The Process of Stroke Rehabilitation - Essay Example

? Importance of Effective Goal-Setting in Stroke Rehabilitation School Importance of Effective Goal-Setting in Stroke Rehabilitation Stroke is a neurological dysfunction that occurs suddenly. “Approximately 50 to 60 percent of stroke survivors are moderately or minimally impaired, and these individuals may greatly benefit from rehabilitation” (Natarjan et al., 2008, p. 841). Effects of the stroke vary depending upon the part of the body that is affected. Survivors of the stroke face numerous psychological challenges during the process of adjustment. In order to make the process of rehabilitation effective, it is imperative that a structured programme is made considering the individualistic goals of the survivor so as to empower them. “Effective rehabilitation interventions initiated early after stroke can enhance the recovery process and minimize functional disability” (Duncan et al., 2005, p. 100). This paper discusses the importance of effective goal-setting and the role of education and support in stroke rehabilitation. Goal setting aids stroke rehabilitation by providing the patients as well as the carers with a direction to proceed, educating them, and keeping them engaged so that they make a concerted effort to improve the patient’s lifestyle and reduce the risk of strokes in the future. Goal planning or goal setting is a fundamental element that aids rehabilitation (Wade, 2009). Planning of goal in the neurological rehabilitation has been found to help in the planning of treatment, supervision of the patients’ progress, and education of the patients as well as their families (Young, Manmathan, and Ward, 2008). Goals in the stroke rehabilitation process serve as milestones that not only provide the patients with a direction in which to proceed, but also keep the patients making a coherent effort to stick to the new lifestyle. After a stroke, it becomes imperative to establish both immediate and long-term goals that help one recover and avoid similar attacks in the future. “Patients of stroke with initial similar clinical deficits can improve dramatically or worsen during the first 48 to 72 hrs” (Ahmed, Zuberi, and Afsar, 2004, p. 267). In the long run, this may necessitate a major change in the whole lifestyle that is indeed, difficult to accomplish as it requires a lot of determination and commitment from the individual. Establishment of personal goals is just a preliminary step; one needs to work towards the achievement of these goals on daily basis. Nurses assume a very important role in the education and support of the survivors of stroke. Nurses help the survivors conduct the basic daily-life activities and educate them on the routinely healthcare matters that include but are not limited to skin care, diet plan follow-up, movement from and to the bed, and medication schedule. Nurses also help the survivors of stroke with management of personal care issues including controlling incontinence and taking a bath. A vast majority of the patients reacquire their capacity to maintain continence through the education and support they receive during the process of rehabilitation. The education is based on strategies meant to strengthen the pelvic muscles with a time-voiding schedule and special activities. “Particular problems include achieving consistency of intervention by different staff to different patients on different days, and documentation of the intervention in a manner that would allow reproduction of the treatments evaluated” (Langhorne et al., 2002, p. 18). Patient education and support are two of the most fundamental essentials of the process of stroke rehabilitation. In order to make the patients intrinsically feel motivated to adopt a risk-free lifestyle, it is imperative that the knowledge of risk-free lifestyle and the potential ways in which it contributes to the recovery process is inculcated in the patients. Since the recovery fundamentally depends upon the level of effort made by the patient, and since effort of the patients is driven by their knowledge about the benefits of making it, education of patients serves as the foundational element in the recovery process. Education of the patients is also important because it enables them to engage in decision making during the goal-setting process, which in turn increases their involvement and participation in the rehabilitation process (Holliday et al., 2007, p. 576). It is important to educate not only the patients but also their family members and/or carers because of their immense tendency to influence the patients. One way to make sure that the patients follows appropriate schedule of medication and exercises is to hospitalize them, but this may be problematic for all parties involved i.e. the patient, family members, and the hospital staff. Patients get very sensitive after they survive a stroke and may react to the behaviors and attitudes of the family members, so feedback received by the patient from the family members needs to be positive to the maximum extent. “Because stroke is an unexpected traumatic event that suddenly forces family members into a caregiving role, caregivers often experience an overwhelming sense of burden, depression, and isolation; a decline in physical and mental health; and reduced quality of life” (Lutz and Young, 2010, p. 152). Carers and/or the family members spend a lot of time with the patient so their education is no less important than that of the patients’. Carers and family members serve as constant reinforcers of the positive changes in the patients’ behavior. Carers provide the survivors of stroke with immense psychological and physical support (Low et al, 1999), which is why, stroke is often referred to as a “family disease” (Visser-Meilly et al., 2006, p1557). Social support for the survivors of stroke yields positive outcomes on their health and rehabilitation (Sit et al., 2004, p. 817). Concluding, establishment of goal is the first and the most fundamental step of the stroke rehabilitation process as it provides the patients and the carers with a direction along which, the achievement of milestones ultimately leads them to successful rehabilitation. To enable the patients and the carers to establish realistic goals and accomplish them, it is imperative that they are educated on various aspects of rehabilitation including the type of diet suitable for the patients, their medication schedule, exercises, and the whole life-style in general. Education of both patients and carers is important since the latter serve as emotional guides and psychological and physical support for the patients during the stroke rehabilitation process. References: Ahmed, R., Zuberi, B. F., and Afsar, S. (2004). Stroke scale score and early prediction of outcome after stroke. Journal of the College of Physicians and Surgeons Pakistan. 14(5): 267-269. Duncan, P. W., Zorowitz, R., Bates, B., Choi, J. Y., Glasberg, J. J., Graham, G. D., Katz, R. C., Lamberty, K., and Reker, D. (2005). Management of Adult Stroke Rehabilitation Care: A Clinical Practice Guideline. Stroke: Journal of the American Heart Association. 36: 100- 143. Holliday, R. C., Cano, S., Freeman, J. A., and Playford, E. D. (2007). Should patients participate in clinical decision making? An optimised balance block design controlled study of goal setting in a rehabilitation unit. J Neurol Neurosurg Psychiatry. 78: 576-580. Langhorne, P., Legg, L., Pollock, A., and Sellars, C. (2002). Evidence-based stroke rehabilitation. Age and Ageing. 17-20. Lutz, B. J., and Young, M. E. (2010). Rethinking Intervention Strategies in Stroke Family Caregiving. Rehabilitation Nursing. 35(4): 152-160. Natarjan, P., Oelschlager, A., Agah, A., Pohl, P. S., Ahmad, S. O., and Liu, W. (2008). Current clinical practices in stroke rehabilitation: Regional pilot survey. Journal of Rehabilitation Research & Development. 45(6): 841-850. Sit, J. W. H., Wong, T. K. S., Clinton, M., Li, L. S. W., and Fong, Y. M. (2004). Stroke care in the home: the impact of social support on the general health of family caregivers. Journal of Clinical Nursing. 13: 816–824 Visser-Meily A., Post, M., Gorter, J. W., Berlekom, S. B. V., Van Den Bos, T., and Lindeman, E. (2006). Rehabilitation of stroke patients needs a family-centred approach. Disability and Rehabilitation, 28: 1557-1561. Wade, D. T. (2009). Goal setting in rehabilitation: an overview of what, why and how. Clinical Rehabilitation, 23: 291-295. Young, C., Manmathan, G., and Ward, J. (2008). Perceptions of goal setting in a neurological rehabilitation unit: a qualitative study of patients, carers and staff. Journal of Rehabilitation Medicine, 40: 190-194. Read More