Stroke is the most common serious neurological condition worldwide. Members of the Black population are at an increased risk of suffering a stroke due to several risk factors which are more prevalent in this racial group. The purpose of this qualitative research study is to describe how African-Caribbean stroke survivors, who live in Canada, understand their illness and manage their care during the early recovery period. Eight participants who were of African-Caribbean origin who were living in Canada and recovering from a stroke were interviewed. Results of the study indicate that participants were not knowledgeable about the risk factors for stroke, they did not recognize the warning signs of a stroke as a medical emergency, and they did not always follow treatment regimes recommended by their physicians. Participants in the study described stroke as a catastrophic event, resulting in feelings of intense fear, being out of control, uncertainty, yearning for their old self, and feelings of detachment from their own body. Motivating factors in their recovery from stroke were the support of family, their own individual personal determination, and the acceptance of the illness by the participants. Nurses and physiotherapists were valued by the participants due to the role they played in improving their functional abilities. Participants expressed a desire for nurses to become knowledgeable about the African-Caribbean culture, in order to provide them with education pertaining to diet as well as steps they can take to reduce their risk of having another stroke. Responding to the care needs of this population will require individualized nursing care which considers the influence of culture on how the illness is perceived. / Thesis (Master, Nursing) -- Queen's University, 2010-04-30 09:59:56.286

Stroke är en av de vanligaste orsakerna till död och funktionsnedsättning. Det är främst personer över 65 år som drabbas. Fysisk, psykisk och social påverkan förekommer ofta. Hjärninfarkt och hjärnblödning är de två orsakerna till stroke och högt blodtryck är en bidragande orsak. Symtom på stroke kan till exepmpel vara förlamning eller talsvårigheter. Att bli sjuk eller uppleva ohälsa innebär påfrestningar och omställningar i livet för hela familjen. Syftet var att beskriva hur partnern påverkas av att leva med en person som drabbats av stroke. Litteraturöversikt har valts som design och tolv artiklar, som är kvalitetsgranskade och etiskt godkända, har inkluderats i resultatet. De databaser som användes var CINAHL, Medline och PsycInfo. Artiklarna analyserades i fem steg. I resultatet framkom sex teman: Förändringar i hälsan, Förändringar i relationen, Förändringar i vardagslivet, Förändringar inför framtiden, Vägen tillbaka till det tidigare livet och Behovet av stöd och information. Det framkom att deltagarna upplevde stora individuella förändringar som var fysiskt och psykiskt påfrestande. Partners upplevde att deras hälsa också påverkades negativt. De upplevde även sociala förändringar, till exempel isolering i hemmet. Det framkom i artiklarna att god kunskap och information hade underlättat bearbetningen av situationen. Partnerna upplevde att deras ansvar för sin livskamrat hade ökat i samband med strokehändelsen. I diskussionen diskuterades vikten av information och kunskap för att upprätthålla god hälsa. / Stroke is one of the most common causes of death and disability. It´s most common that people who are older than 65 years is affected. Physical, mental and social symptoms are common occurrences. Cerebral infarction and haemorrhage are the two causes of stroke and may occur because of high blood pressure, among other factors. Symptoms may present themselves as paralysis and dysarthria. Being sick or experience poor health can cause stress in life for the whole family. The aim of this study was to describe how the spouse is affected by living with a person affected by stroke. Literature review has been chosen as design, twelve articles, that has been quality and ethical approved is included in the result. Databases used in this study were CINAHL, Medline and PsycInfo. These articles were analyzed with five steps. In the result, six themes emerged: Changes in health, Changes in the relationship, Changes in everyday life, Changes for the future, Finding a way back to a normal life and The need for information and support. The result of the studies showed that the participants experienced individual changes that physical and mentally demanding. The spouses experienced that their health was affected negatively. They also experienced social changes in their lives, such as isolation. It emerged from the studies that knowledge and information was important, but was inadequate. The participants experienced that their responsibility for their sick partner had increased after the stroke. The importance of information and knowledge to maintain good health was also discussed in the conclusion.

