Effectiveness of Nursing Interventions on Anxiety, Depression, and Quality of Life in Patients with Advanced Schistosomiasis: A Meta-analysis.

PURPOSE: Advanced schistosomiasis, the most severe stage of Schistosoma japonicum infection, profoundly impairs patients' quality of life (QoL) and increases vulnerability to anxiety and depression. Since 2004, China has launched a medical assistance program for the patients with access to medical and/or surgical treatment, in which health workers have incorporated nursing interventions to address these challenges. This meta-analysis evaluated the effects of nursing interventions on QoL, anxiety, depression, and complications in advanced schistosomiasis patients.

METHODS

Seven databases [PubMed, Web of Science, the Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang] were systematically searched for randomized controlled trials up to August 1, 2024. Data were analyzed using Review Manager 5.4 (Cochrane Collaboration) and R 4.2.3 (R Project, a free, open-source language and environment primarily used for statistical computing and graphics). Outcomes included QoL (World Health Organization Quality of Life Brief scale and Karnofsky performance status), anxiety (Self-rating Anxiety Scale), depression (Self-rating Depression Scale), and complications. The protocol was previously registered with the International Prospective Register of Systematic Reviews (CRD42023406707).

RESULTS

A total of 23 studies with 2232 patients were included. Nursing interventions improved QoL with greater benefits observed in longer intervention periods. Anxiety (standardized mean difference: -1.52, 95% confidence interval (CI): -2.10 to -0.94) and depression (standardized mean difference: -1.13, 95% CI: -1.43 to -0.84) scores were markedly reduced. The risk of complications decreased by 64% (relative risk: 0.36, 95% CI: 0.27 to 0.48). Subgroup analyses highlighted age as a key modifier of intervention efficacy.

CONCLUSION

Nursing interventions effectively enhance QoL, alleviate psychological distress, and reduce complications in advanced schistosomiasis patients. These findings advocate for integrating structured nursing protocols into China's national healthcare programs and global schistosomiasis management strategies.