Impact of extended nursing model after multi-disciplinary treatment on young patient with post-stroke

Table 1 The general information comparison between the two groups of patients

		Intervention group (n = 30)	Control group (n = 30)	T value	P value
Sex (n)	Men	15	16	0.067	0.796
	Women	15	14
Age (yr)		27.20 ± 2.23	28.27 ± 2.53	-1.730	0.089
Occupation	Student	10	11	0.294	0.961
	Worker	7	6
	Civil servant	5	4
	Self-employed	8	9
Education degree (n)	Primary school	7	6	0.269	0.874
	Middle school	8	7
	College degree or above	15	13
Expense category (n)	Health insurance	22	24	0.373	0.542
	Self-pay	8	6
Inpatient days (d)		17.00 ± 2.29	16.33 ± 2.45	1.088	0.281

Table 2 Composition of the multi-disciplinary treatment extended nursing team and their responsibilities

Group members (n)	Group members responsibilities
Associate chief physician (2)	Responsible for the diagnosis and treatment of patients; the administration of medication and the follow-up of discharged
Rehabilitation physician (1)	Guidance of rehabilitation training for patients during convalescence
Dietician (1)	Evaluation of the nutritional status of patients and formulation personalized nutritional meals
Network engineer (1)	network maintenance
Chief nurse (1)	Experiment organization, personnel allocation, liaison and experiment supervision
Associate chief nurse (2)	Assisted in the implementation of the trial and the follow-up survey of discharged patients
Charge nurse (3)	Data collection and analysis
Nurse practitioners (10)	Clinical trial implementation, patient inpatient and discharge care, guide patients to fill in the scale

Table 3 The details of the intervention strategy

Items		Content
Intervention timeline		Immediate admission to week 8 of discharge (1 time per week after discharge)
Intervention content		Psychological care to reduce psychological stress of patients and assist psychologists in psychological intervention
		Assisting the rehabilitation physician in guiding the rehabilitation training of patient
		Investigate the dietary habits of patients and assist dietitians in adjusting nutritional status of patients
		Assisting the bedside physician in daily care
Operators		MDT extended nursing team
Specific implementation steps	Psychological care to reduce psychological stress of patients and assist psychologists in psychological intervention	The bedside nurses assist the patients to fill in the anxiety self-assessment scale and the hospital anxiety and depression scale, the scores of which are analyzed by the psychiatrist and appropriate interventions are made. Talking and communicating with patients once a week through internet technology to understand their inner changes and provide timely feedback to the psychologist
	Assisting the rehabilitation physician in guiding the rehabilitation training of patients	The rehabilitation physician formulates the individualized rehabilitation training plan; the neurologist assists in optimizing the rehabilitation strategy; the rehabilitation physician implements the rehabilitation training plan; the bedside nurse assists the rehabilitation physician. After discharge, the completion of rehabilitation training of patients was investigated once a week through Internet technology such as WeChat video, and the degree of training was monitored
	Investigate the dietary habits of patients and assist dietitians in adjusting nutritional status of patients	The bedside nurse asks patients about their daily eating habits and assists the dietitian in formulating a nutrition improvement plan; follows up with the patient once a week after discharge and gives feedback to the dietitian, and guides the daily diet of patients according to the nutrition supplement plan adjusted by the dietitian
	Assisting the bedside physician in daily care	Implement orders of physician, record the disease progression of patients on the basis of basic care, and provide timely feedback to the bedside physician

MDT: Multi-disciplinary treatment.

Table 4 Comparison of anxiety and depression self-rating scale scores between the two groups of patients

Groups	SAS score			SDS score
	At admission	At discharge	After discharge	At admission	At discharge	After discharge
Control group	65.43 ± 2.08	55.17 ± 3.00a	71.13 ± 2.91c	68.13 ± 2.50	57.27 ± 2.75a	73.47 ± 2.97c
Intervention group	65.57 ± 3.97	21.13 ± 2.52a,c	17.33 ± 3.06c	69.27 ± 2.65	25.13 ± 2.65a,c	16.53 ± 2.27c
T value	-0.163	47.660	69.849	-1.703	46.065	83.452
P value	0.871	< 0.000	< 0.000	0.094	< 0.000	< 0.000

^aP value < 0.05, compared with at admission.