Stroke är en stor orsak till funktionsnedsättningar. Dödligheten från stroke har minskat de senaste åren och därmed har antalet överlevanden med funktionsnedsättningar ökat. Svårigheten av en funktionsnedsättning kommer sig av vad den leder till för den enskilde individen. Målet vid omvårdnaden vid stroke ska individualiseras och arbeta för att uppnå största möjliga hälsa. Meleis transitionsteori beskriver en individs övergång från ett stabilt tillstånd till ett nytt och processen däremellan. Syfte: Syftet med denna litteraturstudie var att beskriva patienternas upplevelser av funktionsnedsättningar efter stroke. Metod: Litteraturstudie baserad på tio vetenskapliga artiklar. Resultat: De strokedrabbade upplevde emotionella reaktioner av de funktionsnedsättningar som de drabbats av. De upplevde också förändringar i sina dagliga aktiviteter och hur de genomförde dessa. De upplevde en förlust av sin identitet och de förlorade sin autonomi i och med att de inte längre kunde klara sig själva. Slutsats: Denna litteraturstudie visar att patienter upplever funktionsnedsättningar efter stroke som en livsförändrande händelse som påverkar hela deras liv. De som drabbas är inte förberedda på i hur stor utsträckning de kommer att påverkas, både socialt och emotionellt, av funktionsnedsättningarna. De tvingas att omstrukturera vardagen, vilket ofta upplevs frustrerande och är tidskrävande / Stroke is a major cause of disability. Mortality from stroke has decreased in recent years and therefore the number of survivors with disabilities has increased. The difficulty of a disability is defined from what impact the disability has on the individuals’ life. The goal of nursing in stroke should be individualized and aim to achieve maximum health. Meleis transition theory describes an individual's transition from one stable state to a new one and the process in between. Purpose: The purpose of this study is to describe patients' experiences of disability after stroke. Method: Literature study based on ten scientific articles. Results: The stroke victims experienced emotional reactions from the disabilities that they had suffered. They also experienced changes in their daily activities and how they carried them through. They experienced a loss of their identity and they lost their autonomy in that they no longer could care for themselves Conclusion: This literature review shows that patients experience impairments after stroke as a life-changing event that affects their entire lives. Those affected are not prepared for how much they will be affected, both socially and emotionally, by their impairment. They are forced to restructure everyday life which is often frustrating and time-consuming

