Effects of professional nursing intervention on compliance and adverse events in patients with depression combined with respiratory failure

Abstract

BACKGROUND

Depression is a common psychological disorder often associated with genetic, neurobiological, and psychosocial factors. This condition is characterized by low mood and decreased conscious activity and can lead to severe consequences such as suicidal thoughts. Respiratory failure, a disorder of pulmonary ventilation and gas exchange, is frequently complicated by depression, aggravating the condition and creating complications in treatment. Patients with both conditions tend to exhibit poor compliance with medical advice, resulting in adverse outcomes such as sleep disorders, arrhythmias, and electrolyte imbalances. Therefore, effective nursing interventions are crucial for improving patient outcomes. While routine nursing care can provide basic support, dedicated nursing, which involves specialized and personalized care by highly trained professionals, may offer additional benefits.

AIM

To examine the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure.

METHODS

A total of 160 patients with depression complicated by respiratory failure admitted to the Second Affiliated Hospital of Soochow University from January to December 2024 were randomly categorized into a control group (n = 80) receiving routine nursing care and observation group (n = 80) receiving routine nursing combined with dedicated nursing care. The establishment of a specialized nursing team; the development of a personalized nursing plan; and the implementation of comprehensive care strategies targeting emotional support, sleep improvement, pulmonary function enhancement, and adherence to medical advice were included in the dedicated nursing intervention. Emotional state [evaluated using the Self-Rating Depression Scale (SDS)], sleep quality [assessed using the Pittsburgh Sleep Quality Index (PSQI)], hope level [measured using the Herth Hope Scale (HHS)], pulmonary function [comprising forced vital capacity (FVC) and forced expiratory volume in the first second (FEV₁)], exercise endurance [6-minute walk distance test (6MWD)], compliance with medical advice, and incidence of adverse events were compared between the two groups.

RESULTS

No significant differences were observed in SDS, PSQI, HHS, FVC, FEV₁, 6MWD, or compliance with medical advice between the two groups (P > 0.05) before the intervention. However, after the intervention, the control group exhibited significantly lower SDS and PSQI scores; higher HHS scores; greater improvements in FVC, FEV₁, and 6MWD; and higher compliance with medical advice compared with the control group (P < 0.05). In addition, the incidence of adverse events was significantly lower in the control group (P < 0.05).

CONCLUSION

Dedicated nursing intervention significantly improves emotional state, sleep quality, hope level, pulmonary function, exercise endurance, and compliance with medical advice while reducing adverse events in patients with depression complicated by respiratory failure. Therefore, dedicated nursing appears to be an effective approach to enhance patient outcomes in this population.

Key Words: Depression; Respiratory failure; Dedicated nursing; Compliance with medical advice; Adverse events

Core Tip: Effective nursing intervention plays a vital role in managing patients with depression complicated by respiratory failure. In this vulnerable group, dedicated nursing care that emphasizes individualized assessment, psychological support, and continuous monitoring can greatly enhance treatment adherence, improve overall recovery, and reduce the risk of complications or adverse outcomes, ultimately promoting both physical stability and emotional well-being.

INTRODUCTION

Depression is a highly prevalent psychological disorder in clinical practice and is characterized by persistent low mood, decreased cognitive and physical functioning, and reduced interest in daily activities[1]. This condition is often linked to various factors, including genetics, neurobiochemical imbalances, and psychosocial stressors[2]. The symptoms of depression can substantially affect an individual’s quality of life and exacerbate the risk of self-harm and suicide[3]. The global prevalence of depression has risen in recent years, posing an immense burden on the public health system[4].

Respiratory failure, a critical condition resulting from impaired pulmonary ventilation and gas exchange, is marked by symptoms such as dyspnea and cyanosis[5]. This disorder is life-threatening and requires prompt medical intervention. According to a clinical study, depression is a common comorbidity in patients with respiratory failure, and approximately 42.92% of the patients experience depressive symptoms[6]. The coexistence of depression and respiratory failure can worsen the severity of both conditions, posing complications in therapy and rehabilitation[7]. Adhering to long-term medical treatment plans is often a challenge for patients with both conditions, which can deteriorate their health outcomes[8,9].

