Effects of predictive nursing intervention on cognitive impairment and neurological function in ischemic stroke patients

Lianyu Xue; Jiangshan Deng; Lingyan Zhu; Feifei Shen; Jiewei Wei; Lihui Wang; Qinqin Chen; Lan Wang

doi:10.1002/brb3.2890

Effects of predictive nursing intervention on cognitive impairment and neurological function in ischemic stroke patients

Brain Behav. 2023 Mar;13(3):e2890. doi: 10.1002/brb3.2890. Epub 2023 Feb 3.

Authors

Lianyu Xue¹, Jiangshan Deng², Lingyan Zhu¹, Feifei Shen², Jiewei Wei², Lihui Wang², Qinqin Chen², Lan Wang³

Affiliations

¹ Department of Nursing, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui District, Shanghai, China.
² Department of Neurology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui District, Shanghai, China.
³ Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Xuhui District, Shanghai, China.

Abstract

Background: Ischemic stroke is a clinical emergency caused by insufficient intracranial blood supply, which eventually leads to brain tissue necrosis and neurological impairment. Predictive nursing intervention has achieved impressive success in the nursing of multiple surgeries. However, the role of predictive nursing intervention in the care of patients with ischemic stroke remains unclear.

Methods: This study was a randomized controlled trial. Based on the inclusion and exclusion criteria, 126 patients were randomly assigned into two groups, namely the control group and the predictive nursing intervention group. Both groups were treated with thrombolytic therapy with alteplase. The patients in the control group were given routine nursing intervention and the predictive nursing intervention group received additional predictive care. Neurologic functions and cognitive impairment were evaluated by National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA), Montreal cognitive assessment (MoCA), and mini-mental state examination (MMSE) scales, respectively. Door-to-Needle Times, venous thromboembolism (VTE)-related parameters, and complications were recorded.

Results: Predictive nursing intervention significantly shortened the Door-to-Needle Times and enhanced the peak/average femoral venous blood flow and femoral venous diameter. In addition, predictive nursing intervention improved the NIHSS, FMA, MMSE, and MoCA scores and remarkably reduced the recurrence of ischemic stroke, deep vein thrombosis and gingival bleeding.

Conclusion: Predictive nursing intervention is beneficial to improve the effects of thrombolytic therapy in patients with ischemic stroke, which improves the neurological, cognitive and motor functions of patients, and reduces the occurrence of complications, suggesting an important clinical application value.

Keywords: cognitive impairment; complications; ischemic stroke; neurological function; predictive nursing intervention; thrombolytic therapy.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / drug therapy
Cognitive Dysfunction* / etiology
Humans
Ischemic Stroke* / complications
Mental Status and Dementia Tests
Stroke* / complications
Stroke* / diagnosis
Stroke* / drug therapy
Tissue Plasminogen Activator

Substances

Tissue Plasminogen Activator