The Critical Role Of Nurse Competence And Communication In Enhancing The Quality Of Care During Electroconvulsive Therapy (ECT): A Literature Review
DOI:
https://doi.org/10.54832/nij.v5i1.1168Keywords:
Nursing education, Electroconvulsive therapy (ECT), Patient satisfaction, Psychiatric care, CommunicationAbstract
Electroconvulsive Therapy (ECT) remains one of the most effective interventions for severe psychiatric disorders. However, despite its established clinical efficacy, ECT continues to be associated with stigma, fear, and misinformation, which significantly impacts patient satisfaction and adherence. Nursing care plays a critical role in shaping patients' perceptions and overall satisfaction with ECT. This literature review explores the influence of nursing education on patient satisfaction throughout the ECT process, highlighting how well-trained nurses contribute to improved communication, reduced anxiety, and enhanced patient-centered care. A systematic literature search was conducted using databases such as EBSCO, ScienceDirect, ResearchGate, IEEE Access, and DOAJ, applying the PRISMA framework to identify, select, and analyze relevant studies. Articles published in English from 2019 to 2025. Findings demonstrate that structured nursing education programs focusing on procedural knowledge, therapeutic communication, and stigma reduction significantly enhance patient satisfaction across pre-treatment, intra-treatment, and post-treatment stages. Educated nurses are better equipped to deliver accurate information, address concerns, and foster trust, ultimately improving the overall patient experience. This review underscores the importance of integrating ECT-specific content into nursing curricula and ongoing professional development to ensure that psychiatric nursing practice aligns with evidence-based, patient-centered care principles.
References
Abdllah, Abdulrahman Nidal, Nadeen Al-Falooji, Lara Khaled, Rashed Hammad, Leen Al Zghoul, Jehad Feras AlSamhori, Radwan Bani Mustafa, and Abdallah Barjas Qaswal. 2024. “Knowledge and Attitudes towards Electroconvulsive Therapy for Psychiatric Conditions in a Single-Center Jordanian Hospital: A Cross-Sectional Study.” Middle East Current Psychiatry 31(1). https://doi.org/10.1186/s43045-024-00484-9
Ansari, Saba, and Sujatha Maiya. 2025. “From Baseline to Recovery: An Audit of Pre- and Post-ECT (Electro Convulsive Therapy) Patient Assessments.” BJPsych Open 11(S1):S117–S117. https://doi.org/10.1192/bjo.2025.10335
Azhari, Indah, and Tintin Sukartini. 2021. “The Effect of Nursing Rounds on Patient Satisfaction in Nursing Services.” Fundamental and Management Nursing Journal 4(1):12. https://doi.org/10.20473/fmnj.v4i1.27007.
Birkenhager, T. K., and L. van Diermen. 2020. “Electroconvulsive Therapy: We Are Hesitant to Use the Most Effective Treatment for Severe Depression.” Acta Psychiatrica Scandinavica 141(4):301–3. https://doi.org/10.1111/acps.13171.
Coman, A. 2022. “Recipients’ Experience with Information Provision for Electroconvulsive Therapy (ECT).” BMC Psychiatry 22(1):1–9. https://doi.org/10.1186/s12888-022-03720-w.
Current Nursing. 2020. “Nursing Care in ECT.” 1–7.
Dominiak, Monika, Anna Z. Antosik-Wójcińska, Marcin Wojnar, and Paweł Mierzejewski. 2021. “Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age.” Pharmaceuticals 14(6). https://doi.org/10.3390/ph14060582.
Du, Ruonan, Kebing Yang, Wei Li, Zhiren Wang, and Haipeng Cai. 2024. “Research Status and Global Trends of Late-Life Depression from 2004 to 2023: Bibliometric Analysis.” Frontiers in Aging Neuroscience 16(April):1–17. https://doi.org/10.3389/fnagi.2024.1393110.
Horínková, J., Bartecku, E., & Kališová, L. (2021). The Practice of Electroconvulsive Therapy in Children and Adolescents in the Czech Republic. The Journal of ECT, 37(2), 94-98. https://doi.org/10.1097/YCT.0000000000000726.
Huang, Chun Jen, Ching Hua Lin, Jyh I. Wu, and Wei Cheng Yang. 2019. “The Relationship Between Depression Symptoms and Anxiety Symptoms During Acute ECT for Patients With Major Depressive Disorder.” International Journal of Neuropsychopharmacology 22(10):609–15. https://doi.org/10.1093/ijnp/pyz038.
Huoponen, Saara H., Katrin Sisa, Tom Saari, Markku Taittonen, and Ulla Ahlmén-Laiho. 2025. “The Recognition and Management of Adverse Effects in Electroconvulsive Therapy: Findings From a Finnish Survey Study.” Brain and Behavior 15(1). https://doi.org/10.1002/brb3.70227
Jelovac, Ana, Sabine Landau, Gabriele Gusciute, Martha Noone, Keeva Kavanagh, Mary Carton, Cathal McCaffrey, Kelly McDonagh, Eimear Doody, and Declan M. McLoughlin. 2025. “Retrograde Amnesia Following Electroconvulsive Therapy for Depression: Propensity Score Analysis.” BJPsych Open 11(3):1–2. https://doi.org/10.1192/bjo.2025.25
Kafashan, Mohammad Mehdi, Lucas Lebovitz, Robby Greenspan, Sijia Zhao, Tae Kim, Masud Husain, Tamara Hershey, Pilar Cristancho, R. Edward Hogan, Ben Julian Agustin Palanca, and Nuri B. Farber. 2025. “Investigating the Impact of Electroconvulsive Therapy on Brain Networks and Sleep: An Observational Study Protocol.” BMJ Open 15(3). https://doi.org/10.1136/bmjopen-2025-098859
Lonergan, A., Timmins, F., & Donohue, G. (2021). Mental Health Nurse experiences of delivering care to severely depressed adults receiving electroconvulsive therapy. Journal of psychiatric and mental health nursing, 28(3), 309–316. https://doi.org/10.1111/jpm.12692.
