A Study on the Multifactorial Causal Relationships of Discharge Readiness Among Women Delivering Vaginally: A Configuration Perspective

Objective Using fuzzy set qualitative comparative analysis (fsQCA), this study identified the necessary conditions for high discharge readiness among women who gave birth vaginally from a configuration perspective, analyzed the sufficiency configurations, and identified multiple equivalent configurations that result in high discharge readiness. Methods: This cross-sectional study recruited women who delivered vaginally at a tertiary hospital in Zunyi City between April 2025 and December 2025. By assessing individual demographic characteristics, the severity of perineal tears, scores on various dimensions of comfort, the quality of discharge instructions, and discharge readiness, the fsQCA method was used to explore the primary factors influencing discharge readiness among women who delivered vaginally. Methods This study employed a cross-sectional design and recruited women who had given birth vaginally at a tertiary hospital in Zunyi City between April and December 2025. By assessing individual demographic characteristics, the severity of perineal tears, scores on various dimensions of comfort, the quality of discharge instructions, and discharge readiness, the fsQCA method was used to identify the primary factors influencing discharge readiness among women who had given birth vaginally. Results The necessity analysis revealed that the consistency of each individual antecedent condition—including the severity of perineal injury, physical comfort, psychological comfort, sociocultural comfort, environmental comfort, and the quality of discharge instructions—was below the 0.90 threshold; thus, no single condition was found to be a necessary prerequisite for high discharge readiness. The adequacy analysis identified five high-discharge-readiness configurations (H1–H5), with an overall solution consistency of 0.816 and an overall solution coverage of 0.612, explaining 61.2% of the cases with high discharge readiness. Among these, the H4 pathway (high physiological comfort + high psychological comfort + high sociocultural comfort + high environmental comfort + high injury severity) is the core pathway, covering 39.7% of patients with high readiness (primitive coverage = 0.397, unique coverage = 0.041, consistency = 0.866). Configuration analysis indicates that psychological comfort and sociocultural comfort are core conditions widely present across all pathways, while physiological comfort and psychological comfort may co-occur (H4) or substitute for one another (H1). Conclusion High readiness for discharge among women who have given birth vaginally does not depend on a single dimension of comfort, but is driven by a combination of factors, including physiological, environmental, and psychosocial-cultural dimensions. This suggests that clinical interventions should be tailored based on the specific comfort profiles of individual mothers. The findings of this study can help obstetric healthcare providers prioritize the identification of weak dimensions in mothers’ readiness-for-discharge profiles, develop personalized intervention strategies, and optimize the quality of guidance provided regarding readiness for discharge and transitional care.