A meta-analysis of the effect of evidence-based nursing for patients with ischemic stroke

The efficacy of evidence-based nursing in ischemic stroke patients remains debated. Therefore, this meta-analysis compared the efficacy of evidence-based nursing with that of usual care in terms of quality of life and psychological outcomes after ischemic stroke.

We searched the Cochrane Library, Web of Science, PubMed, and Scopus from the inception to 20 February 2025 to identify articles comparing the efficacy of evidence-based nursing with that of usual care among those experiencing ischemic stroke. We used the revised Cochrane risk-of-bias tool for randomized trials (RoB2) to assess the risk of bias.

Finally, 10 articles with 1645 participants in the usual care group and 1481 participants in the evidence-based nursing group were included in this meta-analysis. Compared to usual nursing, evidence-based nursing did not significantly change the Barthel index (SMD 0.61, 95% CI (-0.34, 1.55), I² = 95.79%), SP-36 physical component score (SMD 0.40, 95% CI (-0.52, 1.33), I² = 98.25%), SP-36 mental component score (SMD 0.39, 95% CI (-0.46, 1.25), I² = 97.93%), World Health Organization quality of life brief version (WHOQOL-BREF) physical component score (SMD 0.90, 95% CI (-0.90, 2.70), I² = 98.60%), WHOQOL-BREF mental component score (SMD 0.61, 95% CI (-0.31, 0.52), I² = 94.81%), and self-rating anxiety scale (SAS) score (SMD -5.78, 95% CI (-15.73, 4.18), I² = 99.89%), but significantly reduced self-rating depression scale (SDS) score (SMD -1.77, 95% CI (-2.49, -1.05), I² = 87.00%), highlighting the potential benefits of evidence-based nursing in stroke patients with depressed mood.

Among patients with ischemic stroke, evidence-based nursing was not significantly superior to usual nursing in most assessment tests.