Healing minds, restoring lives: a nursing approach to post-stroke emotional recovery reimagined
DOI:
https://doi.org/10.56294/saludcyt20261831Keywords:
Stroke Survivors, Post-stroke Emotional Recovery, Nursing InterventionAbstract
Introduction: Stroke survivors frequently experience depression, anxiety, and other neuropsychiatric issues. Despite this, limited research exists on post-stroke psychological disorders, particularly within the Indian context. Non-pharmacological interventions offer promise and warrant further exploration.
Objective: To evaluate the effect of stroke recovery nursing interventional package among survivors of stroke.
Methods: An assessment was carried out on 144 post-stroke patients.The experimental and control groups each received an equal number of participants, assigned non-randomly.The experimental group received a structured intervention twice weekly for four weeks. Evaluations were conducted at three key points: Initial Screening, Pre-intervention and post-intervention test.
Results: Statistically significant improvements were observed in depression (mean difference: 3,73), anxiety (5,38), and resilience (26,83) at p<0,05. Weak positive correlations were found between resilience and both depression and anxiety. Statistically significant improvements were observed in depression (mean difference: 3,73), anxiety (5,38), and resilience (26,83) at p<0,05. Weak positive correlations were found between resilience and both depression and anxiety.”
Conclusions: The intervention effectively reduced psychological symptoms, especially when combined with pharmacological treatment for severe cases.
References
1. Coupland AP, Thapar A, Qureshi MI, Jenkins H, Davies AH. The definition of stroke. J R Soc Med. 2017 Jan;110(1):9-12. doi:10.1177/0141076816680121. DOI: https://doi.org/10.1177/0141076816680121
2. Rangamani S, Huliyappa D, Kulothungan V, Saravanan S, Murugan PK, Mahadevan R, et al. Stroke incidence, mortality, subtypes in rural and urban populations in five geographic areas of India (2018–2019): results from the National Stroke Registry Programme. Lancet Reg Health Southeast Asia. 2024 Apr;23:100308. doi:10.1177/014107681668012. DOI: https://doi.org/10.1016/j.lansea.2023.100308
3. Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke. 2013;15(3):128-34. doi:10.5853/jos.2013.15.3.128. DOI: https://doi.org/10.5853/jos.2013.15.3.128
4. Kamalakannan S, Gudlavalleti VM, Prost A, Natarajan S, Pant H, Chitalurri N, et al. Rehabilitation needs of stroke survivors after discharge from hospital in India. Arch Phys Med Rehabil. 2016 Sep;97(9):1526-1532.e9. doi:10.1016/j.apmr.2016.02.008. DOI: https://doi.org/10.1016/j.apmr.2016.02.008
5. Kurmi RN, Mandal L, Singh R, Chaudhary PK, Dhungana T, Lamichanne S, et al. Stroke among patients admitted to a tertiary care centre: a descriptive cross-sectional study. J Nepal Med Assoc. 2023 Apr 1;61(260):305-9. doi:10.31729/jnma.8075. DOI: https://doi.org/10.31729/jnma.8075
6. Khan SP. Identifying high-risk populations for stroke in South Gujarat: a cross-sectional analysis of risk factors and implications. Int J Sci Res. 2023 Aug 5;12(8):2291-3. doi:10.21275/SR23824222750. DOI: https://doi.org/10.21275/SR23824222750
7. Feigin, V. L., Forouzanfar, M. H., Krishnamurthi, R., Mensah, G. A., Connor, M., Bennett, D. A., ... & Moran, A. E. (2016). Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet, 383(9913), 245-254. DOI: https://doi.org/10.1016/S0140-6736(13)61953-4
8. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019 Mar 5;139(10):e56–e528. doi:10.1161/CIR.0000000000000659 DOI: https://doi.org/10.1161/CIR.0000000000000659
9. Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM. Diabetes mellitus and stroke: a clinical update. World J Diabetes. 2017 Jun 15;8(6):235–248. doi:10.4239/wjd.v8.i6.235. DOI: https://doi.org/10.4239/wjd.v8.i6.235
10. Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D, Low MR. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018;360:j5855. doi:10.1136/bmj.j5855 DOI: https://doi.org/10.1136/bmj.j5855
11. Sharma, M., Nazar, G. P., Shivashankar, R., & Anjana, R. M. (2020). The burden of dyslipidemia in India: A systematic review. Journal of Atherosclerosis and Thrombosis, 27(4), 281-291.
