Augmented reality-supported self-care training and clinical outcomes in patients with major depressive disorder: a retrospective propensity score-matched cohort study.
Augmented reality (AR) has emerged as a promising educational tool in mental health care; however, evidence regarding its integration into routine psychiatric nursing practice remains limited. This study examined whether participation in an AR-supported self-care training program was associated with improved clinical and functional outcomes among patients with Major Depressive Disorder (MDD) receiving standard psychiatric nursing care.
A retrospective propensity score-matched cohort study was conducted using electronic medical record data from 342 inpatients and outpatients treated at a tertiary psychiatric hospital in Changsha, Hunan, China between January 2023 and June 2025. All patients received routine psychiatric nursing services. A subgroup additionally participated in an AR-supported self-care education program focused on illness management, daily self-care, emotion regulation, and social functioning. Propensity score methods were used to balance baseline demographic and clinical characteristics between exposure groups. Primary outcomes included changes in depressive symptom severity measured by the Hamilton Depression Rating Scale (HAM-D-17) and self-care agency measured by the Exercise of Self-Care Agency (ESCA) Scale. Secondary outcomes included medication adherence and healthcare utilization indicators.
Within the propensity score-matched cohort, participation in the AR-supported program was associated with significantly greater improvement in self-care agency and modestly greater reduction in depressive symptoms compared with standard care alone (both p <.001). Medication adherence was also higher among AR participants. Within the AR group, the number of completed sessions was positively correlated with improvement in self-care agency (r = 0.29, p <.001), whereas the association with symptom reduction was weaker. Multivariable analyses identified AR participation as an independent predictor of both functional and clinical improvement.
AR-supported self-care education may represent a useful adjunct to psychiatric nursing practice by enhancing patient engagement, self-management capacity, and treatment adherence among individuals with MDD. Prospective studies are needed to confirm these findings and evaluate long-term outcomes.
A retrospective propensity score-matched cohort study was conducted using electronic medical record data from 342 inpatients and outpatients treated at a tertiary psychiatric hospital in Changsha, Hunan, China between January 2023 and June 2025. All patients received routine psychiatric nursing services. A subgroup additionally participated in an AR-supported self-care education program focused on illness management, daily self-care, emotion regulation, and social functioning. Propensity score methods were used to balance baseline demographic and clinical characteristics between exposure groups. Primary outcomes included changes in depressive symptom severity measured by the Hamilton Depression Rating Scale (HAM-D-17) and self-care agency measured by the Exercise of Self-Care Agency (ESCA) Scale. Secondary outcomes included medication adherence and healthcare utilization indicators.
Within the propensity score-matched cohort, participation in the AR-supported program was associated with significantly greater improvement in self-care agency and modestly greater reduction in depressive symptoms compared with standard care alone (both p <.001). Medication adherence was also higher among AR participants. Within the AR group, the number of completed sessions was positively correlated with improvement in self-care agency (r = 0.29, p <.001), whereas the association with symptom reduction was weaker. Multivariable analyses identified AR participation as an independent predictor of both functional and clinical improvement.
AR-supported self-care education may represent a useful adjunct to psychiatric nursing practice by enhancing patient engagement, self-management capacity, and treatment adherence among individuals with MDD. Prospective studies are needed to confirm these findings and evaluate long-term outcomes.