Implementation of evidence-based personalized nursing care for Two patients With vasodepressor syncope: a case report

Background: Vasodepressor syncope is a common subtype of reflex syncope. Although lifestyle modification, trigger avoidance, physical counterpressure manoeuvres, and orthostatic training are recommended, post-discharge nursing pathways that translate this evidence into individualized home-based care remain insufficiently described. Case presentation: We report two patients with tilt-test-confirmed vasodepressor syncope. Patient A was a 58-year-old man with recurrent brief syncopal episodes, fall-related injury, and insufficient prodrome recognition and self-monitoring. Patient B was a 74-year-old woman with recurrent dizziness and syncope-like episodes, blood pressure variability, cerebrovascular comorbidity, and higher anxiety related to unpredictable episodes. Intervention: An evidence-based personalized nursing care pathway was developed using guideline recommendations, syncope-related clinical studies, and individualized patient assessment. The intervention included lifestyle modification, fluid and salt intake guidance, physical counterpressure manoeuvre training, orthostatic/tilt training, blood pressure and heart-rate self-monitoring, trigger management, family involvement, and psychological support. Follow-up was performed by telephone and outpatient review over 3 weeks. Outcomes: No syncope recurrence, fall event, or other major discomfort occurred during the 3-week follow-up. Patient A showed improvement in EQ-5D-5L index from 0.720 to 0.906 and EQ VAS from 58 to 75; GAD-7 decreased from 8 to 5 and FES-I from 48 to 32. Patient B showed improvement in EQ-5D-5L index from 0.467 to 0.651 and EQ VAS from 48 to 66; GAD-7 decreased from 15 to 10 and FES-I from 44 to 36. Conclusion: A structured personalized nursing care pathway may support self-management, fall-prevention behaviours, and patient-reported outcomes in vasodepressor syncope. As this report involves only two cases and a short follow-up, the absence of recurrence should be interpreted as an early observation requiring prospective verification.