Depression and respiratory failure are a combination that presents unique challenges in clinical management. Patients with these comorbidities often do not comply with medical advice, aggravating the risk of adverse events such as sleep disorders, arrhythmias, electrolyte imbalances, and digestive system diseases[10]. Effective nursing interventions are therefore essential for improving patient outcomes, enhancing compliance, and reducing complications[11]. Although routine nursing care provides basic support, it is not sufficient to meet the complex needs of these patients[12,13]. Dedicated nursing, which involves specialized and personalized care delivered by highly trained professionals, has shown promise in improving patient outcomes in other clinical settings[14-16]. Nonetheless, its application in patients with depression complicated by respiratory failure has not been adequately examined[17,18].

Hence, this study aimed to explore the effect of dedicated nursing intervention on medical advice compliance and adverse event incidence in patients with depression complicated by respiratory failure. By comparing the outcomes of patients receiving routine nursing care with those receiving dedicated nursing care, this study aimed to provide evidence for the effectiveness of this specialized approach and offer beneficial insights to augment the clinical management and intervention of this complex condition.

MATERIALS AND METHODS

General information

The diagnostic criteria including: Referring to relevant guidelines[19,20], the patients with a Self-Rating Depression Scale (SDS) assessment score of ≥ 53 points were diagnosed with depression complicated by respiratory failure. The inclusion criteria including: Patients who could communicate and interact normally; showed no disturbance of consciousness; were in a stable condition; were diagnosed to have mild to moderate depression by professional tools; and had provided their signed and informed consent form either themselves or through their families. The exclusion criteria including: Patients who did not cooperate with the nursing work; those with other respiratory system diseases; those with malignant tumor diseases; those with a history of alcohol or sedative-hypnotic drug dependence; those with a severe suicidal tendency; those with physical disorders; and those with cognitive impairment.

A total of 160 patients with depression complicated by respiratory failure who were admitted to the Second Affiliated Hospital of Soochow University during January to December 2024 were enrolled in this study. The patients were assigned to a control (n = 80) or control group (n = 80) by the random number table method: (1) Control group (only receiving routine nursing care): The subjects in the group were in an age range of 28-54 years (average age: 41.00 ± 4.30) with a male/female ratio of 55:25. The duration of depression was 6-15 months (average 10.50 ± 1.50). The primary diseases included 41 cases of chronic obstructive pulmonary disease, 22 cases of chronic bronchitis, and 17 cases of other diseases; and (2) Observation group (receiving routine nursing combined with dedicated nursing care): The patients in this group were of the age range 26-55 years (average age: 40.50 ± 4.80), with a male/female ratio of 53:27. The duration of depression was 5-15 months (average 10.00 ± 1.70). The primary diseases included 39 cases of chronic obstructive pulmonary disease, 23 cases of chronic bronchitis, and 18 cases of other diseases. The clinical data of the two groups of patients were homogeneous (P > 0.05).

Methods

Control group: Routine nursing: (1) Psychological nursing: Communication with the patients and their families and understanding the causes of the disease and the patients’ clinical manifestations. Encouraging the patients with positive language, relieving their anxiety, and helping them build confidence in the treatment process; (2) Health education: Making the patients aware of depression and respiratory failure and the relevant treatment and nursing methods, as well as answering patients’ questions, and encouraging them to actively cooperate with the medical staff in their undertaking; (3) Symptom-oriented nursing: Evaluation of the patients’ symptoms weekly and dealing with any abnormalities in a timely manner. Teaching patients effective coughing and expectoration techniques to ensure unobstructed respiration; and (4) Medication nursing: According to the extent of and manifestations of patients’ depression, antidepressant drugs were prescribed by the doctor. In addition, respiratory stimulants were administered as prescribed by the doctor, followed by close monitoring of the patients’ conditions, with a focus on monitoring changes in indicators such as blood pressure and heart rate.

