Impact of Nurse-Led Interventions on Health-Related Quality of Life (HRQOL) in Stroke Patients: A Systematic Review and Meta-Analysis.

Abstract

Stroke is a major global health concern, often resulting in depression, anxiety, and disability. Effective management strategies, particularly nurse-led interventions, are essential for enhancing health-related quality of life (HRQoL) in stroke patients. This study evaluates the impact of these interventions on post-stroke HRQoL outcomes. To evaluate nurse-led interventions on HRQoL in stroke patients, this systematic review followed PRISMA guidelines. Searches were conducted across multiple databases, including Cochrane Central, Scopus, PubMed, Web of Science, and PsycINFO, to identify relevant randomized controlled trials (RCTs) while applying strict inclusion and exclusion criteria. Data extraction and risk of bias (ROB) assessments using the ROB-2 tool were performed independently by two investigators, with statistical analyses executed using Stata 17 software. From the initial 4,834 studies, nine studies were included for final analysis. Nine studies with 1,135 stroke patients (572 intervention, 563 control) assessed nurse-led interventions on HRQoL. Results showed a significant positive effect of nurse-led interventions (standardized mean difference (SMD): 5.26 [2.09, 8.42], I2: 99.72). Subgroup analysis revealed that Asian countries had a higher effect (SMD: 6.75 [3.45, 10.04]) compared to American and European countries (SMD: 0.08 [-0.87, 1.04]), and interventions over 10 weeks showed greater impact (SMD: 8.55 [5.56, 11.55]) compared to shorter ones (SMD: 3.59 [-0.35, 7.53]). Differences between assessment tools were also significant (p < .001). This meta-analysis shows that nurse-led interventions significantly improve stroke patients' HRQoL, with variations based on geography, intervention duration, and assessment tools. Further research is needed to optimize these interventions in clinical practice.