ABSTRACT Speech-language pathology practice in the acute hospital setting has changed dramatically over the last 25 years. A significant increase in the number of referrals and a broadening of the speech-language pathologist’s caseload to include patients with dysphagia has meant there has been less time to see hospital inpatients with communication disabilities. This change in practice has caused speech-language pathologists working in the acute hospital setting to question their role in relation to patients with communication disabilities in the acute hospital setting. The thesis applies the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework to explore the role of speech-language pathologists in the acute hospital setting, specifically the acute hospital stroke unit, in relation to patients with communication disabilities. The ICF proposes that a health condition can be understood in terms of four separate components. These components are Body Structures and Functions, Activities and Participation, Environmental Factors and Personal Factors. Whilst the distinction between body structures and body functions within the ICF Body Functions and Structures component is clear, there is less clarity about the relationship between the ICF concepts of activity and participation in the ICF Activities and Participation component. Therefore, the first part of the thesis explores the conceptual similarities and differences between the concepts of activity and participation generally and communication activity and communication participation in particular. This discussion concludes that the ICF concepts of activity and participation are distinct concepts that are considered separately in this thesis. Following this conceptual clarification, the thesis applies the ICF framework to patients with communication disabilities in the acute hospital stroke unit. Specifically, patients with communication disabilities are described from the perspective of communication-related body functions within the ICF Body Structures and Functions component, communication activities within the ICF Activities and Participation component and communication-related environmental factors in the ICF Environmental Factors component. It is important to understand how many patients experience a communication disability in the acute hospital stroke unit so that adequate supports can be developed. Therefore an efficient way of identifying patients in acute hospital stroke units with a communication-related body function impairment such as hearing, vision, speech, language and/or cognitive communicative impairment was required. Hence, the first study describes the development of ICF compatible scales, called the OHW scales, to rate a patient’s degree of speech, language and cognitive communicative impairment. These three rating scales were called the OHW scales because they reflect the WHO framework and also represent the authors’ initials. The concurrent validity and interrater reliability of the OHW scales were then investigated. Results indicated that the OHW had acceptable levels of concurrent validity against standardised measures of speech, language and cognitive communicative impairment. The speech and cognitive communicative OHW scales also demonstrated moderately high interrater reliability, but exact agreement on the OHW language impairment scale was low. At a minimum, the OHW scales were valid measures of speech, language and cognitive communicative impairment and therefore they were used by the researcher to determine the number of patients with communication-related impairments in the acute hospital stroke unit. Patients in acute hospital stroke units may have communication-related impairments, such as speech, language or cognitive communicative impairments as a consequence of stroke. Patients may also have communication-related impairments (e.g., in hearing, vision and cognitive communicative) due to ageing and age related illnesses. Therefore, the second study of the thesis describes the number of patients with communication-related impairments in acute stroke units, regardless of the cause. Of the 69 patients screened, 88% had a mild or more severe communication-related impairment. In addition, 69% of inpatients, screened on two or more measures, had multiple communication-related impairments. Although many patients in acute stroke units have communication-related impairments, what may be particularly important is how many patients experience difficulty communicating their healthcare needs with healthcare providers in acute hospital stroke units. The ICF describes a person’s ability to carry out an activity, such as communicate healthcare needs, as an activity limitation. The ICF describes activity limitations in four different ways. Two ways are capacity with assistance and performance. Capacity with assistance indicates the person’s highest probable level of function in an activity given assistance and performance indicates a person’s level of function in the context of everyday life. Therefore, the third study of the thesis details how many patients experienced capacity with assistance limitation, that is, difficulty communicating their healthcare needs given assistance, and performance limitation, that is, difficulty communicating their healthcare needs during everyday healthcare routines. Results indicated that 51% of 65 patients had a capacity with assistance limitation and 57% had a performance limitation. Strong and significant relationships were found between patients’ degree of communication-related impairments and their degree of communication activity limitation, in both capacity with assistance and performance. Furthermore, the presence of a communication-related impairment accounted for up to 77% of the variance in a patient’s capacity with assistance limitation. Such impairments only accounted for up to 32% of the variance in a patient’s performance limitation. This finding suggests that other factors, such as environmental factors also affect a patient’s ability to communicate, particularly during everyday health care routines. In light of this, a review of the literature on the range of environmental factors that influence communication between patients with communication-related impairments and healthcare providers in the acute hospital setting was conducted. The review of the literature indicated the need for research on the environmental factors that influence communication between patients and healthcare providers in the acute hospital stroke unit. Therefore, the final study of the thesis investigates this further. This study employed a focused ethnographic methodology to identify the range of environmental factors that appeared to influence communication between patients and their healthcare providers. Seven themes were identified including the healthcare providers’ knowledge of communication-related impairments, skills, attitudes, and individual characteristics. Other themes included the presence of family, the physical environment and hospital systems and services. In summary, this series of studies indicates that the majority of patients admitted into acute hospital stroke units have a communication-related impairment and approximately half to two thirds of patients experience difficulty communicating their healthcare needs with healthcare providers. Whilst having a communication-related impairment increases the likelihood that a patient will experience difficulty communicating with healthcare providers, other factors, such as the communicative environment also appear to play an important role. Speech-language pathologists working in the acute hospital stroke unit may have an important role in identifying patients who are experiencing difficulty communicating their healthcare needs and supporting these patients and their healthcare providers to communicate in optimal ways. Further research is required to demonstrate that improving a patient’s ability to communicate with his or her healthcare providers improves a patient’s health outcomes. With this evidence, speech-language pathologists may be more able to support patients with communication disabilities to get the healthcare they deserve.

Thesis (Ph.D.)--Indiana University, 2008. / Title from screen (viewed on August 27, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Tamilyn Bakas, Joan Kessner Austin, Susan M. Perkins, Susan J. Pressler, Linda S. Williams. Includes vita. Includes bibliographical references (leaves 219-236).

