Rehabilitation nursing with social support improves depression in elderly chronic disease patients based on advocacy promotion theory

doi:10.5498/wjp.v16.i6.115489

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jun 19, 2026; 16(6): 115489
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.115489

Rehabilitation nursing with social support improves depression in elderly chronic disease patients based on advocacy promotion theory

Li-Duo Wang, Hui Tang, Fen-Fang Lei, Xiao-Jun Ma, Kuang Yao, Jing Wang, Xi Cao

Li-Duo Wang, Hui Tang, Fen-Fang Lei, Xiao-Jun Ma, Department of Nursing, Shaoyang University, Shaoyang 422000, Hunan Province, China

Kuang Yao, Department of Endocrinology, The Central Hospital of Shaoyang, Shaoyang 422099, Hunan Province, China

Jing Wang, Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha 430000, Hunan Province, China

Xi Cao, Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha 43000, Hunan Province, China

Co-first authors: Li-Duo Wang and Hui Tang.

Author contributions: Wang LD, Tang H, Lei FF, Ma XJ, Yao K, and Wang J contributed to data collection, and paper writing; Wang LD and Tang H contributed equally to this article, they are the co-first authors of this manuscript; Cao X was responsible for funding application, manuscript reviewing and editing, communication coordination, ethical review, copyright and licensing; Wang LD, Tang H, Lei FF, Ma XJ, Yao K, Wang J, and Cao X contributed to research design, data analysis; and follow-up; and all authors have read and approved the final manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Shaoyang University, approval No. 2025KJKT036.

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: Xi Cao, Chief Nurse, Department of Geriatrics, The Second Xiangya Hospital of Central South University, No. 39 Renmin Middle Road, Furong District, Changsha 43000, Hunan Province, China. wliduo11@163.com

Received: November 18, 2025
Revised: December 22, 2025
Accepted: February 3, 2026
Published online: June 19, 2026
Processing time: 191 Days and 0 Hours

Abstract

BACKGROUND

Depression in elderly patients with chronic diseases is a prevalent issue exacerbated by insufficient social support and traditional care models. While social support and rehabilitation nursing are recognized as beneficial, their integration under a motivational framework remains underexplored. Advocacy-promotion theory offers a structured approach to empower patients and mobilize multi-level support systems. This study hypothesizes that a rehabilitation nursing intervention, enhanced by social support and grounded in advocacy-promotion theory, will significantly improve depressive symptoms, self-efficacy, sleep quality, and overall quality of life in community-dwelling elderly patients with chronic diseases compared to conventional care.

AIM

To investigate the efficacy of advocacy-promotion-based rehabilitation nursing with social support on depression in elderly chronic disease patient.

METHODS

In this randomized controlled trial, 60 elderly patients with chronic diseases were randomly assigned to an observation group (n = 30) or a control group (n = 30). The control group received standard care and social support, while the observation group received an additional intervention based on advocacy-promotion theory. Outcomes included scores on the General Self-Efficacy Scale, Pittsburgh Sleep Quality Index, 17-item Hamilton Depression Rating Scale, World Health Organization Quality of Life for Older Adults module, and nursing satisfaction.

RESULTS

Compared to the control group, the observation group demonstrated significantly greater improvement in all measured outcomes. Post-intervention scores in the observation group were higher for self-efficacy (General Self-Efficacy Scale: 32.87 ± 8.96 vs 28.47 ± 7.60, P = 0.044) and quality of life (World Health Organization Quality of Life for Older Adults module: 80.14 ± 5.12 vs 74.67 ± 4.93, P < 0.001). Scores were lower for depression (17-item Hamilton Depression Rating Scale: 20.96 ± 4.68 vs 24.53 ± 4.49, P = 0.005) and sleep disturbance (Pittsburgh Sleep Quality Index: 8.75 ± 2.62 vs 10.93 ± 3.07, P = 0.005). Nursing satisfaction was also significantly higher in the observation group (93.33% vs 73.33%, P = 0.038).

CONCLUSION

Rehabilitation nursing integrated with social support and advocacy-promotion theory effectively improves self-efficacy, sleep quality, depressive symptoms, and overall quality of life in elderly patients with chronic diseases.

Keywords: Advocacy and promotion theory; Rehabilitation nursing; Chronic diseases of the elderly; Depression; Self-efficacy; Sleep quality; Quality of life

Core Tip: This study investigates the effectiveness of a rehabilitation nursing intervention, combining social support and advocacy-promotion theory, in reducing depressive symptoms among older adults with chronic conditions. It highlights the rising burden of age-related diseases, the intertwined relationship between chronic illness and mental health, and the urgent need for comprehensive interventions to improve elderly care and mental health outcomes. The findings aim to provide evidence for enhancing community health management and elderly care services.