Observation group: On the basis of the control group, dedicated nursing was adopted. Establishment of a dedicated nursing team: The team consisted of 1 head nurse of the respiratory department, 1 attending physician of the respiratory department, 1 psychologist, and 5 dedicated nurses. The head nurse served as the team leader. All team members had the professional title of head nurse or above, with > 5 years of clinical work experience. One expert in depression and another in respiratory diseases were invited to conduct training for the team members. The training was based on the concept and process of dedicated nursing, the knowledge and intervention methods against depression, the knowledge and intervention methods related to respiratory failure, and the matters needing attention during nursing, among others. After the training, an assessment was conducted. Only those members who passed the assessment (score > 90 points) were enrolled in the team.

Development of a dedicated nursing plan: The team leader was deemed responsible for formulating the intervention plan and supervision, whereas the team members were responsible for collecting data, implementing the plan, and conducting data analysis. Based on the actual situation of patients, the terms “dedicated nursing”, “depression”, and “respiratory failure” were used as keywords to collect core literature from across the PubMed database. The retrieved data was combined with clinical experience to develop dedicated nursing plans for the patients.

Dedicated nursing: (1) A good nurse-patient relationship was established at the time of hospital admission, and the patients were welcomed warmly and introduced. The hospitalization environment and the situation of medical staff were conveyed to the patients in detail so as to gain their trust and build a good nurse-patient relationship; (2) Psychological nursing: The psychologist selected an independent psychological counseling room to conduct face to face conversations with the patients. During these sessions, the patient’s personality characteristics were observed and evaluated, and the patient’s feelings and attitude toward the disease were comprehended, and the patient’s negative psychological cognition was corrected in a timely manner. Psychological counseling methods: The psychologist conducted training using the psychological nursing content for dedicated nurses to ensure improvement in their psychological nursing proficiency and implementation (role-playing: The nursing staff played the role of the patient, reproduced the situation when negative emotions arose, and guided the patient to transform their negative thinking into positive thinking. It was recommended that, when the patient showed negative emotions, their inner thoughts and feelings were recorded in a timely manner, and they were allowed to vent their emotions. Emotion transfer method: The patients were encouraged to actively participate in recreational activities, such as handicrafts, listening to music, playing chess, and reading books, when and if their physical condition allowed. Relaxation imagery training: A quiet and comfortable environment was provided to the patient with light music, and the patient was guided to subjectively imagine being in a cheerful environment, such as among trees, streams, and prairies, to allow the patient’s body and mind to relax. The patient was asked to breathe gently and gradually enter a state of deep relaxation. Case sharing: The cases of past patients with similar conditions who showed good prognoses were shared with the present patient, encouraging them to face the disease actively and be proactive in their cooperation); (3) Health education: Brochures, videos, and PowerPoint presentations were distributed to raise awareness. The publicity content included the diagnostic criteria, causes, symptoms, examination contents, intervention methods, and matters needing attention for cases of depression complicated by respiratory failure. The publicity/marketing materials were easy to understand to maximize their acceptance by the patients. A knowledge-based lecture was organized weekly, where patients’ questions were answered and they were guided toward establishing an appropriate and positive view of their disease; (4) Sleep nursing: For patients with poor sleep quality, a quiet and comfortable environment was created before their bedtime every day. Meditation and deep breathing methods were used to relax the body and mind, relieve psychological pressure, and help them fall asleep. For those with more severe symptoms, drugs were used in strict accordance with the doctor’s advice; (5) Basic disease nursing: The patients’ vital signs were closely monitored, they were urged to turn over, and their backs were patted regularly to avoid the development of pressure sores and effectively expectorate and clean any secretions from the mouth and nose to ensure unobstructed respiration; (6) Respiratory tract management: The responsible nurse conducted sputum suction, nebulization, and cleaning based on the chest X-rays or the situation of lung auscultation. The head of the patient’s bed was raised by 30° to ensure patency of the trachea and to replenish the distilled water of the ventilator in a timely manner, ensuring that the gas inhaled by the patient was moist. Meanwhile, the patients were urged to drink more warm boiled water to promote their sputum discharge. If the patient’s physical condition allowed, the patient was asked to sit up in bed, and their backs were patted, and they were asked to shuffle on the bed at least twice a week; and (7) Respiratory function training: When the patient’s condition was stable and respiratory training could be carried out, the patient was guided to perform abdominal breathing. The patient was asked to maintain a lying or sitting position, with one hand pressing on the upper abdomen, such that, when exhaling, the abdomen sank; at the same time, a little more force was put with the hand to increase the abdominal pressure and promote the upward movement of the diaphragm. Also, when inhaling, the upper abdomen was supposed to resist the pressure of this hand to make the abdomen bulge slowly. This session was repeated twice a day, 10-15 minutes each time. Both groups were nursed for 1 month.