<p>Stroke is a widespread disease in Sweden. Nurses play a central part for those who suffer from a stroke irrespective of where in the care chain they meet. To be able to meet the patients’ need of care the nurse must understand his/her lifeworld. Each and every patient is unique and the experience of being struck by a stroke depends on personality and life situation. Those who suffer from aphasia are usually excluded in research and therefore there is lack of improtant knowledge. The aim of this study is to describe the experiences of suffering from and living with a stroke. By studying autobiographies the opportunity has opened to share the experiences of patients suffering from aphasia. To suffer from stroke is a big changeover in life and gives visible and invisible disabilities. These disabilities limit them in their every day life. Nursing staff becomes authorities and it’s important that the staff provides time for discussions. A fruitful discussion reduces suffering and creates feelings of being noticed and involvement. The result shows that those who suffer longs and endeavours for living life as normal as possible.</p> / <p>I Sverige är stroke en av våra stora folksjukdomar. De som drabbas är en stor patientgrupp och sjuksköterskor har en central roll i deras omvårdnad oavsett vart i vårdkedjan de befinner sig. För att kunna bemöta patientens behov av omvårdnad måste sjuksköterskan sätta sig in i patientens livsvärld. Varje patient är unik och upplevelsen av att drabbas är olika beroende på personlighet och livssituation. Personer med afasi har tidigare uteslutits i studier vilket gör att det saknas forskning inom ett stort och viktigt område. Syftet med studien är att beskriva människors upplevelser av att drabbas av och leva med stroke. Genom att studera självbiografier tillkom även möjligheten att ta del av patienter med afasis upplevelser. Att drabbas av stroke är en stor omställning i livet och ger synliga och osynliga handikapp som begränsar i vardagslivet. Vårdpersonal blir auktoriteter i deras liv, och det är viktigt att de har tid för samtal med de drabbade. Ett gott samtal upplevs minska lidande och skapar känslan av att vara sedd och delaktig i vården. Resultatet visar att de drabbade längtar och strävar efter att leva livet så normalt som möjligt.</p>

<p>I Sverige insjuknar ca 30 000 personer årligen i stroke. Stroke är den vanligaste orsaken till neurologiska funktionshinder, som ofta innebär ett stort lidande för individen. I nuläget finns endast lite forskning kring de faktorer som påverkar <em>känslan av sammanhang </em>hos individer som genomlidit en stroke. Syftet med studien var att utifrån självbiografier ta reda på vad som bidrar till individens ökade känsla av sammanhang. Studien utgick från en kvalitativ ansats baserat på fyra självbiografier. Utifrån analysen uppstod fyra teman och tolv kategorier baserat på individernas viktigaste upplevelser av vad som bidrog till ökad <em>känsla av sammanhang</em>. Resultatet presenterades med hjälp av citat från självbiografierna. Det som bidrog till ökad känsla av sammanhang och som framkom i resultatet var <em>Möjlighet till stöd</em>, där stödet från närstående, vänner, sjukvårdspersonal och inte minst logoped var mycket betydelsefullt. Att <em>komma framåt, vardagslivet</em> och <em>livet efter stroke</em>, tar upp vikten av att finna mening och nya utmaningar och mål i livet. Det är viktigt för sjuksköterskan att förstå att stroke är en individuell sjukdom och att alla individer finner olika sätt till att anpassa sig till sin nya livssituation. Detta för att kunna anpassa omvårdnaden till varje enskild individ.</p> / <p> </p><p>Each year, about 30 000 people in Sweden suffer a stroke. It is the most common cause to neurological dysfunction and implicates much suffering for the individual. Few studies have been made about the factors that could conduce to the individuals’ sense of coherence. The aim of this study was to, based on autobiographies, find out which factors there are that contribute to the individuals sense of coherence. The study was based on a qualitative approach. The result was presented in four themes and twelve categories that arouse when reading the materials. Each team and category where described with the help of quotations from the autobiographies. The most important things for the individuals’ sense of coherence were; Possibility for <em>support</em>, the support from friends, relatives, healthcare stuff and speech therapist meant a lot for the individuals’ wellbeing. To <em>head forward</em>, <em>everyday life, Life after stroke</em> and finding new meaning where other factors that turned out to have a great value for the individuals. It’s important that the nurse understands the individuality of stroke and that each individual finds his or her own way to adapt the new life situation, this because the nurse has to adjust the care that is given.</p>

No description available.

