To explore the effectiveness of comfort nursing intervention in the care of elderly patients with acute cerebral infarction to improve patient comfort and quality of life.
In this study, 120 elderly patients with acute cerebral infarction were randomly divided into an experimental group and a control group. The experimental group was given individualized nursing intervention based on comfort nursing intervention, including physical, psychological, social and environmental nursing. The control group received routine nursing measures. The National Institutes of Health Stroke Scale, Fugl-Meyer Assessment of Motor Function Scale, Activities of Daily Living Assessment Scale, Newcastle Nursing Satisfaction Scale and Hamilton Anxiety Scale were used to evaluate the degree of neurological deficits, motor function recovery, self-care ability of daily life, satisfaction with nursing services and anxiety level of the two groups of patients. The data were analyzed using SPSS software.
The effective implementation of comfort nursing intervention significantly improved the neurological function, motor ability, activities of daily living and nursing satisfaction of elderly patients with acute cerebral infarction, and reduced the level of anxiety (
The effective implementation of comfort nursing intervention significantly improved the comfort and quality of life of elderly patients with acute cerebral infarction, indicating that the application of this theory in clinical nursing is of great value.
Acute cerebral infarction, commonly known as stroke, is due to the interruption of blood supply to the brain, resulting in brain tissue hypoxia and undernutrition, which leads to local neurological dysfunction (
Scientific nursing programmes play a vital role in the treatment and rehabilitation of acute cerebral infarction. Effective nursing can not only improve the patient's physical condition and promote the recovery of physical function but also considerably improve the patient's psychological state and quality of life (
Comfort care theory emphasizes the creation of a comprehensive and comfortable treatment and nursing environment for patients, aiming to improve their overall comfort through physiological, psychological and social support (
The purpose of this study is to explore the effect of individualized nursing programmes based on comfort nursing intervention on the comfort and overall recovery of elderly patients with acute cerebral infarction, thus providing a more scientific basis for clinical nursing. Through the implementation of individualized nursing programmes based on comfort care theory, this study systematically evaluates the effectiveness of nursing interventions in improving patients' physical comfort, reducing psychological burden and enhancing social support. In addition, the results of the study provide an important reference for future nursing practice and related policy formulation. Through empirical data, nursing staff and managers can understand more deeply the importance of comfort care, thus promoting the innovation and development of nursing modes.
In this study, 120 elderly patients with acute cerebral infarction were randomly divided into an experimental group and a control group. The experimental group received individualized nursing programmes based on comfort nursing intervention, whereas the control group received routine nursing. The study collected general information of patients, including age, gender, marital status, body mass index (BMI), underlying diseases (e.g., hypertension, diabetes, dyslipidaemia) and other information for subsequent analysis and comparison. No participants dropped out during the study period.
The inclusion criteria were as follows: (1) aged ≥60 years, in line with the definition of elderly people; (2) diagnosed as acute cerebral infarction and participated in the study within 72 h after admission; (3) understood the research content, participated voluntarily and signed informed consent; (4) had cognitive ability and could perform effective communication and cooperation with nursing; and (5) had no serious complications (e.g., severe heart disease, renal failure) and could accept routine nursing and comfort nursing intervention.
The exclusion criteria were as follows: (1) received other related intervention studies in the past 6 months; (2) serious mental illness, cognitive impairment or inability to understand the research content; (3) serious complications (e.g., cerebral hemorrhage, infection) during the study period that required transferral to the intensive care unit; (4) refusal to participate in, or withdrawal from, the study for other reasons (e.g., family factors, personal wishes); and (5) other diseases that could affect the results of the study (e.g., malignant tumors, severe lung diseases).
Routine nursing programme: (1) regular monitoring of the patient's heart rate, blood pressure, respiratory rate and body temperature; (2) timely detection of abnormalities; (3) close observation of the patient's neurological function changes, such as state of consciousness, motor function and language ability; (4) recording of the disease development; and (5) assisting the patient in daily activities, such as washing, dressing and eating, to ensure that their basic living needs were met according to their specific circumstances, and developing an appropriate diet plan to ensure adequate nutritional support and promote rehabilitation.
