Nursing interventions including psychological support and quality of life determinants in patients with dysphagia following stroke
Abstract
Background: Poststroke dysphagia (PSD) affects nearly half of stroke survivors and impairs health?related quality of life. Nursing interventions increasingly integrate psychological support, yet their effectiveness remains unclear. This systematic review and
meta?analysis evaluated the impact of nursing strategies incorporating psychological support on QOL in PSD patients and examined the influence of intervention duration and type.
Materials and Methods: This review followed the Preferred Reporting
Items for Systematic Reviews and Meta?Analyses guidelines. PubMed, EMBASE, Scopus, Web of Science, and CINAHL were searched up to August 2025. Randomized controlled trials (RCTs) assessing nursing interventions with psychological components, such as counseling or education, cognitive behavioral therapy?informed strategies, relaxation or stress management, emotional support, and motivational interviewing, and reporting QOL outcomes were included. Standardized mean differences (SMDs) were pooled using random?effects models. Subgroup analyses compared short (?4 weeks) versus longer (>4 weeks) interventions and psychological?only versus combined approaches.
Results: Nine RCTs involving 693 participants were included. Nursing interventions improved QOL compared with control conditions (SMD = 0.95; 95% confidence interval [CI]: 0.48–1.41; P<0.001), with substantial heterogeneity (I2 = 84.5%). Interventions lasting ?4 weeks showed larger effects (SMD = 1.21; 95% CI: 0.13–2.29) than longer interventions (SMD = 0.82; 95% CI: 0.32–1.31). Psychological?only interventions produced greater benefits (SMD = 1.25; 95% CI: 0.68–1.82) than combined approaches (SMD = 0.82; 95% CI: 0.20–1.43). No publication bias was detected (Egger’s test,
P = 0.79).
Conclusion: Nursing interventions incorporating psychological support enhance QOL in PSD. Short?duration and psychological?only approaches appear most effective, supporting integration into stroke rehabilitation.