Nursing progress has been significant for making healthcare better and improving the overall healthcare system. In the future, my goal as a healthcare expert is to focus on improving my knowledge and positively impacting stroke management. A stroke is a significant health issue that can cause severe problems and even death. Managing stroke effectively includes different aspects. These include right-away medical care, ongoing support, mental healing, teaching patients, and recognizing how external factors like the COVID-19 pandemic affect stroke treatment. The goal is to improve patients, lessen the sickness’s impact, and improve the lives of people who have had a stroke. This essay explains how strokes are taken care of. Creating a PICOT question and thoroughly examining related studies in the field is essential. The four research databases used are PubMed, Cochrane Library, Science Direct and Medline.
Development of a PICOT Question
In order to effectively deal with the clinical problem of stroke treatment, it is essential to create a carefully planned PICOT (Population, Intervention, Comparison, Outcome, Time) question. The PICOT question helps us find the most critical and easy-to-find evidence to guide and influence clinical practice (Melnyk et al., 2009). I have created the following PICOT question for this review: ” “In adults with a history of stroke (P), how does the provision of information (I) compared to standard care (C) affect stroke management and patient outcomes (O) over one year (T)?”
This question, called PICOT, looks at how giving stroke survivors and their caregiver’s information about stroke management affects their recovery and overall health. To get relevant evidence, the question focuses on adults who have had a stroke. The thing we are focusing on is giving out information. It might consist of teaching, talking, or tools designed to improve how strokes are treated.
The standard care group serves as the comparison in this PICOT question. It shows how stroke survivors are usually treated or taken care of. The question wants to see if giving extra information helps improve stroke treatment and patient results by comparing it to regular care. I am interested in how strokes are managed and how patients recover. These factors include getting better, how good life is, following medication and lifestyle changes—preventing strokes from happening again and ensuring that patients are happy with their overall experience. By looking at these results for a whole year, we can thoroughly evaluate how giving information affects stroke treatment in the long run.
Overview of Stroke Management
Managing stroke is a complex condition that needs different experts to work together. The main goal of immediate medical care is to help blood flow return to the part of the brain that’s been affected (Prasad et al., 2011). This is done through treatments like drugs to dissolve clots and procedures that work from inside the blood vessels. Long-term care includes treatments to help improve how well you can do things. To help with thinking problems and teach patients how to take care of themselves and avoid having more strokes, cognitive rehabilitation is used for cognitive impairments, and patient education is used. Understanding how things like the COVID-19 pandemic affect stroke care is essential. To improve and make stroke management strategies better suited.
Providing information to stroke survivors and their caregivers is extremely important in managing strokes. It helps patients gain power. Help them understand the condition better and encourage them to participate in their care actively. Providing information has the power to affect significantly stroke management in many ways when compared to standard care. Firstly, giving stroke survivors and their caregivers information can help them understand the condition better, including its risk factors and why it is important to follow treatment plans (Prasad et al., 2011). Patients gain the power to make well-informed choices about their health through this knowledge. They can also use strategies to manage themselves and actively take part in getting better. Patients can lower their chances of having more strokes by understanding the importance of taking their medication, making lifestyle changes, and going to follow-up appointments. They can also effectively handle their condition.
Also, providing information can help stroke survivors better identify the signs and symptoms of a stroke. Recognizing a stroke quickly and taking immediate action is crucial in managing it. Acting early can help reduce brain damage and improve the results. By teaching patients and their caregivers about the signs of a stroke, like sudden weakness or numbness in the face, arm, or leg, trouble speaking or understanding speech, and a bad headache, they can promptly get medical help. This may make strokes less severe and increase the chances of getting better.
Moreover, giving details about the resources and support services that are accessible can assist individuals who have experienced a stroke and their caregivers in better understanding and utilizing the healthcare system. This sentence contains details about services for getting better, groups offering help, and community resources that can aid in the healing process. Stroke survivors can experience improved care and support by accessing these resources. This can result in improved results and a better quality of life.
Furthermore, sharing information can help to tackle common misunderstandings and worries linked to strokes. After having a stroke, many people might feel anxious, sad, or like they have lost something because their body and thinking abilities might change. Healthcare professionals can ease these emotional burdens by giving correct information and addressing their worries. Stroke survivors can also receive support for their mental health.
Review of Studies
Organized Inpatient (Stroke Unit) Care for Stroke: Network Meta-Analysis:
The study reviewed and analyzed how well-organized inpatient stroke unit care works compared to other services. It also looked into how different types of stroke care units in hospitals are organized. A total of 29 different clinical studies were reviewed, each chosen randomly and controlled. In these trials, 5,902 people who had a stroke and needed to stay in the hospital were involved (Langhorne & Ramachandra, 2020).
This study is considered Level 1 evidence regarding the level of proof. This evidence is at the top level. This happened because it included a careful study and comparison of different experiments that were randomly assigned. Level 1 evidence consists of reviews analyzing many randomized and individually randomized trials. These are known to offer the most trustworthy and robust proof.
This study is intense because it takes a thorough approach. It examined many trials and had lots of people involved. By looking at 29 tests involving a total of 5,902 people. The study gives a big picture of the current proof of organized stroke unit care for patients staying in the hospital. Moreover, network meta-analysis made it possible to compare various treatments within a single analysis. This gave us a better understanding of all the evidence.
The study showed that their outcomes improve when stroke patients receive care in organized inpatient stroke units. Regardless of factors such as age, sex, initial stroke severity, or stroke type, we noticed this improvement. The results indicate that having a well-structured stroke unit during a hospital stay helps improve how patients recover. It works well for many different stroke patients.
