Internet plus-based post-discharge continuity care for mild-to-moderate depression: An exploratory study

Abstract

BACKGROUND

Depression is a prevalent global mental health disorder affecting over 300 million individuals, with studies indicating a 34% rise in cases from 2001 to 2020. In China, depression accounts for 3.0% of psychiatric disorders among adolescents, severely impairing patients’ quality of life. Despite pharmacological efficacy in acute-phase treatment, post-discharge relapse rates remain high (50% within one year), highlighting the need for effective continuity-of-care interventions. Traditional follow-up models (e.g., outpatient visits or telephone calls) face limitations, including inefficient symptom monitoring and low medication adherence (26.4% decline post-discharge). Emerging evidence supports “Internet”-based interventions, such as cognitive behavioral therapy, which improve adherence (76% vs 54%) and outcomes. However, few studies have explored "Internet+"-enabled extended nursing for mild-to-moderate depression. This study investigates an integrated “Internet+” continuity-of-care model leveraging WeChat to enhance post-discharge management, targeting anxiety/depression reduction, cognitive improvement, and nurse professional identity.

AIM

To explore the application of the “Internet+” concept in post-discharge continuity of care for patients with mild to moderate depression.

METHODS

From January 2024 to December 2024, 82 patients with mild and moderate depression who met the discharge criteria were selected as participants and randomly divided into an observation group and a control group (n = 41 each). The control group received conventional continuity care, while the observation group was provided with an integrated “Internet+”-based extended nursing model in addition to standard care. Both groups underwent a comprehensive three-month intervention program. Comparative assessments were conducted between the two groups regarding anxiety and depression levels, cognitive function, medication adherence, satisfaction rates, quality of life, and nursing staff’s professional identity.

RESULTS

After the intervention, the observation group demonstrated significantly superior outcomes compared to the control group (P < 0.05 for all). Specifically, they exhibited lower scores on the Hamilton Anxiety Scale (7.14 ± 3.08) and Hamilton Depression Scale (6.11 ± 1.05), along with a higher score on the Montreal Cognitive Assessment Scale (26.82 ± 1.53). Medication compliance was also significantly higher in the observation group (90.24%) than in the control group (70.73%) (P < 0.05). Furthermore, patient satisfaction ratings across all surveyed domains—including overall satisfaction, the service effect of nursing staff, professional knowledge and skills, communication and listening abilities, time management and punctuality, friendliness and care, privacy protection, and the rationality of nursing service costs were significantly elevated in the observation group. After the intervention, both groups improved. Quality of life assessments revealed significantly better scores in the observation group across all dimensions: Physical function (51.31 ± 5.49), psychological function (44.49 ± 5.85), social function (43.62 ± 4.91), material life (46.21 ± 5.56), subjective perception of quality of life (3.57 ± 0.66), subjective perception of health status (3.57 ± 0.68), and total score (146.21 ± 12.37). Finally, the score of professional identity in the observation group was 28.49 ± 4.62, which was significantly higher than that of the control group (P < 0.05). And the professional identity of nurses in the observation group after the intervention was negatively correlated with anxiety and depression (P < 0.05), and positively correlated with cognition and medication compliance (P < 0.05).

CONCLUSION

“Internet+” continuous nursing can effectively improve the anxiety and depressive symptoms and cognitive function of patients with mild to moderate depression, improve their medication compliance, quality of life, and nursing satisfaction, and enhance the professional identity of nurses, which is worthy of clinical promotion and application.

Keywords: Internet+; Mild-to-moderate depression; Post-discharge; Continuity of care; Nursing intervention

Core Tip: This study investigates the impact of an “Internet+”-based extended care model on patients with mild to moderate depression following hospital discharge. It demonstrates that integrating Internet-based real-time supervision, reminders, and education significantly reduces anxiety and depressive symptoms (measured by Hamilton Anxiety Scale and Hamilton Depression Scale scores), enhances cognitive function (Montreal Cognitive Assessment Scale scores), and improves medication adherence and quality of life compared to traditional care methods. Furthermore, this innovative approach boosts patient satisfaction and strengthens nursing staff’s professional identity, highlighting its potential as a scalable intervention for post-hospital treatment of depression.