Sep 24, 2019 in Informative

Introduction/Personal Reflection

A cerebrovascular accident is a cardiovascular disease also known as a stroke. The disease affects blood vessels that supply the brain with blood. It occurs when nutrients and oxygen contained in the blood are blocked from reaching the brain. Blood clotting often clogs a vessel, and it can lead to a burst with time. When a burst happens, the brain is deprived of oxygen and blood it requires to function or run normally. As a result, tissues and cells in the brain die, causing an irreversible damage.

 

There exist two types of stroke, namely ischemic and hemorrhagic. The first one is caused by an obstruction, typically blood clotting in the brain’s blood vessels. On the other hand, hemorrhagic stroke results from weakened blood vessels that burst and bleed into the surrounding brain. An effect of a stroke varies in different cases depending on the location of the obstruction. If the latter occurs on the left side, effects can be memory loss, weakness or paralysis of the right side of the body and slow body processes. If it occurs on the right side of the brain, effects can be vision problems, judgment difficulties, memory loss, quick and inquisitive body processes, and weakness or paralysis of the left side of the body. The symptoms above help in identifying the hemisphere obstructed.

 

A cerebrovascular accident can have a major impact on one’s life. Due to its prevention problems, there is the need for people to appreciate the seriousness of the disease. The public need to be more vibrant in terms of behavioral changes needed to eliminate stroke risk factors. On the other hand, health professionals need to ensure the public is fully aware of the symptoms and actions to take before rushing to hospitals. People should be informed of the prevention, rehabilitation and adaptation aspects of CVA. This paper seeks to focus on the reactions and reflections of CVA on families and individuals with the disease, personal and professional response to CVA, effects of CVA, level of prevention and nursing practices and strategies developed by caregivers to manage the challenge and meet the needs of individuals with the chronic illness.

 

The Reaction and Reflection of CVA as a Chronic Illness

My Husband, My Hero... Frank & Elia’s Life after Stroke

Having this chronic illness is among the most distressing experience that can happen to anyone. People who have experienced a stroke are in a state of uncertainty about their degree of recovery and possible reoccurrence. The uncertainty creates anxiety and indeed makes individuals reconstruct their lives. From the story of Frank and Elisa, it is very evident that stroke cases change the life of the victims and their family greatly.

 

The Frank’s story provided information that before suffering from ‘vertebral artery dissection (VAD),’ he had been training for the strongest man competition. After the incidence, it was even hard for him to stand on his feet. It is one of the examples how patients with a stroke face life shocks, which can lead to unmanageable stress levels if not well managed. Anxiety also becomes part of the victim and his or her family members, causing the fear of the unknown, in the context of Elia. She thought she was going to lose ‘her love’. Besides, the story tells us that Frank continues to experience pain, and this demands him to continue with taking pain-relieving medication. As a result, it is manifested in Elia’s anxiety due to uncertainty about the husband’s case.

 

From the case of Frank and Elia, it is evident that patients who have suffered from a stroke are faced with the problem of how to handle a new life they face and the challenges involved in the rehabilitation process. On the one hand, family members have to provide a support platform needed by the patient, but at the same time face the challenge of handling anxiety and dealing with a completely new person in their family (the patient). In the case of Elia, she informs us that although her husband is recovering well, she now has to deal with apathy and frustration of her husband (stress levels). It calls for health professionals to ensure that all relevant information in terms of medication and rehabilitation methods is availed. 

Personal and Professional Responses to CVA as a Chronic Illness Diagnosis

Personal Responses

Considering the seriousness of the illness, the first response portrayed by patients and their families is panic and confusion, because stroke cases lead to changes in one’s life as a result of the loss of ability to perform tasks previously done with ease. This drastic change in one’s life is responsible for stress, panic and depression in patients and their families. However, panic and fear should not be a way forward. Stroke is a medical emergency, and one should seek medical help as soon as possible. The first reaction is to identify parts affected by a stroke, checking one’s face, arms, speech and time known by an acronym as FAST. These are the simplest needed actions.

