The little consideration has been given to another

The
brain is the most complex organ in the body. Stroke is caused by no oxygen to
the brain, without no blood flow to the brain it causes the cell to die. When the
stroke happens on the right side of the brain, the left side of the body gets
the impact. The patient will have issues with speech and languages, loss of
motion on the left side; their behavior might alter.  Majority of patients who suffers Ischemic
stroke symptoms such as suddenly confusion, the trouble of speaking, blurred
vision or dizziness. Ischemic stroke can last from 2-15 minutes.

Depression
after stroke is a genuine neuropsychiatric confusion with a high rate of
predominance following a stroke. The side effects of gloom after stroke are
like those of endogenous dejection; discouragement after stroke is portrayed by the fast improvement and
beginning of manifestations, a nonattendance of response to external components and restraint that can
influence a few territories (Sugawara et al.,2015).

Emotional
changes following a stroke are once in a while tended to at the intense,
restoration or outpatient phases of intercession. To be sure, they regularly
stay undiscovered and therefore untreated, unless they are seen by medicinal
staff as sufficiently serious to warrant the mental audit. The care of
individuals with extreme enthusiastic issues is then overseen by specialists
and, where analyze are made, pharmacological and psychotherapeutic medicines
have been accounted for (George, Wilcock & Stanley 2001).

These
uplifted horribleness and mortality dangers, in conjunction with the general
increment in restorative usage recorded for geriatric depressive patients
without stroke, recommend that patients with Post Stroke Depression may
likewise be in danger for higher therapeutic services use after stroke than
those without post-stroke depression. Furthermore, although sorrow is
the most well-known emotional well-being condition after stroke, little
consideration has been given to another post-stroke
emotional well-being disorder. One reason for this is the high comorbidity of
other emotional wellness determined to have anxiety
( Ghose, Williams & Swindle 2005).

Confidence
has been recommended to be a possibly essential variable in the enthusiastic
change and practical result of beginning period survivors of stroke. Past work
has suggested that stroke negatively affects the survivor’s confidence and
lower confidence evaluations have been related to more prominent levels of
revealed depressive and uneasiness side effects self-consciousSC1  (Vickery et al.,2009)

Depression
in stroke patients, when contrasted and the individuals who are not
discouraged, have brought down survival rates; demonstrate less inspiration to
experience restoration; have more extensive healing facility stays and poorer
useful recuperation; and neglect to take part in recreational furthermore,
social interests. As the dominant part of recovery is accomplished at a
beginning period and as discouragement can weaken this recuperation, it is
proverbial that early finding and treatment of sorrow is imperative (Watkins et
al., 2007).

 

 

 

 

 

Method

Design

 Before the study conducts the patient magnetic resonance brain imaging (MRI) will illustration
where the stroke appears in the patient brain.
Physical strength will be measured by
Time Up and Go Time (TUG). The damage left from the stroke might cause
the patient to suffer from an emotional problem
such as anxiety.  The Hospital Anxiety
and Depression Scale will be used to for
the 150 stroke patients that are inpatient
to complete seven questions asking them
about their anxiety levels. Also, 150
outpatient post-stroke will complete nine
questions of their anxiety levels. The Patient Health Questionnaire depression scale
(PHQ-9) will be used. The total of
the duration of the study will be
approximately one year, from December 2017 until December 2018.

Participant

A total of 300 stroke patients who suffers from ischemic were conducted from the study.  Stroke survivors will be a divided into
two groups. There will be a study that will be
conducted for inpatient and outpatient. 150 inpatient post-stroke
anxiety who are compared to 150
outpatient post-stroke anxiety.  In inpatient, there will be 85 male and 65
females, and outpatient there will be 95 male and 55 females. The age range of the stroke patients is 23- 45 years old. A cross-section questionnaire and interview survey will be conducted by inpatient and outpatient stroke
survivors.

Hypothesis

                The outpatient post-stroke patient will suffer
more anxiety than inpatient post-stroke since they are in the rehab they are
getting 24 hours care their mind is occupied
with getting better, the therapist and
doctors are keeping them busy.

 

Description

Post-stroke anxiety influences roughly two-thirds of ischemic stroke survivors, anxiety
frequently undiagnosed and insufficiently treated, and
is related to increased condition
and fatality after stroke. Anxiety screening after stroke is critical also it can be challenged by lack of cognitive and physical.

A stroke patient that comes through
the emergency room the doctor will check to see what type of stroke the patient
is having. CT scan is a very crucial test
for the patient. The CT scan detects what
kind of stroke the patient has. The moment the doctor bust the blood clot in
the patient brain, the patient should start therapy immediately. The patient
only stays in the hospital for four days, if the patient remains longer than four days that’s mean they
have other medical complication.  They
will transfer the patient to inpatient rehabilitation.

In inpatient rehabilitation, the patient will stay there for
a month to get a thread for physical therapy, occupation therapy, and speech therapy. Therapy beings in the acute
care after the overall patient condition
has been stabilized. The first thing they
should do is promote independent movement because the patient might be
paralyzed or have serious weakness. While
the patient is in inpatient rehabilitation,
the therapist will measure the patient progress of balance, sit to stand and to walk. While the patient is in rehabilitation it will help the stroke patient with relearning
new skill of what they lost.

Doctors primary responsibility is
to care for the general patient health
and provide guidance. Sometimes doctors
overlook the patient psychological wellbeing. The doctors are only worrying about the patient physical wellbeing they are neglecting the mental apart. If
the patient is feeling frustrated and angry that stroke survivor will not be
able to improve their physical well-being.

