# The impact of ward noise management and comprehensive nursing intervention on cognitive function, psychological health, and prognosis of post-stroke patients: a randomized controlled trial

## TL;DR

This study found that managing ward noise and providing comprehensive nursing care improves recovery and well-being in stroke patients.

## Contribution

The novel integration of ward noise management with comprehensive nursing intervention is shown to enhance post-stroke recovery outcomes.

## Key findings

- The experimental group showed significantly better cognitive recovery compared to the control group.
- Psychological health and quality of life improved more in patients receiving the combined intervention.
- The intervention group had lower complication rates and better motor function recovery.

## Abstract

This study aimed to investigate the impact of ward noise management combined with comprehensive nursing intervention on cognitive function, psychological health, and prognosis in post-stroke patients.

A total of 144 stroke patients admitted between January 2022 and December 2023 were randomized into a control group and an experimental group, with 72 patients in each group. The control group received conventional care, while the experimental group received systematic ward noise management (including noise control of medical equipment, medical staff, other patients in the same ward, and visiting family members) in addition to comprehensive nursing intervention (encompassing holistic assessment, individualized care plans, multidisciplinary collaboration, patient education, and continuous monitoring). Cognitive function, psychological status, motor function, quality of life, and complication rates were assessed using the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Stroke-specific Quality of Life Scale (SS-QOL), and complication records.

The results showed that after the intervention, the experimental group demonstrated significantly greater cognitive recovery than the control group, with large effect sizes for MoCA (Cohen’s d = 0.75, 95% CI: 0.45–1.05) and MMSE (d = 0.80, 95% CI: 0.50–1.10). Motor function (FMA) improved more substantially in the experimental group, yielding a mean difference (MD) of 13.71 (95% CI: 9.94–17.48). Similarly, psychological well-being improved significantly, with MDs of −5.03 for HAMD (95% CI: −6.25 to −3.81) and −2.82 for HAMA (95% CI: −3.80 to −1.84). Quality of life (SS-QOL) also showed a moderate-to-large increase (MD = 13.23, 95% CI: 3.83–22.63). Furthermore, the experimental group had significantly lower odds of complications (OR = 0.35, 95% CI: 0.18–0.70; p = 0.021) compared to the control group.

In conclusion, the results suggest that the integration of ward noise management with comprehensive nursing intervention may contribute to improvements in cognitive function, motor recovery, psychological health, quality of life, and clinical prognosis in post-stroke patients. This combined approach offers a promising strategy for optimizing rehabilitation outcomes and reducing complications. Further multicenter studies with larger sample sizes are recommended to validate these findings and refine intervention protocols.