Abstract
AIM: We aimed to elucidate the underlying mechanisms influencing Oral nutritional supplementation (ONS) adherence in postoperative patients with gastric cancer (GC) by developing a structural equation model. BACKGROUND: ONS represents a cost-effective nutritional intervention for postoperative patients with GC, with its efficacy largely dependent on sustained patient adherence over time. However, the interrelationships among the quality of discharge teaching (QDT), readiness for hospital discharge (RHD), medication beliefs and adherence to ONS remain inadequately understood. METHODS: A convenience sample of 505 postoperative patients with GC was recruited from January 1, 2023, to December 1, 2024, for a cross-sectional survey conducted at a tertiary-grade A specialised oncology hospital. The data of this study were subjected to descriptive analysis, Harman's one-way analysis of variance, Pearson correlation analysis and mediation effect analysis. REPORTING METHOD: The STROBE checklist was employed for reporting in the study. RESULTS: Pearson correlation analyses revealed that all four variables were significantly interrelated. Structural equation modelling showed that medication beliefs had the strongest correlation with ONS adherence (β = 0.589), followed by readiness for hospital discharge (RHD) (β = 0.557) and quality of discharge teaching (QDT) (β = 0.523). The structural equation model demonstrated a robust overall fit. CONCLUSION: There was a significant chain mediation effect through RHD and medication beliefs. For the development of targeted intervention strategies to improve ONS adherence, future research should prioritise enhancing QDT, optimising RHD and strengthening patients' medication beliefs. RELEVANCE TO CLINICAL PRACTICE: To help nurses and nursing managers formulate intervention measures to improve QDT, RHD, medication beliefs and ONS adherence in postoperative patients with GC.