General ward nurses play a key role in discharge planning for end-stage cancer patients. It is necessary to assess the factors regarding their practice to promote discharge planning in accordance with end-stage cancer patients’ wishes. This study aimed to investigate the relationships between general ward nurses’ practice of discharge planning for end-stage cancer patients, self-efficacy, ethical behavior, attitude, knowledge and experience, perceived skills, and perceived barriers. A total of 288 general ward nurses from nine hospitals in a city in Japan completed the questionnaire. Path analysis was conducted to test the hypotheses. The results showed that nurses’ self-efficacy, ethical behavior (do-no-harm, do-good), knowledge (experience of attending home care seminars), and perceived skills (assertiveness) were positively and directly related to the practice of discharge planning. Nursing experience and perceived skills (assertiveness) were positively associated with discharge planning practice, while perceived barriers (death discussion) and attitude (degree of leaving it to discharge planning nurses (DPNs)) were negatively associated, with self-efficacy acting as a mediator. Thus, our findings show that it is important to enhance self-efficacy and nursing ethical behavior to improve the practice of discharge planning. Accordingly, education regarding home care, assertive communication skills, death discussion, and ethics is needed for general ward nurses.

Objectives: We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract. Methods: Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLAN_ref) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D_0.5cc) was evaluated for each planning at-risk volume of the GI tract. Spearman’s correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD_0.5cc dose to D_0.5cc dose in PLAN_ref (ΔD_0.5cc/PLAN_ref) for quantitative analysis. Results: The median shortest distance in PLAN_ref was 0 mm in the gastroduodenum (interquartile range, 0–2.7), 16.7 mm in the small intestine (10.0–23.7), and 16.7 mm in the large intestine (8.3–28.1 mm). The D_0.5cc of PLAN_ref in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD_0.5cc/ PLAN_ref in the small or large intestine (p < 0.001) but not in the gastroduodenum (p = 0.404). Conclusions: The gastroduodenum had a higher D_0.5cc and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT. Advances in knowledge: This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract. Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.

Background: The Care Transitions Scale for Patients With Heart Failure (CTS-HF) is a scale that registered nurses working in the cardiovascular ward use to assess patients' readiness for hospital discharge; CTS-HF has shown sufficient reliability and validity for use. Objective: In this study, our aim was to test the relationship between assessments using CTS-HF by nurses and patients' difficulties of symptom management and self-care 1 week after discharge. Methods: In this longitudinal study we paired responses from nurses and patients with heart failure between 2022 and 2023. A nurse assessed a patient’s readiness for hospital discharge using CTS-HF. One week after discharge, patients with heart failure completed a questionnaire about their daily difficulties at home. The relationship between the nurse-reported CTS-HF scores and patients' difficulties at home was analyzed. Results: Twenty-three dyads of nurse-patient responses were included in the analysis. Nurse-assessed CTS-HF scores were significantly correlated with patients' symptom management difficulties at home ( r = −0.471, P = .012), degree of interference with daily life due to symptoms ( r = −0.530, P = .005), daily healthy ways to manage symptoms ( r = 0.561, P = .003), and emotional support at home ( r = 0.435, P = .019). Conclusions: Nurse-reported CTS-HF scores showed a relationship with patients' difficulties after discharge. Because nurses' assessment before discharge may predict patients' difficulties managing symptoms after discharge, such discharge readiness assessment by nurses using CTS-HF may be useful in transitional care from hospital to home. Further studies on patients with complex care needs are warranted.