**Background:** Percutaneous transhepatic biliary drainage (PTBD) is a palliative treatment for malignant obstructive jaundice, most commonly caused by liver and bile duct cancers—the sixth most diagnosed cancers globally in 2020 (~906,000 cases) and the third-leading cause of cancer-related deaths (~830,000 deaths). In Thailand, liver and bile duct cancers have the highest cancer mortality rates. Current standards recommend hospital discharge 1–2 days after PTBD insertion, but there is limited evidence on patient, caregiver, and provider perceptions of discharge readiness. Readiness for hospital discharge encompasses four dimensions: personal status, knowledge, coping ability, and expected support. This study aimed to explore perceived readiness for hospital discharge among patients with liver and bile duct cancers after their first invasive PTBD, along with perspectives of family caregivers and healthcare providers.
**Methods:** A convergent parallel mixed-methods design was used. The quantitative strand included 30 patients (21 men, 9 women; mean age 62.93 years) diagnosed with liver or bile duct cancer who received PTBD between August 1, 2019 and December 31, 2020 at a 1,800-bed university teaching hospital in Thailand. The Thai version of the Readiness for Hospital Discharge Scale (RHDS) was used, consisting of a dichotomous readiness question and 22 items across four subscales (personal status, knowledge, coping ability, expected support) rated 0–10. Cronbach's alpha was 0.8. The qualitative strand involved semi-structured interviews with 10 patients, 10 family caregivers, and 10 healthcare providers (1 doctor, 6 registered nurses, 3 practical nurses). Interviews lasted 30–50 minutes until data saturation. Thematic analysis was used for qualitative data, and quantitative and qualitative results were merged for integration.
**Key Results:** Quantitative: 96.7% (n=29) of patients reported being ready for discharge. The overall mean RHDS score was 8.02 (SD=1.12), classified as high. Among subscales, expected support scored highest (mean 8.89, SD=1.21), followed by coping ability (mean 8.42, SD=1.74), knowledge (mean 7.78, SD=1.67), and personal status (mean 6.74, SD=0.75). Mean length of hospitalization was 11.47 days. Mean length of illness was 62.97 days. Most patients (86.6%) planned post-discharge care by spouses and/or descendants. Qualitative: Three main themes emerged: (1) Improved health condition—patients, caregivers, and providers emphasized physical stability, stable vital signs, adequate lab results, pain control, and absence of complications as prerequisites for discharge. One patient explicitly stated they were not ready due to ongoing pain and weakness. (2) Self-care knowledge—three sub-themes included taking care of biliary drainage (cleaning, preventing infection, avoiding catheter dislodgement), consumption of a suitable diet (small frequent meals, low-fat, nutritious foods), and observation to detect abnormal symptoms (infection, occlusion, dislocation, leakage, cholangitis). (3) Preparedness for homecare—patients and caregivers described practical preparations such as modifying sleeping arrangements, preparing clean environments, and assigning family members to provide care.
**Clinical Implications:** Although overall readiness scores were high, the personal status subscale was the lowest, and qualitative data revealed that some patients felt unready despite reporting readiness—possibly due to gender roles (70% male) or cultural factors. The knowledge subscale was moderate, suggesting that discharge teaching delivered on the day of discharge may be insufficient; gradual education throughout hospitalization is recommended. The high expected support scores and the qualitative theme of preparedness for homecare underscore the importance of family involvement in discharge planning, particularly in Thai cultural contexts where family support is central. Healthcare providers should reassess discharge criteria with attention to individual patient needs, identify readmission risks, and involve both patients and families in discharge preparation to ensure safe transitions and prevent rehospitalization.