While
the stroke patient is laying in the hospital bed feeling frustrated and angry,
thinking what is next for them. Now they are getting comprehended what
happened to them. The stroke survivors
are thinking when I am going back to work. If the patient cannot go back to their
old job, what are they going to do for money?
How they are going to support their
family. They don’t want to be a burned to
anyone. The patient starts getting
anxiety attack by thinking about their new life. The stroke survivor stops
progressing in therapy and stops eating.
The therapist will the gave the patient the hospital anxiety depression scale it
depends on the result the might prescribe medication.

The stroke survivor is out of
inpatient rehabilitation; now the patient
is home. They are going to outpatient rehab three days a week. When they are in
therapy, their mind is focused on getting better.  When they are at home, they will be worrying
about their health and how they are going
to resume their lives. The patient is in the house grief about their physical
and mental health, and playing the blaming
game. The patient will start crying they don’t want to eat they just want to
lay in bed not doing anything. In their mind,
they think they will never be normal.

Now the patient has been home for three months, no more therapy the patient
discharges from outpatient treatment for the last two months. Now he or
she is in denial. They are in the house
all day, the only time the patient goes
outside is when they are going to doctor’s appointment. In their mind they
cannot see any progress they have made because the stroke survivors speech
still has the slurred, they can’t feel
the sensation in their left hand and they
not able to walk without a walker. The stroke patients get angry because he or
she have lost their independent, they must
depend on someone to help them do the
basic of essential such as getting dress and beating. The patient will be
trying to speak but not able to put the word
together. The patient start getting frustrated and the middle of nowhere they
start crying.

Five
months pass the patients only gain 50 percent muscle strength on their life
side. The stroke survivor is happy to see that they regain some muscle strength. The stroke patient starts feeling sad because they are seen people
going back to their normal activities, they are not able to recover to their normal activities again. The
stroke patient used to like doing home exercise to rebuild their muscle
strength back. As time goes by, they lost interest in the home
exercise.  The patient used to enjoy
playing with their children; suddenly
they stop playing with the kids.  Now the
only thing they want to do is sit by the
window and stare at the window. The patient energy starts decreasing and they having a
difficult time going to sleep. The
patient is stressing about finances, how they
are going to pay for the medical bill and how they going to support their family because they are not able to go
back to work yet. Even though the car is in the drive
way, they are not able to drive
it. Every major move they made they need
someone assistance. The patient seen all this limitation they must go through,
they feel worthless.   

Nine months after the post-stroke the patient wants to resume work.
Before the patient needs to go back to
work they need to be aware of their limitation, the work they used to do, they
might not be able to complete the task. When the patient resumes back to work, it was not comfortable getting around the company.  The patient will try to type a simple
sentence in the computer their left arm gets tired quickly, the patient often becomes
exhausted when they are doing a simple task.
 While the patient is back at work, the
patient will have issue communicate with their coworker. Vice versa the patient
is having difficulty understanding what the coworkers are saying to them.

Now the patient had to resign from their job position because they are not
able to accomplish their duties. Now
anxiety step in, the patient feels like a failure. They are asking themselves
question why are they still alive they should have died. The patient does not want to be bothering to do anything.
They withdraw from the things they like
to do. The patient will start getting
jitteriness and loss of appetite. The patient
is losing weight too fast in a short period. When the patient sees others are going
to work, the patient will start throwing up. The patient is not sleeping so
there is dark stress under patient eyes.
The patient is fear that they might never work again. The patient is worrying about
they can get another stroke again. The
men are afraid to have sex they might get a stroke during sex. 

  Patient
family sees how the patient withdraws themselves from activities and all
they do is stare at the window. The family can set up and find a support group. Stroke support group will help
the patient to see they are not alone their others in the same position as
them. They will hear other people stories. 
From their stories, they will find
strength, and they will be able to make
friends. They have a haven to go to.

Two months
later the patient is feeling better; the patient has a better understanding of their condition. The patient
is volunteering at the center where they attend a support group. The patient is working part-time job three days a week. Now the patient is feeling better; the
patient stops watch their diet, stop exercising and stop taking the medication.  The patient will skip doctor’s appointment
and sometimes they might even go. Three weeks later the patient had another
stroke on the right side of the brain.
This time is going to take them longer to recover.

Result

Total of 300 patients were enroll in the study, 150 are outpatients
and 150 are inpatient. The age range of the stroke patients is 23 to 45 the
majority of the patient are males.
Females who are married (60%) male who
are married (40%), stroke patient who live alone (20%) and patient that lives
in the urban areas (55%). Seventy percent of the stroke patients will have the highest
level of education, twenty percent of stroke patients have a high school education. Ten percent of the stroke patients have no education.
Forty-five percent of the stroke patient
had a current job, and the rest of the stroke
patient had no job.

Analysis results will primary be
base on the sign of the stroke symptom with only 75 patients have CT scan done.
85% of the CT scans will confirm ischemic stroke, while 1% will show sign of hemorrhagic
stroke.  

Inpatient

Thirty-five percent of the stroke
patient will be able to recognize their anxiety of the stroke, by responding
yes or no to the question. Seven-five strove survivor will perceive their anxiety as being serious. Forty percent will mention lack of energy, withdraw from loved one and fear. Other factors will mention by the patient how long is the recovery
are will they be able to go back to normal
life. Twelve percent of the stroke patient mention
other alternative medicine and faith.  

Outpatient

                Sixty
percent of the stroke patients will be able to recognize their anxiety of the
stroke patients by responding yes or no to the question. Twenty percent will perceive
their anxiety as being serious. Fifty percent will mention the loss of interest, lack of energy, low self-esteem,
sadness, lack of concentration and weight loss. Other factors will mention by the patient when are they going back
to work. The patient will ask will they
be able to drive again, and will they be able to speak clearly? Forty percent of the stroke survivor mention other alternative
treatment such as therapy and faith healing and other.

 

 

 SC1

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