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Journal of nursing management
Par Luo Y, Ni Q, Hou J et 3 autres.
Contenu en anglais
Evaluate the efficacy and safety of EMAC comprehensive intervention programme for poststroke depression patients.
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Poststroke depression has a high incidence and significant adverse impacts. Pharmacological treatments for PSD carry certain risks. However, there is currently a lack of a comprehensive, evidence-based nonpharmacological intervention programme for PSD in China.
Between May to October 2024, we recruited patients with first-onset stroke complicated by poststroke depression through convenience sampling from a tertiary hospital in Zhejiang Province. Participants were allocated to the EMAC intervention group and the conventional care control group according to their order of enrolment. This programme incorporated four key components: structured health education, mindfulness-based stress reduction training, behavioral activation techniques, and standardised cognitive training. ANCOVA was used to compare the primary outcome between groups while adjusting for baseline scores and repeated-measures analysis of variance was applied to analyze secondary outcomes across the three assessment points. Measures: The primary outcome of this study was the change in depressive symptoms measured using the HAMD-17. Secondary outcomes included the five facet mindfulness questionnaire, behavioral activation for depression scale-short form, Montreal Cognitive Assessment, stroke-specific quality of life scale, and records of adverse event frequency.
Compared with the control group, participants receiving the EMAC programme had significantly lower adjusted HAMD-17 scores at T1 (10.632 [95% CI, 10.119-11.146] vs. 12.112 [95% CI, 11.611-12.613], p < 0.001) and T2 (9.344 [95% CI, 8.663-10.025] vs. 12.053 [95% CI, 11.388-12.718], p < 0.001). Secondary outcomes showed significant improvements over time in the intervention group compared with the control group (p < 0.05).
This programme can effectively improve the health outcomes of patients and provides valuable evidence and reference for clinical application and dissemination of the intervention. Implications for the patient care: The EMAC programme provides nurses with a practical, evidence-based protocol for poststroke depression. It combines education, mindfulness, behavioral activation, and cognitive training and may provide a clear and replicable framework for supporting patients with poststroke depression. The observed improvements in depressive symptoms, cognitive function, and quality of life suggest its potential value in clinical nursing practice. Future studies may explore whether selected components of the programme can be adapted to digital platforms to improve accessibility and implementation efficiency.
Chinese Registry of Clinical Trials: ChiCTR2300070335.
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