12. Quiñones-Ossa GA, Lobo C, Garcia-Ballestas E, Florez WA, Moscote-Salazar LR, Agrawal A. Obesity and stroke: does the paradox apply for stroke? Neurointervention. 2021 Mar;16(1):9-19. doi:10.5469/neuroint.2020.00108. PMID:33389919; PMCID:PMC7946563. DOI: https://doi.org/10.5469/neuroint.2020.00108
13. Wendel-Vos GC, Schuit AJ, Feskens EJ, Boshuizen HC, Verschuren WM, Saris WH, Kromhout D. Physical activity and stroke: a meta-analysis of observational data. Int J Epidemiol. 2004 Aug;33(4):787-98. doi:10.1093/ije/dyh168. PMID:15166195. DOI: https://doi.org/10.1093/ije/dyh168
14. Rehm, J., Imtiaz, S., & Holmes, J. (2020). The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health, 20(1), 1-22.
15. Traylor M, Farrall M, Holliday EG, Sudlow C, Hopewell JC, Cheng YC, et al.; METASTROKE Collaboration. Genetic risk factors for ischaemic stroke and its subtypes (the METASTROKE collaboration): a meta-analysis of genome-wide association studies. Lancet Neurol. 2012 Nov;11(11):951–962. doi:10.1016/S1474-4422(12)70234-X. DOI: https://doi.org/10.1016/S1474-4422(12)70234-X
16. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Executive summary: heart disease and stroke statistics — 2015 update: a report from the American HeartAssociation.Circulation.2015 Feb;131(4):434–441. doi:10.1161/CIR.0000000000000157. DOI: https://doi.org/10.1161/CIR.0000000000000157
17. Tiwari S, Joshi A, Rai N, Satpathy P. Impact of stroke on quality of life of stroke survivors and their caregivers: a qualitative study from India. J Neurosci Rural Pract. 2021 Sep 22;12:680-8. doi:10.1055/s-0041-1735323. DOI: https://doi.org/10.1055/s-0041-1735323
18. Kanwal S, Hashmi R, Perveen W, Ali MA, Akhtar M, Munawar A. Outcomes of multidisciplinary team approach in rehabilitation of patients with stroke. Pak J Med Health Sci. 2022 Mar 26;16(3):78-9. doi:10.53350/pjmhs2216378. DOI: https://doi.org/10.53350/pjmhs2216378
19. Zhang S, Xu M, Liu ZJ, Feng J, Ma Y. Neuropsychiatric issues after stroke: clinical significance and therapeutic implications. World J Psychiatry. 2020 Jun 19;10(6):125-38. doi:10.5498/wjp.v10.i6.125. DOI: https://doi.org/10.5498/wjp.v10.i6.125
20. Stein LA, Goldmann E, Zamzam A, Luciano JM, Messé SR, Cucchiara BL, et al. Association between anxiety, depression, and post-traumatic stress disorder and outcomes after ischemic stroke. Front Neurol. 2018 Nov 2;9:890. doi:10.3389/fneur.2018.00890. DOI: https://doi.org/10.3389/fneur.2018.00890
21. Khan AA, Chen L, Zhang G, Guo X, Wu G, Wang H, et al. Management of poststroke neuropsychiatric disorders. Transl Neurosci Clin. 2016 Dec;2(4):244-51. doi:10.18679/CN11-6030_R.2016.031. DOI: https://doi.org/10.18679/CN11-6030_R.2016.031
22. Clarke DJ, Forster A. Improving post-stroke recovery: the role of the multidisciplinary health care team. J Multidiscip Healthc. 2015 Sep 22;8:433-42. doi:10.2147/JMDH.S68764. DOI: https://doi.org/10.2147/JMDH.S68764
23. Terrill AL, Schwartz JK, Belagaje SR. Best practices for the interdisciplinary rehabilitation team: a review of mental health issues in mild stroke survivors. Stroke Res Treat. 2018;2018:6187328. doi:10.1155/2018/6187328. DOI: https://doi.org/10.1155/2018/6187328
24. Devereux N, Berns AM. Evaluation & treatment of psychological effects of stroke. Del J Public Health. 2023 Aug 31;9(3):62-9. doi:10.32481/djph.2023.08.011. DOI: https://doi.org/10.32481/djph.2023.08.011
25. Mental health issues poststroke: underrecognized and undertreated. Stroke. 2023 Jun;54(6):1519-27. doi:10.1161/STROKEAHA.123.042585. DOI: https://doi.org/10.1161/STROKEAHA.123.042585
26. Early screening for post-stroke depression and its effect on functional outcomes, quality of life, and mortality: a meta-analysis. Front Neurol. 2024;15:11417657. doi:10.3389/fneur.2024.11417657.
