The effect of nurse-led interventions on quality of life in stroke patients: a systematic review and meta-analysis.
Yan Zhong, Min Zhou, Chang-Qin Huang
PMID 42047536WHAT IT FOUND
Nurse-led stroke programs improved quality of life on average, but the evidence was weak and results varied widely.
Some programs improved only mental or physical domains, so benefits depend on the intervention content and duration.
Key findings
01Pooled analysis found nurse-led care improved quality of life compared with standard care (mean difference 20.36, 95% CI 4.99-35.73, P=0.009), but heterogeneity was I2=99.93.
02The certainty of evidence for the quality-of-life outcome was rated as low.
03Several included studies improved only specific quality-of-life domains, not all aspects of quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The pooled result had extremely high heterogeneity (I2=99.93). The average effect may not represent any single nurse-led program. GRADE rated the certainty of evidence for quality of life as low. The included nurse-led programs were very different. They included outreach care, nurse navigation, early or remote rehabilitation, home nursing and carer-assisted therapy. It is hard to know which program type or duration worked. Many studies used different quality-of-life scales. The pooled mean difference cannot be read as points on one familiar score. Fifteen of the 21 studies were conducted in China. Most research came from low- and middle-income countries. The results may not transfer to other settings. Non-English publications were excluded. Database filters may have missed relevant studies.
The easy way to misread this
Do not conclude nurse-led care alone improves quality of life. The pooled result was low certainty, heterogeneity was extremely high, and many studies combined nurses with rehabilitation therapists, caregivers or other staff, so the nursing component cannot be separated.