Mediating role of coping styles in the relationship between readiness for hospital discharge and quality of life among patients after radical prostatectomy

The promotion of enhanced recovery after surgery has shortened hospital stay of patients after radical prostatectomy, with most being discharged during the critical recovery period. These patients are prone to inadequate discharge preparation due to issues such as urinary dysfunction and indwelling catheterization. Although readiness for hospital discharge has been regarded as an important factor influencing patient prognosis, the mechanism by which it affects quality of life remains unclear. Based on the stress and coping theories, this study aims to explore the mediating role of coping styles in the relationship between readiness for hospital discharge and quality of life among patients after radical prostatectomy, providing evidence for developing targeted transitional care interventions.

A prospective longitudinal study design was adopted. From August 2024 to September 2025, 161 patients undergoing radical prostatectomy in the urology departments of 3 tertiary grade A hospitals in Chongqing were conveniently selected as the survey subjects. Within 24 h before discharge, the general information questionnaire, Readiness for Hospital Discharge Scale (RHDS), and Medical Coping Modes Questionnaire (MCMQ) were used for the investigation. Quality of Life (QOL) score was assessed through on-site or telephone evaluation at 1 month after surgery. The Process macro program Model 4 was utilized to construct a mediating effect model to test the mediating effect of coping styles.

The mean RHDS score of the 161 patients after radical prostatectomy was 84. 72±17. 96. The 3 dimensions of coping styles scored as follows: confrontation 19. 02±4. 02, avoidance 14. 57±2. 69, and resignation 8. 19±2. 57. The QOL score was 46. 50±7. 11. Pearson correlation analysis showed that the total score of quality of life was positively correlated with the total score of discharge readiness and the scores of each dimension (r=0. 485 to 0. 618, P<0. 01), positively correlated with the confrontation dimension of medical coping modes (r=0. 361, P<0. 01), not significantly correlated with the avoidance dimension, and negatively with the resignation dimension (r=-0. 383, P<0. 01). Process mediating effect analysis indicated that the mediating effect value of coping styles between readiness for hospital discharge and quality of life was 0. 038, with a 95%CI of 0. 014 to 0. 068, and the total mediating effect was significant (P<0. 01). The mediation effect accounted for 15. 89% of the total effect, with confrontation coping and resignation coping accounting for 6. 74% and 9. 15%, respectively.

Coping styles play a partial mediating role between readiness for hospital discharge and quality of life, with the mediating effect of reducing resignation coping being stronger. This suggests that clinicians should focus on identifying and intervening in patients with resignation coping tendencies to improve quality of life.