Comfortable care programme: the interventions were explicitly designed based on Kolcaba's four comfort dimensions: (1) physical—personalized rehabilitation plan, nutritional support, vital signs monitoring, skin care, thrombosis prevention; (2) psychological—emotional support, psychological counseling, establishing nurse–patient relationship; (3) social—family communication and education; and (4) environmental—provision of a quiet and comfortable nursing space. Based on ensuring routine care, the following care methods were also included. (1) Based on the patient's self-care ability, a personalized rehabilitation plan was developed, including physical therapy, functional training and rehabilitation training to improve the patient's self-care ability and recovery function. (2) A comprehensive nutritional assessment was conducted to understand the nutritional status of patients; based on the evaluation results and the patient's taste preferences, a personalized diet plan was developed to ensure that patients received sufficient nutrients. (3) Patients were provided with emotional support and comfort and a good nurse–patient relationship was established, meaning patients' confidence and enthusiasm for treatment were enhanced, helping them to understand the development of relevant treatment programmes, disease progression, pipeline maintenance and the occurrence and treatment of adverse events. Psychological counseling and intervention were also provided to help patients cope with emotional and psychological distress during treatment. (4) Vital signs, including blood pressure, body temperature, pulse and respiration, were regularly observed to detect abnormalities promptly. Nursing measures, including turning over, bedding and skin care, were implemented to prevent pressure sores and other complications. (5) To prevent thrombosis, patients were encouraged to perform activities such as exercising their limbs and using anticoagulants on time. (6) Effective education and communication with the patient's family members were established, providing disease knowledge and nursing guidance, so that they could participate in the patient's care.
The intervention period of this study was 4 weeks. All patients completed the baseline assessment (T0) at the time of enrolment (before intervention). The first post-test (T1) was conducted within 24 h after the end of the intervention to evaluate the immediate effect. To evaluate the persistence of the short-term effect, the second post-test (T2) was conducted 1 month after the end of the intervention. The control group received the same assessment at the same time points. All assessments were completed by researchers who were unaware of the grouping situation.
The National Institutes of Health Stroke Scale (NIHSS) (
The Fugl-Meyer Assessment (FMA) scale (
The Activities of Daily Living (ADL) scale (
The Newcastle Satisfaction with Nursing Scale (NSNS) (
The Hamilton Anxiety Scale (HAMA) (
Statistical analysis was performed using SPSS 26.0 statistical software. The measurement data were expressed as mean ± standard deviation (x ± s), and the mean comparison between groups was performed using the
In this study, 120 elderly patients with acute cerebral infarction were randomly divided into an intervention group and a control group. There were 34 men and 23 women in the intervention group, with an average age of 65.46 ± 3.77 years, and there were 38 men and 20 women in the control group, with an average age of 66.34 ± 4.16 years. There was no significant difference in age, sex ratio, BMI, marital status and basic diseases between the two groups (
Comparison of general data of patients.
| Variable | Experimental group ( |
Control group ( |
||
|---|---|---|---|---|
| Mean age | 65.46 ± 3.77 | 66.34 ± 4.16 | −1.199 | 0.233 |
| Gender | 0.423 | 0.516 | ||
| Male | 34 | 38 | ||
| Female | 23 | 20 | ||
| BMI index |
23.89 ± 1.43 | 23.97 ± 1.76 | −0.268 | 0.790 |
| Marital status | 0.078 | 0.780 | ||
| Non-married | 12 | 11 | ||
| Married | 45 | 47 | ||
| Underlying | 0.091 | 0.763 | ||
| diseases | ||||
| Yes | 48 | 50 | ||
| No | 9 | 8 |
Before the intervention, the NIHSS score of the experimental group was 21.33 ± 2.75, and that of the control group was 21.59 ± 3.13. There was no significant difference in the scores between the two groups before intervention (
Comparison of NIHSS scores within and between groups before and after intervention.
| Group | Number | Before intervention | After intervention | ||
|---|---|---|---|---|---|
| Experimental group | 57 | 21.33 ± 2.75 | 6.82 ± 1.02 | 39.986 | < 0.001 |
| Control group | 58 | 21.59 ± 3.13 | 11.24 ± 1.79 | 21.589 | < 0.001 |
| −0.459 | −16.220 | ||||
| 0.647 | < 0.001 |
Before the intervention, the FMA score of the experimental group was 41.86 ± 5.51, and that of the control group was 42.55 ± 6.38. There was no significant difference in the scores between the two groups before the intervention (
Comparison of FMA scores within and between groups before and after intervention.
| Group | Number | Before intervention | After intervention | ||
|---|---|---|---|---|---|
| Experimental group | 57 | 41.86 ± 5.51 | 75.95 ± 7.71 | −26.173 | < 0.001 |
| Control group | 58 | 42.55 ± 6.38 | 63.34 ± 6.59 | −16.696 | < 0.001 |
| −0.622 | 9.433 | ||||
| 0.535 | < 0.001 |
Before the intervention, the ADL score of the experimental group was 32.00 ± 3.88, and that of the control group was 32.36 ± 4.26. There was no significant difference in the scores between the two groups before the intervention (
Comparison of ADL scores within and between groups before and after intervention.