 

When one suspects that a person may be a victim of a stroke, he or she should ask the individual to smile, whereby the intention is to see whether one side of the face droops, and ask him/her to raise arms with the same aim. Moreover, it is necessary to ask the victim at hand to repeat a simple sentence to identify if there is the presence of slurred pronunciation. It is also advisable to be keen on whether the sentence is repeated in a correct manner. If a person has all these symptoms, time becomes of the essence, and quick actions are required to reach a health care facility as soon as possible.

Professional Responses

A professional should provide comprehensive care as soon as possible. Once the victim gets to the ER, the first actions taken are examination and testing. Here the doctor at hand will check on vision, reflexes, understanding, and speech. Testing these parameters is continuous to gauge whether the stroke is worsening or improving. Informing the public of the symptoms of stroke is also a key component in defeating the chronic disease. Over and above, the aim of a professional is to help the victims and their families get back to their earlier life as soon as possible. It can be met only if health professionals give a stroke an appropriate response geared towards timely and relevant diagnosis accompanied by better-informed public. 

Concepts Related to CVA as a Diagnosis

Quality of Life

Once diagnosed with CVA, there is a complete turnaround in terms of quality of life due to the problems that emanate as a result of the loss of the ability of doing things previously doable. As a result, CVA highly undermines the quality of life of both the victim and their support team. The patient may also suffer from heightened stress levels and frequently from uncontrollable mood swings. These two variables are responsible for changes in victims’ character and relations with people.

Social Isolation

Due to partial or total disabilities from which patients suffer, some of them tend to keep away from the public. It becomes difficult for them to accept their dependency and requires either a support cane to walk or a wheel chair. These drastic changes in one’s life may limit his/her degree of socialization. 

Adaptation 

As discussed earlier, CVA leads to permanent or temporal changes in the patient’s life. A good example is Frank, who has deteriorated from the strongest man competitor to a person who requires a cane to walk. These changes require an intensive rehabilitation program to go back to normal life. However, in other cases, the damage is permanent and requires adaptive measures. For example, 15-30% of stroke cases in America lead to permanent disability. In the case of Frank, Elia informs that they now have to adapt to dealing with a high level of frustration and pain. Therefore, patients need psychological support for adaptation to these circumstances.

Effects of CVA

Human Cost of Stroke/Personal Effects

The number of stroke victims in America is extremely high reaching over six million people. It is the third rated cause of death in America with affecting people to the tune of over 700 individuals annually, both new and recurrent victims. The death statistics goes shows about 150000 with 54% dying before they reach the hospital. Stroke is also the leading causal effect of long-term disability cases in the USA. It is a result of the fact that out of all stroke victims, only 50-70 have an opportunity to regain fully their lost senses. The rest 15-30% end up being permanently disabled, having hemiparesis on one side of their body.

Economic Cost of Stroke/Population Effects

Although human costs pose the greatest challenge of stroke cases, economic costs cannot be assumed. A stroke is associated with huge financial figures in the USA. In 2008, stroke cases attracted financial costs to the tune of $65.5 billion. A good illustration of huge costs incurred by victims of stroke cases is demonstrated using an example of treating an ischemic stroke using around $148. Medicare on its part pays an accumulated figure of around $3.7 billion per year. The above figure demonstrates a huge financial burden to which stroke cases expose society, not to mention a great challenge it presents to victims and their families.

Levels of Prevention

Despite advancements made in the field of medicine, the prevention of stroke cases remains a great challenge. Numerous researches have provided a deeper understanding of modifiable and non-modifiable risk factors. The latter are those that can be altered and include age, gender and race to name but a few. Modifiable are risk factors that can be altered and are mostly in the form of lifestyle behaviors. Therefore, it is of importance to note that prevention measures are geared towards modifiable factors.

