Abstract
BACKGROUND: Stroke remains a leading cause of morbidity and mortality worldwide, with post-stroke pneumonia significantly impacting patient outcomes. Despite progress in stroke management, there was a lack of emphasis on targeted preventive measures for pneumonia. This study evaluates the impact of airway management guided by Protection Motivation Theory (PMT) on preventing post-stroke pneumonia. METHODS: A retrospective study was conducted with 100 stroke patients admitted to the general neurology ward between January and December 2023. Patients were divided into two groups based on chronological admission order: 50 received standard airway management (January-June 2023), and 50 received PMT-guided intervention (July-December 2023). The PMT group engaged in structured educational sessions (30 min daily for 7 days) and actionable coping strategies to enhance adherence to airway management. Outcomes assessed included incidence of post-stroke pneumonia (diagnosed by chest CT within 7 days post-admission), respiratory function, length of hospital stay, and cognitive and psychological measures. RESULTS: The PMT group showed a lower incidence of pneumonia (16% vs. 34%, p = 0.038) and reduced hospital stay (13.47 ± 3.86 days vs. 15.72 ± 4.36 days, p = 0.007). The absolute risk reduction was 18% with a number needed to treat (NNT) of 5.6. Improvements were noted in respiratory function, with higher forced vital capacity (2.46 ± 0.68 L vs. 2.15 ± 0.56 L, p = 0.013). Cognitive function, as measured by the Montreal Cognitive Assessment, was enhanced (23.58 ± 4.06 vs. 21.35 ± 3.84, p = 0.006), with both groups remaining below the normal threshold of 26 points. Depression levels were reduced (PHQ-9: 12.05 ± 3.12 vs. 13.46 ± 3.56, p = 0.038). CONCLUSION: PMT-guided airway management significantly enhances post-stroke outcomes through improved respiratory function, reduced pneumonia incidence, and better cognitive and psychological wellbeing. Future prospective studies with larger sample sizes are warranted to validate these findings.