^cP value < 0.05, compared with at discharge.

SAS: Self-rating Anxiety Scale; SDS: Self-rating Depression Scale.

Table 5 Comparison of Hamilton Depression and Hamilton Anxiety scores between the two groups of patients

Groups	HAMD score			HAMA score
	At admission	At discharge	After discharge	At admission	At discharge	After discharge
Control group	34.17 ± 1.49	25.23 ± 1.74a	31.10 ± 1.85c	26.27 ± 2.23	21.53 ± 1.96a	31.83 ± 2.00c
Intervention group	33.93 ± 1.23	17.33 ± 2.54a,c	11.13 ± 1.59a,c	25.20 ± 2.83	15.23 ± 1.76a,c	10.57 ± 2.39a,c
T value	0.662	14.076	44.884	1.621	13.112	37.385
P value	0.510	0.000	0.000	0.110	0.000	0.000

^aP value < 0.05, compared with at admission.

^cP value < 0.05, compared with at discharge.

HAMD: Hamilton Depression; HAMA: Hamilton Anxiety.

Table 6 Comparison of Barthel Index between the two groups of patients

Group	At admission	At discharge	After discharge
Control group	40.17 ± 2.23	53.20 ± 1.86a	41.23 ± 2.01c
Intervention group	39.70 ± 1.60	76.13 ± 2.00a,c	83.77 ± 2.43a,c
T statistics	0.931	-45.997	-73.831
P value	0.356	0.000	0.000

^aP value < 0.05, compared with at admission.

^cP value < 0.05, compared with at discharge.

Table 7 Comparison of Short-Form 36 scores for each dimension between the two groups of patients

Dimension	Control group			Intervention group
	At admission	At discharge	After discharge	At admission	At discharge	After discharge
Physical functioning	44.17 ± 1.49	52.23 ± 1.72a	41.10 ± 2.06a,c	43.20 ± 2.06	67.13 ± 1.25a,e	78.83 ± 2.07a,c,e
Physical problems	43.93 ± 1.28	49.17 ± 1.72a	40.97 ± 1.71a,c	42.70 ± 2.52	71.03 ± 1.83a,e	88.97 ± 1.71a,c,e
Bodily pain	28.20 ± 2.31	41.87 ± 2.03a	23.60 ± 1.45a,c	29.00 ± 2.13	61.60 ± 2.06a,e	75.27 ± 1.95a,c,e
Generalhealth	24.37 ± 3.09	44.30 ± 2.48a	51.53 ± 1.28a,c	23.93 ± 3.13	74.47 ± 2.00a,e	80.07 ± 1.64a,c,e
Social vitality	33.17 ± 3.51	46.80 ± 1.97a	22.23 ± 1.45a,c	34.20 ± 2.78	64.70 ± 1.56a,e	74.43 ± 1.85a,c,e
Social functioning	34.67 ± 2.14	48.63 ± 2.03a	27.10 ± 2.28a,c	33.53 ± 2.74	72.13 ± 2.42a,e	86.47 ± 1.98a,c,e
Emotional problems	40.53 ± 2.15	50.17 ± 1.80a	26.93 ± 2.75a,c	41.80 ± 2.41	65.27 ± 1.31a,e	76.83 ± 2.38a,c,e
Mental health	35.27 ± 2.94	49.63 ± 2.58a	30.83 ± 1.62a,c	36.07 ± 2.38	69.37 ± 2.63a,e	77.37 ± 1.40a,c,e

^aP value < 0.05, compared with at admission.

^cP value < 0.05, compared with at discharge.

^eP value < 0.05, compared with the control group.