (β = 0.34, P = 0.002). Self-management behaviour showed the strongest association with quality of life (β = 0.57, P < 0.001). Transition readiness, self-care self-efficacy and self-management behaviour were involved in statistically significant indirect associations between discharge planning quality and quality of life, while family support moderated the association between self-care self-efficacy and self-management behaviour (β = 0.18, P = 0.024). Conclusions Perceived discharge planning quality was associated with kidney disease-specific quality of life in a model incorporating transition readiness, self-care self-efficacy and self-management behaviour. These findings emphasise patient capability-related factors and family engagement as relevant components of transitional nursing care for adults receiving maintenance haemodialysis.