Bakgrund: Stroke är en sjukdom som drabbar många människor. Strokeanfall medför inte bara bestående förändringar för den strokedrabbade utan påverkar även de närståendes situation. Det är inte ovanligt att närstående hamnar i en krissituation i det tidiga skedet av en stroke. Syftet: Syftet med studien är att beskriva upplevelsen av att vara närstående till en person med stroke. Metod: Detta är en litteraturstudie baserad på 10 vetenskapliga artiklar med kvalitativ ansats. Data insamlades genom litteratursökning i databaserna Cinahl och Pubmed. Artiklarna granskades och analyserades utifrån Fribergs (2012)  analysmodell litteraturstudier. Resultat: Resultatet visar att många närstående inte erhåller tillräckligt med information, stöd och vägledning i sjukvården. Situationen förändras för många närstående och detta påverkar olika aspekter så som närståendes sociala liv, relationer samt syn på tillvaron. Den nya situationen medför en känsla av oro, osäkerhet och ensamhet. Diskussion/slutsats: I resultatet framträder närståendes upplevelser anknutna till vårdpersonalen, den strokedrabbade samt andra närstående. Närståendes livsvärld påverkas när någon nära drabbas av stroke. Närstående vill ha mer uppmärksamhet från vårdpersonalen och framförallt delaktiggöras i patientens vård under sjukhusvistelsen. Denna litteraturstudie visar på att närståendes upplevelser kan se olika ut och att det därför är viktigt att sjuksköterskan uppmärksammar dessa som unika individer. Således bör den information samt stöd som de erhåller vara individuellt anpassat. Om närståendes behov och upplevelser bemöts på ett professionellt sätt kan sjuksköterskan bidra med att den nya situationen blir mer hanterbar för dessa. / Background: Stroke is a common disease that affects many people. Stroke causes permanent changes in the life of the stroke survivors and consequently affects the lives of next of kin. It is not uncommon for next of kin to end up in a crisis in the early stage of a stroke. Purpose: The purpose of this study is to describe next of kin’s experience of life after a close person suffered a stroke. Methods: A literature review based on 10 scientific articles with qualitative approach. Data were collected through literature search in the databases Cinahl and Pubmed. Articles were reviewed and analyzed using Friberg (2012)  analytical model. Result: The results show that most next of kin do not receive adequate support and guidance in health care. Situation changed for most next of kin and this in turn affect their social life, relationships and view toward life. This new situation leads them to feel sense of anxiety, insecurity and loneliness. Discussion/Conclusion: The results show next of kin’s experiences in relation to nursing staff, the stroke victims and other related next of kin.  Life situation and the life-world of next of kin is affected when someone close suffer a stroke. Next of kin’s wanted more attention from healthcare professionals and above all to be involved in the patient's care during hospitalization. This literature study shows that next of kin experiences can be different from person to person and it is therefore important that the nurse recognizes them as unique individuals. Thus, the information and support they receive should be individually adapted. If the next of kin’s needs and experiences are encountered in a professional manner, the nurse can assist in making the new situation more manageable for them.

Bakgrund: Årligen drabbascirka 12 000 personer av afasi i Sverige, 35% av dessa är under 65 år. Vid afasi har det uppkommit skador i de områden i hjärnan som styr språkfunktionerna, vilket ger upphov till tal- läs och skrivsvårigheter. Detta skapar svårigheter i livet för den drabbade och resulterar ofta i frustration.   Syfte: Syftet med denna studie var att beskriva upplevelsen av att leva med afasi till följd av stroke.  Metod: En litteraturöversikt kvalitativ ansats baserad på 13 vetenskapliga artiklar.  Resultat: Resultatet av litteraturöversikten är att den subkjektiva upplevelsen av att leva med afasi delades in i tre teman; psykosociala, psykologiska och sociala förändringar. Studien visade att personer drabbats av afasi inte längre förmår att göra det de tidigare gjort. Föt att kunna känna välbefinnande och få en god livskvalitet uttrycktes vikten av goda relationer och delaktighet.  Slutsats: Slutsatsen av litteraturöversikten är att det behövs förståelse och kunskap om hur sjukdomen upplevs för den enskilda personen. Detta för att kunna lindra lidandet som afasin oftast orsakar. För att personer med afasi ska känna sig bekräftade är det viktigt att ta sig tid att aktivt lyssna på ett empatiskt och respektfullt sätt för att främja kommunikationen. / Background: According to the aphasia association , approximately 12,000 people suffer from aphasia in Sweden, 35% of whom are under 65 years of age. In the case of aphasia there have been injuries in the areas of the brain that control language functions, which results in speech and writting difficulties. This creates difficulties in the life victim and often results in frustration.  Purpose: The purpose of this study was to describe the experience of living with aphasia due to stroke. Method: A litterature review with qualitative approach based on 13 scientific articles.  Results: The subjective experience of living with aphasia was divided into three themes; psychosocial, mental and social changes. The study showed that people who suffered from aphasia no longer have the ability to do what they previously did. In order to be able to be able to feel well-being and to have good quality of life, the importance of good relationships and participation was expressed.  Conclusion: There is a need for understanding and knowledge of how the disease is experienced for the individual. This in order to relieve the suffering that aphasia usually causes. In order for people to feel confirmed, it is important to take the time to actively listen in an empathetic and respectful way to promote communication.