Observation indicators

The emotional state, sleep quality, and hope level of the two groups were compared: (1) Emotional state: The degree of depression of patients was evaluated based on the SDS. This scale has 20 items, and the raw score was obtained by simple addition. The raw score was then multiplied by 1.25, and the integer (standard score) was taken. A SDS standard score < 53 points indicated no depression, 53-62 points indicated mild depression, 63-72 points indicated moderate depression, and ≥ 73 points indicated severe depression[21]. The reliability of the scale was 0.90 and 0.89, respectively, and the Cronbach’s coefficients were 0.850 and 0.847; (2) Sleep quality: The Pittsburgh Sleep Quality Index (PSQI) included 7 dimensions in total, with each dimension scored from 0 to 3 points, and the total score ranging from 0 to 21 points. The higher the score, the worse the sleep quality[22]. The reliability of this scale is 0.88, and the Cronbach’s coefficient was 0.702; and (3) Hope level: The Herth Hope Scale (HHS) was used, which includes 12 items, divided into 3 dimensions, with each item using a 4-level scoring system (1-4 points) and the total score ranging from 12 to 48 points. The higher the score, the higher the hope level[23]. The reliability of the scale is 0.92, and the Cronbach’s coefficient was 0.850.

Comparison of the pulmonary function and exercising endurance of the two groups: A pulmonary function test analyzer (Chengdu Risheng Electric Co., Ltd., model: RSFJ600) was used to detect the forced vital capacity (FVC) and forced expiratory volume in the first second of the patients. Exercise endurance: The 6-minute walk distance test (6MWD) method was applied. The patients were asked to walk as fast as possible in a straight corridor, and the distance walked within 6 minutes was measured.

Comparison of the compliance behavior with the medical advice of the two groups: The self-made “Compliance Behavior Questionnaire” of the hospital was used, which included 3 dimensions: Compliance with medication, emotional management, and behavior change. Each item was scored from 0 to 100 points. Scores < 60 points, 60-89 points, and ≥ 90 points were rated as poor compliance, general compliance, and good compliance, respectively. The higher the score, the better the compliance. The reliability of the scale is 0.879, and the validity is 0.875.

Comparison of the incidence of adverse events of the two groups: Adverse events, including sleep disorders, arrhythmias, electrolyte imbalances, and digestive system diseases, were measured.

Statistical analysis

The data were entered into the SPSS 26.0 software. Qualitative data were described as [n (%)] and tested by the χ² test. Quantitative data were described as (mean ± SD) and tested by the t-test. P < 0.05 indicated statistical significance.

