Behavioral recurrence mechanisms of “pain shadow memory” and nursing intervention opportunities in postherpetic neuralgia during the skin lesion regression stage

Guoqin Li, Wuchao Wang, Qinxin Shu, J Huang, Yuqiong Yang

Objective To address clinical nursing challenges associated with postherpetic neuralgia(PHN), including recurrent pain shadow memory (PSM), refractory pain, and marked negative affect, this study assessed the effectiveness of a staged nursing pathway and identified key opportunities for cognitive–sensory–behavioral staged regulation, thereby providing a scientific foundation for improving nursing care for patients with PHN. Methods A total of 100 patients diagnosed with PHN between July 2025 and April 2026 were enrolled and assigned to either a control group or an experimental group according to the admission period in a quasi-experimental design. The control group received routine nursing care, such as general nursing (e.g., vital signs, observation of the patient’s condition, and medication administration). The observation group received a step-by-step nursing intervention, in addition to the control group’s treatment, with three steps as follows: cognition correction (correcting irrational cognition about pain), sensory intervention (cold compress treatment combined with sensory desensitization), and behavioral counseling (desensitization language combined with behavior intervention). Results were evaluated with the Pain Shadow Behavior Identification Scale, the Numerical Rating Scale (NRS), and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using a t-test. Results Baseline characteristics were comparable between the two groups (all p > 0.05). After the intervention, the experimental group demonstrated significantly greater improvements in all three behavioral dimensions of pain shadow memory, namely situational recurrence, action avoidance, and verbal response, than the control group on both day 4 and day 7. On day 4, the experimental group showed significantly lower scores in situational recurrence (1.70 ± 0.54 vs. 1.96 ± 0.40, p < 0.001), action avoidance (1.70 ± 0.61 vs. 2.76 ± 0.43, p < 0.05), and verbal response (1.88 ± 0.52 vs. 2.32 ± 0.55, p < 0.05). On day 7, the experimental group continued to demonstrate significantly greater improvements in all three dimensions: situational recurrence (0.68 ± 0.65 vs. 1.64 ± 0.48, p < 0.005), action avoidance (1.30 ± 0.46 vs. 2.06 ± 0.24, p < 0.001), and verbal response (0.94 ± 0.42 vs. 1.72 ± 0.50, p < 0.01). The Numerical Rating Scale score was significantly lower in the experimental group than in the control group on day 4 (4.78 ± 0.88 vs. 5.22 ± 0.58, p < 0.05) and day 7 (2.56 ± 0.54 vs. 3.82 ± 0.66, p < 0.001). Regarding emotional status, the experimental group showed significantly lower scores on both the Hospital Anxiety and Depression Scale-Anxiety subscale (8.52 ± 1.89 vs. 9.88 ± 1.43, p < 0.001) and the Hospital Anxiety and Depression Scale-Depression subscale (7.68 ± 1.39 vs. 8.72 ± 1.14, p < 0.001) compared with the control group on day 7. Conclusion The staged nursing pathway, which integrates sequential cognitive, sensory, and behavioral interventions, significantly reduced the recurrence of pain shadow memory, rapidly relieved pain, and improved anxiety and depression in patients with postherpetic neuralgia. This approach addresses the limitations of conventional nursing care and provides a feasible, effective, and evidence-based strategy for clinical practice.