27. Rastenytė D, Krančiukaitė D. Poststroke depression and its impact on quality of life. Medicina (Kaunas). 2007;43(1):1-7. doi:10.3390/medicina43010001. DOI: https://doi.org/10.3390/medicina43010001
28. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011;377(9778):1693-1702. DOI: https://doi.org/10.1016/S0140-6736(11)60325-5
29. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. DOI: https://doi.org/10.1016/S0140-6736(20)30925-9
30. World Health Organization. (2018). Depression: Let’s talk. Retrieved from https://www.who.int/news-room/detail/30-03-2017--depression-let-s-talk
31. Marques LM, Battistella LR. Well-being as a core element of rehabilitation: preventing mental health challenges in a global context. Glob Health J. 2025 Mar;9(1):1-5. doi:10.1016/j.glohj.2025.02.004. DOI: https://doi.org/10.1016/j.glohj.2025.02.004
32. Nguyen TTP, Hoang HB, Vu HTT. Effectiveness of multifaceted interventions including motivational interviewing and home-based rehabilitation program for improving mental and physical health in stroke patients: a randomized controlled trial. Int J Nurs Stud Adv. 2024 Dec;7:100259. doi:10.1016/j.ijnsa.2024.100259. DOI: https://doi.org/10.1016/j.ijnsa.2024.100259
33. Sociodemographic and clinicoradiological profile in acute stroke patients. Ann Indian Acad Neurol. 2024;27(1):23-8.
34. Kaur P, et al. Factors associated with physical and psychosocial problems among Indian stroke survivors. Indian J Palliat Care. 2018;24(2):196-200. Available from: https://jpalliativecare.com/factors-associated-with-physical-and-psychosocial-problems-among-indian-stroke-survivors/
35. Lazar RM, Speizer AE, Festa JR, Krakauer JW, Marshall RS. Variability in language recovery after first-time stroke. J Neurol Neurosurg Psychiatry. 2008;79(5):530-534. doi:10.1136/jnnp.2007.132340 DOI: https://doi.org/10.1136/jnnp.2007.122457
36. Cai, Q., Qian, M. & Chen, M. Association between socioeconomic status and post-stroke depression in middle-aged and older adults: results from the China health and retirement longitudinal study. BMC Public Health 24, 1007 (2024). https://doi.org/10.1186/s12889-024-18503-z DOI: https://doi.org/10.1186/s12889-024-18503-z
37. Wang SB, et al. Cognitive behavioral therapy for post-stroke depression: a meta-analysis. J Affect Disord. 2018;235:589-96. doi:10.1016/j.jad.2018.04.011. DOI: https://doi.org/10.1016/j.jad.2018.04.011
38. Song Y, et al. An evidence-based nursing intervention decreases anxiety, depression, sleep quality, and somatic symptoms of patients with acute ischemic stroke. Neuropsychiatr Dis Treat.2022;18:4075-84.Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617554/pdf/ndt-18-4075.pdf
39. Ahrens J, Shao R, Blackport D, Macaluso S, Viana R, Teasell R, et al. Cognitive-behavioral therapy for managing depressive and anxiety symptoms after stroke: a systematic review and meta-analysis. Top Stroke Rehabil. 2022;30(4):368–83. doi:10.1080/10749357.2022.2034573 DOI: https://doi.org/10.1080/10749357.2022.2049505
40. Li Y, et al. Resilience as the mediating factor in the relationship between sleep disturbance and post-stroke depression. Front Psychiatry. 2021;12:625002. doi:10.3389/fpsyt.2021.625002. DOI: https://doi.org/10.3389/fpsyt.2021.625002
41. Todorov V, Dimitrova M, Todorova V, Mihaylova E. Assessment of anxiety and depressive symptoms in the early post-stroke period. Folia Med (Plovdiv). 2020 Dec;62(4):695-702. doi:10.3897/folmed.62.e49453. DOI: https://doi.org/10.3897/folmed.62.e49453
42. Ghosh PA, Chaudhury S, Rohatgi S. Assessment of depression, anxiety, stress, quality of life, and fatigue in patients after a cerebrovascular accident. Cureus. 2024;16(10):e72051. doi:10.7759/cureus.72051. DOI: https://doi.org/10.7759/cureus.72051
43. Mahmoud S. Prevalence of depression and anxiety among post-stroke geriatric patients. Tishreen Univ J Res Health Sci. 2022 Jan 17;43(6):203-17. Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/11551
44. Krick S, Koob JL, Latarnik S, Volz LJ, Fink GR, Grefkes C, et al. Neuroanatomy of post-stroke depression: the association between symptom clusters and lesion location. Brain Commun. 2023;5(5):fcad275. doi:10.1093/braincomms/fcad275. DOI: https://doi.org/10.1093/braincomms/fcad275
45. Klingbeil J, Brandt ML, Wawrzyniak M, Stockert A, Schneider HR, Baum P, Hoffmann KT, Saur D. Association of lesion location and depressive symptoms poststroke. Stroke. 2021;52:830-7. doi:10.1161/STROKEAHA.120.031889. DOI: https://doi.org/10.1161/STROKEAHA.120.031889
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Betty Koshy, Kritagna Sinh Vaghela (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.