RESULTS

Comparison of emotional state, sleep quality, and hope level between the two groups

Before the nursing intervention, the SDS, PSQI, and HHS scores of the two groups did not vary significantly (P > 0.05). However, after nursing, the scores of both groups improved compared with those before nursing. The scores of SDS and PSQI were lower in the observation group, whereas the score of HHS was higher (P < 0.05) (Table 1).

Table 1 Comparison of inter-group differences for the factors emotional state, sleep quality, and hope level (mean ± SD, points).

Group	n	SDS		PSQI		HHS
		Before	After	Before	After	Before	After
Control	80	60.50 ± 5.65	54.20 ± 4.60	11.90 ± 2.15	4.50 ± 1.20	35.50 ± 3.30	39.50 ± 3.15
Observation	80	60.85 ± 5.80	51.95 ± 4.75	11.65 ± 2.10	4.00 ± 1.15	34.95 ± 3.40	41.35 ± 3.50
t value		0.387	3.044	0.744	2.691	1.038	3.514
P value		0.700	0.003a	0.458	0.008a	0.301	0.001a

^aP < 0.05.

SDS: Self-Rating Depression Scale; PSQI: Pittsburgh Sleep Quality Index; HHS: Herth Hope Scale.

Comparison of lung function and exercise endurance between the two groups

Table 2 presents the results of the study comparing two groups (control and observation) comprising 80 participants each, with a focus on three pulmonary function indicators: FVC, FEV₁, and 6MWD. The observation group showed significantly more improvements in these indicators after receiving nursing care (P < 0.05). The significant improvements in FVC, FEV₁, and 6MWD observed in the dedicated nursing group highlight the positive impact of specialized care on pulmonary function and exercise endurance. Improving lung function is crucial for patients with respiratory failure as it directly affects their overall quality of life and their ability to perform daily activities. The increased 6MWD score indicates improved cardiopulmonary function and exercise tolerance, which are crucial for reducing the risk of future respiratory complications and enhancing long-term outcomes.

Table 2 Comparison of the lung function and exercise endurance between the groups (mean ± SD).

Group	n	FVC (L)		FEV1 (L)		6MWD (minutes)
		Before	After	Before	After	Before	After
Control	80	2.50 ± 0.35	2.93 ± 0.30	1.28 ± 0.15	1.73 ± 0.23	355.65 ± 23.50	398.50 ± 20.50
Observation	80	2.48 ± 0.38	3.08 ± 0.28	1.26 ± 0.16	1.86 ± 0.26	360.10 ± 24.55	412.60 ± 19.65
t value		0.346	3.269	0.816	3.350	1.171	4.441
P value		0.730	0.001a	0.416	0.001a	0.243	0.000a

^aP < 0.05.

FVC: Forced vital capacity; FEV₁: Forced expiratory volume in the first second; 6MWD: 6-minute walk distance test.

Inter-group comparison of medical behavior

Table 3 comparatively analyzes the compliance behaviors of the two groups (control and observation) with 80 participants each, focusing on three aspects: Medication adherence, emotional management, and behavioral change. For the control group, scores for medication adherence increased from 78.50 ± 6.65 to 88.65 ± 4.50, emotional management from 72.50 ± 5.50 to 80.45 ± 5.50, and behavioral change from 71.00 ± 8.60 to 80.50 ± 5.60 after receiving nursing care. In contrast, for the observation group, scores for medication adherence increased from 80.15 ± 6.90 to 90.35 ± 4.60, emotional management from 73.00 ± 6.00 to 83.55 ± 6.00, and behavioral change from 73.50 ± 8.45 to 83.60 ± 5.90. The t-values and P-values revealed significant variations in the changes in medication adherence and emotional management between the two groups after nursing care, with the observation group exhibiting more substantial improvements in these areas.

Table 3 Comparison of the inter-group compliance with medical advice (mean ± SD, score).

