I. Most important goal for the patient – The patient will have increased mobility. Stroke patients often have impaired physical mobility. This is related to activity limitations which are associated with a decrease in motor functions and a decrease in spatial-perceptual impairment…
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230). Impaired mobility is related to a variety of factors, including activity intolerance, perceptual or cognitive impairment, musculoskeletal impairment, neuromuscular impairment, medical restrictions, prolonged bed rest, limited strength, pain or discomfort and depression or severe anxiety (Gulanick & Meyers 2003, p. 107). When the patient has impaired mobility, there is also risks which are associated with a lack of physical exercise – circulatory and respiratory problems and poor physical condition (Sparks & Taylor, 2005, p. 29). II. Why the patient needs to be at the centre - Stroke is a medical issue which is multifaceted. Cowman et al. (2010, p. 1) states that 50% of stroke victims will make a full recovery, 30% will make an incomplete recovery with no need for assistance with any functions, and 20% will make an incomplete recovery with a need for assistance with some functions. Horgan et al. (2011, p. 4) states that, despite the statistics which show that a good percentage of stroke patients have some disability upon being discharged from the hospital, follow up care is often lacking. According to Miller et al. (2010, p. 2403), care for a stroke patient should consider three factors: pathophysiological factors, the impact on the individual, and the individual's environmental and personal resources. Hartigan et al. (2011, p. ...
2011 p. 23). Moreover, there is ample indication that strokes do not just affect the patient, but the caregivers as well. Lutz & Young (2010, p. 152) state that caregivers of stroke patients suffer depression, isolation, a sense of being burdened, a decline in physical and mental health and decreased quality of life. However, Khan et al. (2012, p. 1) indicates that caregivers may not always be given the proper support. It is therefore crucial that the patient participate in his or her own recovery, in that it will alleviate the burden on the caregiver as well as give the patient a better outcome. That said, it is important that the perceived nursing behavior be conducive to this. The patient's perception of the nurse's behavior influences how active the patient will be in participating in his or her own recovery process (Larsson et al. 2011, p. 1). All of these factors must be considered in planning a nursing care program for a stroke survivor, because one of the goals must be to prevent readmission to the hospital, because hospital readmission results in higher mortality rates, greater disability levels and increased costs (Licthman et al. 2010, p. 2526). Therefore, it is important that Mr. Brown and his caregiver, his wife, be at the centre. Both need to understand what will be involved in Mr. Brown's recovery, and both need to understand the steps that will be needed to take. Because of the evidence that the burden on the caregiver is acute, and that the stroke patients' hope for recovery hinges partially upon social and environmental needs, and, additionally, the evidence suggests that patients must participate in their own care, the most important goal is to increase the mobility of the patient. This will ultimately not only be beneficial to the patient,
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