Mutz, Julian, Vijeinika Vipulananthan, Ben Carter, René Hurlemann, Cynthia H. Y. Fu, and Allan H. Young. 2019. “Comparative Efficacy and Acceptability of Non-Surgical Brain Stimulation for the Acute Treatment of Major Depressive Episodes in Adults: Systematic Review and Network Meta-Analysis.” BMJ (Online) 364. https://doi.org/10.1136/bmj.l1079.
Nakayama, Naho, Tatsuo Nakahara, Hideyuki Iwanaga, Manabu Hashimoto, Takako Mitsudo, Yoshiomi Imamura, Hiroko Kunitake, Yoshito Mizoguchi, and Takefumi Ueno. 2025. “Differential Effects of Electroconvulsive Therapy on Patients with Schizophrenia Versus Depressive Disorder: Clinical Distinction Between Antipsychotic and Antidepressant Effects of Electroconvulsive Therapy.” Brain Sciences 15(2):1–14. https://doi.org/10.3390/brainsci15020126.
Napierala, Maria, Anna Bodnar, Maria Chlopocka-Wozniak, Agnieszka Permoda-Osip, and Janusz Rybakowski. 2019. “Electroconvulsive Therapy and Autobiographical Memory in Patients with Treatment-Resistant Depression.” Psychiatria Polska 53(3):589–97. https://doi.org/10.12740/PP/85787.
Obbels, J., Vansteelandt, K., Verwijk, E., Lambrichts, S., Bouckaert, F., & Sienaert, P. (2020). Understanding electroconvulsive therapy-related anxiety: a prospective study. Acta psychiatrica Scandinavica, 142(2), 132–140. https://doi.org/10.1111/acps.13198.
Petrides, G., Lapid, M., Mueller, M., Hermida, A., Nykamp, L., Seiner, S., Sanghani, S., & Forester, B. (2025). The ECT-AD trial for severe treatment-refractory agitation and aggression in advanced dementia: Scientific rationale and study design. Brain Stimulation, 18(1), 324–325. http://dx.doi.org/10.1016/j.brs.2024.12.332
Pettifor, Emily, and Mohan Bhat. 2025. “Understanding the Care Home Psychiatric Service in North Kent.” BJPsych Open 11(S1):S203–4. https://doi.org/10.1192/bjo.2025.10519.
Priasmoro DP, Dradjat RS, Zuhriyah L, Lestari R, Subagiyono. (2023). A model of acceptance for family caregivers in the management of severe mental disorders. The Medical Journal of Malaysia, 78(6), 821-829.
Priasmoro, D. P., Dradjat, R. S., Zuhriyah, L., & Lestari, R. (2023). Factors influencing family acceptance of people with schizophrenia receiving care at home: a systematic review. The Malaysian Journal of Nursing (MJN), 14(4), 183-191. https://doi.org/10.31674/mjn.2023.v14i04.019
Rummel, Lea, Katharina Göke, Alexandra Philipsen, René Hurlemann, and Maximilian Kiebs. 2024. “Role of Stimulus Dose on Neuropsychological Functioning after Electroconvulsive Therapy in Patients with Major Depressive Disorder.” Frontiers in Psychiatry 15(September):1–9. https://doi.org/10.3389/fpsyt.2024.1443270.
Sweetmore, Victoria. 2022. “What Are the Ethical Dilemmas in the Decision-Making Processes of Nursing People Given Electroconvulsive Therapy? A Critical Realist Review of Qualitative Evidence.” Journal of Psychiatric and Mental Health Nursing 29(2):204–19. https://doi.org/10.1111/jpm. 12778.
Taha Abd El-Raof, Mahmoud, Zeinab Abd El Hameed Loutfi, and Amal Elias Abdel-Aziz. 2022. “Nurses` Performance Regarding Care of Patients Undergoing Electroconvulsive Therapy.” Egyptian Journal of Health Care, 13(4), 757–68. https://doi.org/10.21608/ejhc.2022.265089.
Tsai, J., Huang, M., He, H., Selek, S., & Rosenheck, R. A. (2021). Cross-cultural Comparison of Perceptions and Knowledge About Electroconvulsive Therapy Among Adults Who Screened Positive for Depression in the United States, India, and China. The journal of ECT, 37(4), 274–280. https://doi.org/10.1097/YCT.0000000000000775
Wilson, K., Purushothaman, S., & Kolur, U. (2022). Psychiatric advance directives and consent to electroconvulsive therapy (ECT) in Australia: A legislative review and suggestions for the future. International Journal of Law and Psychiatry, 85, 101836. https://doi.org/https://doi.org/10.1016/j.ijlp.2022.101836.
Yadigar Cevik Durmaz, Filiz Ersogutcu, Ela Uzun. 2023. “The Effect of Nursing Education on Patient Satisfaction in Electroconvulsive Treatment.” International Journal of Caring Sciences 16(3):1331–57.
Zhang, Ying, Zhaojuan Ke, Jie Luo, Qibin Chen, Xiaoming Xu, Xin Jiang, and Jialin Xiong. 2025. “Effects of Binaural Beat Music and Esketamine for ECT in the Treatment of Major Depressive Disorder: A Randomized Controlled Trial Protocol.” Neuropsychiatric Disease and Treatment Volume 21(June):1249–60. https://doi.org/10.2147/ndt.s514640
