Effect of WeChat-based "Internet + Extended Nursing Care" on rehabilitation outcomes of children with bronchopneumonia: a retrospective cohort study

Bronchopneumonia is one of the leading causes of pediatric hospitalization globally, particularly in low- and middle-income countries. While in-hospital treatment has improved significantly, post-discharge care remains fragmented, and many children experience incomplete recovery, caregiver anxiety, and unplanned medical visits. The “Internet + Nursing Care” initiative, promoted by China’s National Health Commission, encourages the integration of mobile platforms into nursing services. However, evidence regarding the effectiveness of WeChat-based extended nursing care for pediatric respiratory conditions remains limited. This retrospective cohort study included 240 children aged 6 months to 6 years diagnosed with bronchopneumonia and discharged from a single tertiary hospital between June 2023 and December 2025. Using a before-and-after (historical control) design, children were categorized according to the post-discharge care they had actually received: those discharged between April 2024 and December 2025, after implementation of the WeChat-based extended nursing program, formed the WeChat Extended Nursing Care Group ( n = 120) and received daily scheduled online nursing consultations, regular health knowledge push notifications, and peer support through a WeChat group; those discharged between June 2023 and March 2024, before program implementation, formed the Conventional Extended Care Group ( n = 120) and received standard discharge education and telephone follow-up. All follow-up assessments had been performed as part of routine clinical care and were extracted retrospectively for this study. Propensity score matching (PSM) was performed yielding 108 matched pairs (90.0% match rate). Co-primary outcomes were recovery rates at 7 and 14 days post-discharge, evaluated using a hierarchical testing procedure. Secondary outcomes included caregiver self-efficacy measured by the General Self-Efficacy Scale (GSES) and non-planned revisit within 30 days. Caregiver satisfaction was evaluated as an exploratory endpoint. After PSM, the 14-day recovery rate was higher in the WeChat group than in the Conventional group (99.1% vs. 88.0%; OR = 14.642, 95% CI: 1.88-114.038, P = 0.010), although the wide confidence interval indicates substantial imprecision in the effect estimate and its lower bound (1.880) suggests that the true benefit may be modest, with a number needed to treat (NNT) of 9.0. The 7-day recovery rate did not differ between groups (77.8% vs. 77.8%; OR = 1.000, 95% CI: 0.526–1.899, P = 1.000). Caregiver self-efficacy was higher in the WeChat group (mean GSES score: 27.4 vs. 23.4; beta = 3.981, 95% CI: 2.847–5.115, P < 0.001). The WeChat group showed higher caregiver satisfaction scores > = 4 (70.4% vs. 41.7%, P < 0.001) and a lower rate of non-planned revisit within 30 days (OR = 0.336, 95% CI: 0.147–0.765, P = 0.009). Sensitivity analysis with E-value calculation (point estimate: 28.78, CI lower bound: 3.17) indicated robustness to unmeasured confounding. WeChat-based extended nursing care was associated with higher 14-day recovery rates, greater caregiver self-efficacy, and fewer non-planned revisits in children with bronchopneumonia compared with conventional post-discharge care. Given the retrospective before-and-after design, these findings suggest that this intervention may be a feasible approach for integrating digital health platforms into pediatric transitional care; prospective randomized studies are needed to confirm its effectiveness. Not applicable.