Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2025; 13(25): 108124
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.108124
Nursing care of a patient with negative symptoms of schizophrenia who underwent tracheotomy: A case report
Jin-Yuan Li, Xiao-En Liu, Wei Li, Li-Na Wang
Jin-Yuan Li, Department of Nursing, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
Xiao-En Liu, Wei Li, Li-Na Wang, Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
Co-first authors: Jin-Yuan Li and Xiao-En Liu.
Author contributions: Li JY and Liu XE contributed equally to this study and are co–first authors; Li JY was responsible for data analysis and manuscript writing; Liu XE revised and edited the manuscript; Li W contributed to data curation; Wang LN was involved in planning and executing the research activities; All authors have read and approved the final manuscript.
Supported by Tianjin Key Medical Discipline (Specialty) Construction Project, No. TJYXZDXK-033A
Informed consent statement: Written informed consent for the publication of this case report was obtained from the patient’s legal guardian.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have reviewed the CARE Checklist (2016), and the manuscript was prepared and revised in accordance with its guidelines.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Yuan Li, Chief Nurse, Deputy Director, Department of Nursing, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, No. 13 Liulin Road, Hexi District, Tianjin 300222, China. jinyuan515@126.com
Received: April 7, 2025
Revised: April 26, 2025
Accepted: May 27, 2025
Published online: September 6, 2025
Processing time: 91 Days and 21.8 Hours
Abstract
BACKGROUND

Patients with schizophrenia may lack awareness of the importance of post-tracheotomy care due to the impact of their condition, often showing resistance or misunderstanding of care measures. When coupled with the impact of negative symptoms and the risk of complications after tracheotomy, patients may experience emotional fluctuations, restlessness, anxiety, and hostile behaviors, which pose significant challenges to nursing work.

CASE SUMMARY

We have reported the case of an 87-year-old male patient who was admitted to the hospital because of negative symptoms of schizophrenia and who underwent tracheotomy for severe pneumonia. In this study, we have summarized the nursing experience of a patient with negative symptoms of schizophrenia who underwent tracheotomy. The key nursing strategies included proper tracheotomy care, the management of psychiatric symptoms, a thorough assessment and implementation of enteral and parenteral nutrition, effective skincare, infection prevention, and comprehensive mental care. Individualized nursing skills helped stabilize the patient’s condition, followed by isolation and observation in a psychiatric hospital.

CONCLUSION

Effective postoperative tracheostomy care in patients with schizophrenia necessitates a tailored, multidisciplinary approach that addresses their psychiatric, physical, and emotional needs to achieve optimal clinical outcomes.

Keywords: Negative symptoms; Schizophrenia; Tracheotomy; Care; Case report

Core Tip: Managing postoperative tracheostomy care in elderly patients with chronic schizophrenia, particularly those presenting with negative symptoms and multiple comorbidities, presents significant clinical challenges. This case report discusses an 87-year-old man with a 63-year history of schizophrenia, complicated by pneumonia and other health issues, who exhibited persistent low mood and restlessness after undergoing a tracheostomy. We present novel clinical strategies and practical care approaches designed to support nursing staff in psychiatric settings. The involvement of a multidisciplinary care team and comprehensive risk assessments are essential for enhancing patient outcomes and experiences in similar complex cases. This report underscores the importance of specialized, integrative care in managing postoperative recovery in older adults with long-standing schizophrenia.