Group	n	Follow doctor’s advice on medication		Emotion management		Behavior change
		Before	After	Before	After	Before	After
Control	80	78.50 ± 6.65	88.65 ± 4.50	72.50 ± 5.50	80.45 ± 5.50	71.00 ± 8.60	80.50 ± 5.60
Observation	80	80.15 ± 6.90	90.35 ± 4.60	73.00 ± 6.00	83.55 ± 6.00	73.50 ± 8.45	83.60 ± 5.90
t value		1.540	2.363	0.549	3.407	1.855	3.409
P value		0.126	0.019a	0.583	0.001a	0.066	0.001a

^aP < 0.05.

Inter-group comparison of adverse event incidence

Table 4 compares the incidence of adverse events between the two groups (control and observation), each comprising 80 participants. In the control group, the incidence rates were as follows: Sleep disorders (2.50%), arrhythmias (5.00%), electrolyte imbalances (5.00%), gastrointestinal diseases (3.75%), and overall adverse event rate (16.25%). These rates were significantly lower in the control group: Sleep disorders (1.25%), arrhythmias (1.25%), electrolyte imbalances (2.50%), gastrointestinal diseases (1.25%), and overall adverse event rate (6.25%). The t-value of 4.006 and P-value of 0.045 indicated that the overall adverse event rate differed significantly between the two groups, with the control group experiencing fewer adverse events.

Table 4 Comparison of incidence of adverse events between the groups, n (%).

Group	n	Dyssomnia	Arrhythmia	Electrolyte imbalance	Digestive system disease	Incidence of adverse events
Control	80	2 (2.50)	4 (5.00)	4 (5.00)	3 (3.75)	13 (16.25)
Observation	80	1 (1.25)	1 (1.25)	2 (2.50)	1 (1.25)	5 (6.25)
χ2						4.006
P value						0.045a

^aP < 0.05.

DISCUSSION

Depression is the major cause of the disease burden associated with mental health issues[8]. The predominant feature of depression is a significant and persistent low mood. Certain patients may also exhibit self-harming and suicidal behaviors. Although the prevalence and clinical cure rates of the disease are high, the treatment acceptance and recurrence rates are high, inflicting great harm to the physical and mental health of patients[9]. Psychological treatment is an effective means of improving the condition, which can alter the patient’s mentality, increase their sense of security, and alleviate adverse symptoms[24,25]. However, owing to several factors such as social discrimination, lack of medical knowledge, and the repeated course of the disease, patients often do not wish to undergo long-term treatment, and their compliance with medical advice is poor[26]. The condition of patients with depression complicated by respiratory failure is more severe and complex, and the treatment is more challenging, requiring active patient cooperation. Therefore, providing effective nursing care for patients with depression complicated by respiratory failure is crucial.

The SDS is a common tool for assessing the emotional state of patients with depression. When these patients experience a low mood, the levels of central neurotransmitters decrease, in turn affecting their sleep quality[13]. A neurotransmitter imbalance occurs in the brain of patients with depression, with a decline in 5-hydroxytryptamine affecting emotional and cognitive processing, resulting in a low level of hope[27]. This study found that after nursing care, the scores of SDS and PSQI in the control group were lower. In contrast, the score of HHS was higher (P < 0.05), indicating that dedicated nursing can alleviate patients’ adverse emotions and improve their sleep quality and hope level[28]. The reason is that a team composed of excellent medical and dedicated nursing staff can ensure the standardization, systematic nature, and scientific basis of nursing work[29,30]. The nursing plan is formulated based on clinical experience, the patient’s condition, and core literature, making the nursing content more evidence-based, targeted, and effective. Establishing a good rapport between the responsible nurse and the patient can foster the patient’s trust, increase the patient’s favorability toward the medical staff, and improve compliance[19,20]. Effective psychological counseling measures can significantly enhance the patient’s condition. For example, role-playing can enable patients to change their thinking and express their negative emotions actively[31]. The emotion transfer method can timely transfer the patient’s negative emotions, increase social interest, and prevent disease progression. Furthermore, the relaxation imagery training method can place the patient’s body and mind in a relaxed state, thereby alleviating adverse psychological emotions[32]. Case sharing can enhance the patient’s confidence in overcoming the disease and improve the hope level. By creating an environment that incorporates deep breathing, meditation, and other methods, the pressure cycle can be broken, emotions can be soothed, and the patient can fall asleep more easily. These measures also exert a positive effect on enhancing the depth of sleep[33].