| Group | Number | Before intervention | After intervention | ||
|---|---|---|---|---|---|
| Experimental group | 57 | 32.00 ± 3.88 | 69.61 ± 6.98 | −36.068 | < 0.001 |
| Control group | 58 | 32.36 ± 4.26 | 59.81 ± 4.93 | −30.761 | < 0.001 |
| −0.476 | 8.713 | ||||
| 0.635 | < 0.001 |
The NSNS score of the experimental group was 5.05 ± 0.35, whereas that of the control group was 3.07 ± 0.26. Statistical analysis showed that the difference in NSNS scores was significant (
Comparison of NSNS and HAMA scores between groups after intervention.
| Group | Number | NSNS | HAMA |
|---|---|---|---|
| Experimental group | 57 | 5.05 ± 0.35 | 7.84 ± 2.80 |
| Control group | 58 | 3.07 ± 0.26 | 14.48 ± 3.50 |
| 34.782 | −11.229 | ||
| < 0.001 | < 0.001 |
Our findings are consistent with several recent randomized controlled trials (RCTs) that have applied holistic or comfort-based interventions in stroke care. For example, an RCT by Li et al. (
The results of this study reveal that the experimental group had a significant improvement in functional exercise recovery, daily living ability and psychological state, indicating that the nursing intervention measures adopted effectively promoted the comprehensive rehabilitation of patients with stroke. This result is consistent with the research results in the relevant literature, emphasizing the importance of active intervention for patients with stroke on their functional and mental health. In terms of functional exercise recovery, the FMA score of the experimental group was significantly higher than that of the control group, which may be attributed to a more systematic and personalized rehabilitation plan. By formulating individualized nursing strategies, more accurate interventions can be provided according to the needs of different patients, thus effectively improving their exercise and self-management abilities. In the improvement of daily living ability, the ADL score of the experimental group was significantly improved, indicating that nursing intervention not only enhanced the physical function of patients but also improved their ability to participate in daily activities. This change helps patients rebuild their confidence and independence, thus promoting a better quality of life. In addition, the experimental group showed lower anxiety levels and better neuropsychiatric status in terms of psychological status, indicating that nursing measures played an important role in psychological support and emotional care. Anxiety is a common complication of patients with stroke, affecting their recovery process. Therefore, the implementation of comprehensive nursing measures can help to reduce the psychological burden of patients and provide a positive psychological environment, thus promoting overall rehabilitation. In conclusion, the results support the necessity and effectiveness of comprehensive nursing intervention for patients with stroke. In future studies, the specific mechanisms of different nursing measures can be explored, and the long-term effects can be evaluated to provide a more solid theoretical basis for clinical practice.
Although this study has drawn positive conclusions, there are still some limitations that need attention. First, the sample size is relatively small, which may affect the generalization of the results. Future studies may consider expanding the sample size to enhance the reliability of statistics and the general applicability of the results. Second, the observation period of this study was short, and the long-term effect of nursing intervention was not evaluated. Therefore, it is recommended that follow-up studies use a longer follow-up time to observe the patient's continuous functional recovery and quality of life changes. In addition, there may be differences in baseline characteristics between the experimental group and the control group, which may have an impact on the results. Future research should be conducted on the basis of random grouping to enhance the reliability of the results.
Nursing intervention for patients with stroke has a wide range of clinical benefits. Future research can compare the effects of different types of nursing intervention (e.g., physical therapy, psychological counseling, nutritional support) to find the best combination of interventions to achieve a more comprehensive improvement effect. Based on the specific conditions of patients, we should develop individualized nursing programmes, analyse the differences in response of different patients and provide more targeted nursing methods for clinical practice. We should endeavor to study the independent effect of psychological support on the rehabilitation of patients with stroke and explore modes of combining psychological intervention with medical nursing to improve the overall therapeutic effect. Furthermore, long-term follow-up surveys should be established to evaluate the impact of nursing intervention on patients' long-term health and quality of life and establish a corresponding evaluation mechanism to provide a basis for future clinical decision-making. By actively exploring these directions, future research will further enrich the theoretical basis of nursing intervention for patients with stroke and provide a more comprehensive solution for improving their treatment effect and quality of life.
The results of this study indicate that the experimental group was significantly better than the control group in functional exercise recovery (FMA score), daily living ability (ADL score) and psychological state (NSNS and HAMA scores) following specific nursing intervention. The results reveal that the nursing intervention measures in the experimental group had significant effects in improving the functional recovery, daily living ability and psychological state of patients after stroke, which suggests that the measures have important clinical application value. It is recommended to promote the application of this intervention in the nursing process of patients post-stroke to improve their overall treatment outcome and quality of life.
The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.
The studies involving humans were approved by the Ethics Committee of Ganzhou People's Hospital. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
RuD: Conceptualization, Formal analysis, Methodology, Supervision, Writing – original draft, Writing – review & editing. ZG: Data curation, Investigation, Writing – review & editing. RoD: Data curation, Investigation, Writing – review & editing.
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that generative AI was not used in the creation of this manuscript.
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