Effect of Nursing Care Strategy on Functional Outcomes among Patients after First Time Stroke

Abstract

Context: Strokes are life-changing events that not merely affect a person physically but also emotionally as it may result in physical disabilities, which lead to functional disabilities as difficulties carrying out daily activities as working, walking, talking, eating, bathing, with loss of energy in addition to depressive status as a result of functional disabilities. Daily nursing care strategies are essential to stroke management since they can overcome spasticity and hemiplegia through sustained stretching by various positioning, the repetitive performance of a specific movement, and teaching the patient to use and adapt the affected limb during functional activities.

Aim: This study aims to evaluate the effect of nursing care strategy on functional outcomes among patients after a first-time stroke. Methods: A quasi-experimental design was used to conduct the current study in the neurology department to be followed through the neurology outpatient clinic at Benha University Hospital. During the period from the beginning of February 2018 till the beginning of January 2019.Subjects: Purposive sample of 171 patients to be at the end of the study period (Intervention group 72 & control group 69), recruited according to the study formula based on the total number admitted to the study settings during 2017. Tools: Two tools utilized for data collection, (1)Structured interviewing questionnaire for patients, (II)Functional outcomes scales, involving: Modified Ashworth scale, Modified Barthel index, as well as the Center for Epidemiologic Studies Depression Scale (CES-D Scale).

Results: Showed that there was a highly statistically significant difference in terms of increased knowledge score among the intervention group compared to controls, as well as a higher level of independence in performing the activity of daily living (ADL), besides, lower depression score among the intervention group compared to controls. It also showed a significant correlation between spasticity with both independence in performing ADL and degree of depression among intervention groups after nursing care strategy implementation.

Conclusion: The nursing care strategy effectively improved patients' knowledge and the functional outcomes among intervention groups, revealing a significant correlation between the degree of spasticity with both independence in performing ADL and degree of depression. The study suggested continuous education and training program planned and offered regularly to stroke patients in the neurology and rehabilitation unit. Also recommended written, a simple booklet about stroke and its management should be provided & be available for patients and their families (relatives).