COM-B-based holistic rehabilitation and psychological care on postoperative headache dizziness and depression in hypertensive intracerebral hemorrhage patients

doi:10.5498/wjp.v16.i5.117958

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World Journal of Psychiatry

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World J Psychiatry. May 19, 2026; 16(5): 117958
Published online May 19, 2026. doi: 10.5498/wjp.v16.i5.117958

COM-B-based holistic rehabilitation and psychological care on postoperative headache dizziness and depression in hypertensive intracerebral hemorrhage patients

Hui-Juan Zhang, Yun-Feng Zhao, Zhi-Jie Wang, Zi-Lei Pang

Hui-Juan Zhang, No. 1 Department of Neurological Surgery, The First Hospital of Zhangjiakou City, Zhangjiakou 075000, Hebei Province, China

Yun-Feng Zhao, Respiratory Intensive Care Medicine, The First Hospital of Zhangjiakou City, Zhangjiakou 075000, Hebei Province, China

Zhi-Jie Wang, Department of Otolaryngology Head and Neck Surgery, The First Hospital of Zhangjiakou City, Zhangjiakou 075000, Hebei Province, China

Zi-Lei Pang, Department of Health Management, The First Hospital of Zhangjiakou City, Zhangjiakou 075000, Hebei Province, China

Co-first authors: Hui-Juan Zhang and Yun-Feng Zhao.

Co-corresponding authors: Zhi-Jie Wang and Zi-Lei Pang.

Author contributions: Zhang HJ and Zhao YF contributed to data collection, and paper writing, they contributed equally to this article, they are the co-first authors of this manuscript; Wang ZJ and Pang ZL were responsible for funding application, reviewing and editing, communication coordination, ethical review, copyright and licensing, and follow-up, they contributed equally to this article, they are the co-corresponding authors of this manuscript; Zhang HJ, Zhao YF, Wang ZJ, and Pang ZL contributed to research design, data analysis; and all authors have read and approve the final manuscript.

Supported by 2026 Hebei Provincial Program of Scientific Research Projects in Traditional Chinese Medicine, No. 2026411.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Hospital of Zhangjiakou City, Approval No. 2025-KY-17.

Clinical trial registration statement: This study has not yet been registered with clinical trials.

Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: No other data available.

Corresponding author: Zi-Lei Pang, Associate Chief Nurse, Department of Health Management, The First Hospital of Zhangjiakou City, No. 6 Libaisixiang, Xinhua Front Street, Qiaoxi District, Zhangjiakou 075000, Hebei Province, China. 15933332886@163.com

Received: January 23, 2026
Revised: February 10, 2026
Accepted: March 11, 2026
Published online: May 19, 2026
Processing time: 96 Days and 0.2 Hours

Abstract

BACKGROUND

Postoperative headache, dizziness, and depression are intertwined challenges that impede recovery in patients with hypertensive intracerebral hemorrhage (HICH), while conventional care often lacks a systematic approach. The Competency-Opportunity-Motivation-Behavior (COM-B) model, targeting capability, opportunity, and motivation, provides a comprehensive framework for behavior change. This study hypothesizes that a COM-B-based holistic rehabilitation program combined with psychological nursing will be more effective than routine care in alleviating these symptoms and improving functional outcomes in post-HICH patients.

AIM

To evaluate a COM-B-based integrated rehabilitation and psychological care intervention for postoperative headache, dizziness, and depression in HICH patients.

METHODS

A total of 100 HICH patients admitted between January 2023 and January 2025 were enrolled and randomly divided into an observation group and a control group (50 cases each). The control group received routine care, while the observation group received additional COM-B-based holistic rehabilitation training combined with psychological nursing for 8 weeks. Headache, dizziness, depression, sleep quality, neurological/motor function, and daily living ability were compared before and after treatment.

RESULTS

Showed that compared with the control group, the observation group exhibited significantly lower scores on the Visual Analogue Scale, the Dizziness Assessment Rating Scale, the Dizziness Handicap Inventory, the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the National Institutes of Health Stroke Scale, significantly lower headache duration and frequency, and significantly higher Fugl-Meyer Assessment and Barthel Index scores after treatment (P < 0.05).

CONCLUSION

The COM-B-based integrated rehabilitation and psychological intervention alleviates headache, dizziness, depression, and sleep issues, while promoting neurological and motor recovery in HICH patients.

Keywords: Competency-Opportunity-Motivation-Behavior model; Holistic rehabilitation training; Psychological nursing; Hypertensive intracerebral hemorrhage; Depression; Dizziness

Core Tip: Current rehabilitation research predominantly focuses on cerebral ischemia, while intervention studies targeting hypertensive intracerebral hemorrhage patients remain relatively limited. This study employed an intervention based on the innovative Competency-Opportunity-Motivation-Behavior model, overcoming the limitations of traditional postoperative care. By systematically enhancing patient capabilities, optimizing external support opportunities, and stimulating intrinsic motivation, this model achieves multidimensional rehabilitation support. This study first demonstrates that integrated rehabilitation combined with psychological care guided by the Competency-Opportunity-Motivation-Behavior model not only effectively alleviates symptoms such as headaches, dizziness, and depression but also concurrently promotes neurological recovery and improves functional prognosis.