Rehabilitation Interventions for Improving Balance Following Stroke: An Overview of Systematic Reviews:
The study looked at different reviews examining ways to improve stroke survivors’ balance through rehabilitation interventions. The summary contained Cochrane Systematic Reviews and reviews that were not from Cochrane. These included clinical trials that were randomly controlled and clinical trials that were not randomized. The studies reviewed included adults who had a stroke as participants. In all the studies, there were 10,638 participants, which is a large enough group for analysis (Arienti et al., 2019).
This study is considered Level 1 evidence regarding the level of proof. This evidence is the most substantial level available. This is because it included a summary of organized evaluations, which consisted of randomized-controlled clinical tests. Level 1 evidence includes reviews of studies randomly assigning participants and individual studies doing the same. These are the most dependable and robust proof.
This study is vital because it looked at 51 systematic reviews in a comprehensive way. These reviews included 248 primary studies (Arienti et al., 2019). This thorough analysis examines the current proof of rehabilitation treatments for helping stroke survivors improve their balance. However, the research also discovered a restriction. More than half of the systematic reviews were found to have a “low or critically low” methodological quality. This limitation makes it difficult to reach clear conclusions based on the available evidence. This shows that systematic reviews in this area must improve their methods.
Barriers and Facilitators to the Adoption of Evidence-based Interventions for Adults within Occupational and Physical Therapy Practice Settings: A Systematic Review:
The study analyzed different reviews that looked at rehabilitation methods for helping adults who had a stroke improve their balance. The overview contained Cochrane Systematic Reviews and reviews that were not from Cochrane. Different clinical trials were included, such as randomized-controlled and non-randomized trials.
All the people who participated in the studies were grown-ups with a stroke. A total of 10,638 participants participated in all the studies (Kinney et al., 2023). This large and varied number of people is great for analyzing. This study is considered Level 1 evidence regarding how much evidence there is. The highest level of evidence. This is because it included a summary of organized evaluations with randomized-controlled clinical experiments. Level 1 evidence includes organized reviews of randomized trials and individual randomized trials. They are seen as giving the most dependable and robust proof.
This study is intense because it used a thorough method and looked at 51 systematic reviews. The reviews examined 248 central studies and involved a big group of people, up to 10,638 participants (Kinney et al., 2023). This thorough examination looks at the current proof of treatments that help stroke survivors improve their balance. However, the study also found a restriction. The authors mentioned that more than half of the systematic reviews were considered to have “low or critically low” quality in terms of methodology. This limitation makes it difficult to reach clear conclusions based on the existing evidence. High-quality systematic reviews accounted for only 22% of the total. This shows that systematic reviews in this specific field should have improved methods.
Real-time Visual Analytics for In-home Medical Rehabilitation of Stroke Patients: Systematic Review:
The study involved carefully examining all the existing literature wholly and thoroughly. The main goal was to find essential studies that followed a specific plan and could help with the research topic. We analyzed a total of 69 studies, which shows how much evidence we looked at.
This study stands out because the research studies it found are in-depth and trustworthy. Most of the studies included in the review were classified as Level 1 evidence, which shows a robust methodological approach and a high level of scientific validity (Boumrah et al., 2022). This evidence is seen as the most trustworthy and robust, giving a solid base for making conclusions. This study is intense because it used a systematic review approach. The study followed a clearly explained way of choosing participants, which helped keep the process fair and easy to understand. The study’s findings become more trustworthy and more robust with this organized method. It reduces prejudice and guarantees that all vital research is considered.
Conclusion
Improvements in how strokes are taken care of are essential for making patients get better results and have a better life after a stroke. This thorough examination emphasized how crucial it is to have well-structured stroke units for patients who stay in the hospital. We should improve the way we do rehabilitation, find out what stops us from using proven methods, and explore how real-time visual tools can help stroke patients improve by keeping ourselves updated on the newest information and progress in treating strokes. Healthcare experts can help improve patient care and results in this critical field.
References
Arienti, C., Lazzarini, S. G., Pollock, A., & Negrini, S. (2019). Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews. PloS one, 14(7), e0219781. https://doi.org/10.1371/journal.pone.0219781
Boumrah, M., Garbaya, S. & Radgui, A. Real-time visual analytics for in-home medical rehabilitation of stroke patient—systematic review. Med Biol Eng Comput 60, 889–906 (2022). https://doi.org/10.1007/s11517-021-02493-w
Kinney, A. R., Stearns-Yoder, K. A., Hoffberg, A. S., Middleton, A., Weaver, J. A., Roseen, E. J., Juckett, L. A., & Brenner, L. A. (2023). Barriers and Facilitators to Adopting Evidence-based Interventions for Adults within Occupational and Physical Therapy Practice Settings: A Systematic Review. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2023.03.005
Langhorne, P., & Ramachandra, S. (2020). Organized inpatient (stroke unit) care for stroke: a network meta-analysis. The Cochrane Library. https://doi.org/10.1002/14651858.cd000197.pub4
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58. Retrieved from https://journals.lww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice__Step_by_Step__Igni ting_a.28.aspx
Prasad, K., Kaul, S., Padma, M. V., Gorthi, S. P., Khurana, D., & Bakshi, A. (2011). Stroke management. Annals of Indian Academy of Neurology, 14(Suppl 1), S82–S96. https://doi.org/10.4103/0972-2327.83084
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