In patients with depression complicated by respiratory failure, the oxygen supply is reduced and the pulmonary function is compromised[34]. Determining exercise endurance can help doctors evaluate cardiopulmonary function based on walking distance and changes in heart rate[35]. The data in Table 2 demonstrate that the improvements in FVC, FEV₁, and 6MWD in the control group after nursing were more significant (P < 0.05), suggesting that dedicated nursing can increase pulmonary function and enhance the patient’s exercise endurance. The possible reason is that effective expectoration, sitting up and patting the back, and bedside activities promote gas exchange in the lungs, enhance oxygen uptake and carbon dioxide excretion, and thus improve respiratory and pulmonary ventilation functions[36]. Respiratory function training can aid in increasing the depth of breathing, improving lung volume, exercising the respiratory muscles, enhancing pulmonary function, and strengthening endurance[37].

The data obtained from this study demonstrate that the compliance of the control group was higher, and the incidence of adverse events was lower after nursing care (P < 0.05). This finding could be attributed to the fact that in routine nursing, psychological counseling for patients primarily involves oral reassurance. The patients cannot be adequately engaged, and the acceptance level is low. On the contrary, in dedicated nursing, various methods, such as role-playing, emotion transfer, relaxation imagery training, and case sharing, are used for psychological counseling of patients[38]. These approaches are novel and interesting, which increases the level of acceptance[39]. Effective psychological counseling can help patients appreciate their intrinsic value, instill confidence that the disease will be cured, and encourage them to cooperate actively with clinical nursing work. Moreover, the “humanization” is fully reflected in the nursing care, providing patients with sufficient psychological support, thereby alleviating their anxiety and fear. Patients are more satisfied and comply better with the treatment[40,41]. Effective psychological nursing measures not only improve the mental health level of patients but also lay the foundation for subsequent clinical nursing work. Once patients develop a positive attitude, they are more likely to actively cooperate in basic disease management, respiratory tract management, and respiratory function training, resulting in a significant improvement of their condition and a reduction in adverse events.

Despite the promising results, this study has several limitations that should be acknowledged. First, this research included only 160 patients from a single medical institution, which may limit the representativeness of the sample and the generalizability of the findings to other regions. Moreover, the age range of the participants was relatively narrow (26-55 years) as elderly populations with more complex nursing needs in cases of depression complicated by respiratory failure were excluded. Future studies should consider larger, more diverse samples and include a broader age range to better understand the applicability of dedicated nursing interventions across diverse patient populations. Second, the intervention period was only 1 month, and although it demonstrated short-term effects, this research lacked data on medium to long-term follow-ups. Evaluating the sustained benefits of the intervention, such as relapse rates or quality of life changes after 6 months or 1 year, is crucial for assessing the long-term impact of dedicated nursing. Future research should incorporate extended follow-up periods to provide a more comprehensive understanding of the intervention’s effectiveness over time. In summary, while this study provides valuable insights into the benefits of dedicated nursing for patients with depression complicated by respiratory failure, certain limitations exist, which should be addressed in further investigations to enhance the robustness and applicability of the findings.

CONCLUSION

Providing dedicated nursing care to patients with depression complicated by respiratory failure can significantly improve their emotions, sleep quality, hope level, pulmonary function, exercise endurance, and medical advice compliance while reducing the incidence of adverse events. These findings confirm the significant clinical applicability of specialized nursing interventions for this patient population. The comprehensive and personalized approach of dedicated nursing not only addresses the immediate needs of patients but also lays a solid foundation for their long-term recovery and improvement in quality of life.