Abstract
BACKGROUND: Readiness for hospital discharge is a critical factor in the recovery of breast cancer patients, facilitating the transition from inpatient care to home-based self-management. While adequate preparation equips patients with the necessary knowledge and skills, effective behavioral change often requires support from the family system. Grounded in Family Systems Theory and Family Resilience Model, this study examined the relationship between readiness for hospital discharge (RHD) and self-management efficacy (SME) and tested the mediating role of family resilience (FR)-a key indicator of family adaptability. METHODS: A cross-sectional survey was conducted between February 2024 and January 2025 at a tertiary hospital in Wuxi, China. Data were collected from 265 postoperative breast cancer patients using the Readiness for Hospital Discharge Scale (RHDS), the Family Hardiness Index (FHI), and the Self-Management Efficacy Scale for Cancer Patients (C-SUPPH). Pearson correlation analysis and structural equation modeling (SEM) were employed to examine associations and mediation effects. RESULTS: Of the 274 questionnaires distributed, 265 were valid (response rate: 96.72%). The mean scores were 85.56 ± 9.62 (RHDS), 42.55 ± 5.70 (FHI), and 95.62 ± 13.16 (C-SUPPH). Readiness for hospital discharge was significantly correlated with both family resilience (r = 0.343, p < 0.01) and self-management efficacy (r = 0.394, p < 0.01). SEM results indicated that family resilience partially mediated the relationship between Readiness for hospital discharge and self-management efficacy, accounting for 29.60% of the total effect. CONCLUSION: Readiness for hospital discharge significantly predicts self-management efficacy in breast cancer patients, with family resilience serving as a key mediating factor. These findings support targeted interventions to improve discharge preparation and family resilience, thereby enhancing recovery and outcomes.