Personal Level of Prevention 

The greatest risk factor on an individual level is hypertension, a phenomenon that is present in 70% stroke cases. The number of the latter remains high in individuals with blood pressure lower than the recommended levels. Therefore, one personal level of stroke prevention is the management of blood pressure. Since stroke incidences have a linear progressive relation with hypertension, one way of ensuring there is a reduction in the number of victims is to call for proper management of hypertension cases. Another personal level of prevention is targeted at individual behavior qualified as a risk factor. Smoking, inactivity, and diet form another personal level of prevention.

 

Smokers face a higher probability (close to 1.8) of suffering from a stroke than non-smokers. Physical activity, which is closely related to body weight, also forms another aspect of a personal level of prevention. Healthy physical activity leads to the maintenance of a healthy body weight. Inactivity and unhealthy body weight are risk factors with the coefficient of 2.7, showing a high probability of a stroke as compared to active people. In terms of eating habits, it is advisable to ensure one is on a diet rich in fruits, low fats, vegetables and whole grain.

Societal Level of Prevention   

The lack of detailed information on stroke cases remains the greatest challenge when it comes to the prevention of this chronic disease on this level. A study done in Michigan demonstrated that out of 2500 adults only 27% could name three risk factors for strokes. A majority of them, namely, 80%, were aware of a single risk factor only. To ensure the public is fully aware of issues relating to a stroke, there is the need to enact a Stroke Prevention and Awareness Program. It will ensure that the public is fully aware of the symptoms of stroke. Early treatment ensures the reduced severity of stroke cases. 

 

Random community stroke screening undertaking is another way of preventing stroke cases. The screening ensures that the latter are identified before they happen by determining risk factors (primary prevention). Identifying the target society and tailoring a message is also a viable societal level of stroke prevention. It ensures that information on stroke is presented in a comprehensible manner.

Best Nursing Practices in Relation to the Illness

The role of a nurse is to ensure stroke symptoms are quickly identified on admission to ensure the patient gets the right medical attention promptly. The nurse is also expected to provide follow-up services in the line of evaluating the progress being made. These two practices are manifested in the form of secondary prevention and neurological assessment. 

Secondary Prevention/Screening 

It is expected that the concerned nurse should be in a position to screen the victim for all relevant risk factors in the line of ensuring he or she gets the right secondary prevention. In addition, there is a need to screen the patient for depression. Depression makes it more difficult to rehabilitate a patient, delaying his or her recovery.

Tertiary Prevention/Neurological Assessment

Nurses should ensure they perform a neurological assessment of the patient on intervals to evaluate the progress of a stroke. In addition, they should perform an assessment using a validated tool like a Canadian Neurological Scale. It is very helpful in the provision of tertiary prevention, known as helping in softening the impact of the stroke.

Three Major Ongoing Aspects of Treatment

For a long time, chronic diseases have been faced medically only, overlooking the emotional aspect. Research has shown that due to the accompanying life changes, close to 13% of men and 17% of women develop depression once diagnosed with chronic diseases. In response, there is a realignment of medication taken to cure chronic diseases including a stroke hand in hand with counseling to help the patient and the family to cope with associated challenges better. In addition, researchers have assessed the important role hope plays in the recovery process. Healthcare workers provide this support platform by offering hope that is realistic and medically visible. Using these two aspects, stroke cases are now being handled in a patient-centered manner. Lastly, there has being increasing awareness of the risk factors leading to stroke cases. These have helped medical practitioners to inform the public of the primary prevention measures.

Conclusion

Based on the statistics, stroke constitutes a threat to the welfare of the majority of the American people and people around the world. Its effects face both an individual and the family concerned. There are also huge financial repercussions on society through expensive medications and extra demands to care for the disabilities associated with the disease. It calls for health workers to be more vigilant on informing and guiding both patients and their caregivers on the best approach to handling possible challenges. The only advancement that has been made is reducing risk factors of the disease. It is therefore of importance for the public to be fully aware of the best course of action, if faced with the disease, and lifestyle practices that will eliminate risk factors.

 

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