Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The past literature suggests the hypothesis that depression is associated with decreased physical functional ability in stroke patients. On a medical rehabilitation ward, 21 stroke patients were evaluated for depression by psychiatric interview and self-report, and were also rated on the Barthel's Functional Index (BFI). The hypothesis was supported: Patients scoring 17 or higher on the Beck Depression Inventory (BDI) (N = 7) had lower initial scores on the BFI than patients with lower BDI scores. There was a trend for these seven depressed patients to improve more slowly as ascertained by the BFI. Depression was suggested to lower functional ability by increasing fatigue, hopelessness, and decreasing motivation.
 ...
PMID:Physical consequences of depression in the stroke patient. 173 Apr 3

We investigated the relation of psychosocial risk factors to mortality in a prospective study of 1353 inhabitants of Crvenka, 619 of whom died between 1966 and 1976. All 38 lung cancer deaths occurred in those with high scores for rationality and antiemotionality (R/A), a factor related to suppression of aggression. Compared with lower R/A, high R/A was also associated with a relative risk of mortality of 29 for other cancer, 4.3 for ischaemic heart disease and 6.5 for stroke. Standardising for R/A reduced the smoking/lung cancer association, virtually eliminated the smoking/other cancer and smoking/heart disease relationships and reduced the association of heart disease with blood cholesterol, blood sugar and hypertension. Long lasting hopelessness was also independently associated with cancer as was anger with heart disease, though not so strongly as for R/A. Psychosocial variables are important predictors of mortality and decisively modify the effect of physical risk factors such as smoking.
 ...
PMID:Psychosocial factors as strong predictors of mortality from cancer, ischaemic heart disease and stroke: the Yugoslav prospective study. 400 17

The hospital mortality rate for stroke patients is now approximately 20%. Those who survive stroke are discharged to home disabled and the responsibility for providing adequate care to the patient has fallen primarily on family members. Maintaining the patients in the community may be ideal but it is not without cost. Although it is known that the role of family is critical to stroke rehabilitation, relatively few studies have examined caregiving within context of stroke, and nursing care is still limited to the patients ignoring family caregivers. Therefore, this study using grounded theory method was carried out to explore and explain the experiences of family caregivers from the time of the incidence throughout the course of stroke. The informants of the study were 24 family caregivers caring for the patients with stroke at hospitals or their homes. The study was conducted from March through August, 1992. Data were collected through in-depth interviews, telephone interviews and participant observation. Data collection and analysis were conducted concurrently allowing theoretical sampling and facilitating hypotheses to evolve. According to the results, caregiving has been associated with a range of negative experiences including emotional crisis, physical discomfort, guilty feeling, anxiety, feeling of social isolation, depression, hopelessness, and financial difficulties. Caregiving activities, commitment, recovery pattern accounted for the experiences of family caregivers, and the experiences varied according to the phases of the patient's recovery. The experiences of family caregivers are; emotional crisis upon a sudden occurrence of stroke; physical discomforts during hospitalization and the period the patients need an assistance with bathroom; feeling of social isolation beginning after discharge; and depression, hopelessness thereafter. Anxiety regarding the recurrence of stroke and the patient's prognosis was intensified with the patient's discharge to home. Guilty feeling was related to the caregiver's perceived role inadequacy. The type of relationship between caregiver and patient, sex of caregiver, and caregiver's financial status correlated to the experiences of family caregivers. Considering all the factors being related to such experiences as mentioned above, the following hypothesis were evolved. (1) The family caregivers who perceive that the patient's recovery has not reached their expectation feel higher level of anxiety. (2) Daughters-in-law feel the caregiving experiences more negative than spouses or adult-children. (3) Unmarried adult-children and daughters-in-law feel more of social isolation, depression, and hopelessness when the period of caregiving lasts longer. (4) Family caregivers who are male and self-supportive receive higher family support and feel the caregiving experiences less negatively.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Experience of family caregivers caring for patients with stroke]. 795 84

Stroke is a significant diagnosis for referral to home care services, and depression is a common co-occurring disorder. Depression can lead to loss of motivation or hopelessness about recovery, which poses barriers to accomplishing treatment goals. When skilled nurses or physical therapists identify depression in stroke patients, they can include the expertise of the psychiatric home care nurse to provide a comprehensive, multidisciplinary treatment plan to achieve successful outcomes.
 ...
PMID:Depression & stroke. Improving patient outcomes with a team approach. 1119 Sep 82

This study investigated the prevalence and clinical correlates of hopelessness among 91 patients diagnosed with probable Alzheimer's disease (AD) according to National Institute of Neurological Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria. Hopeless ideation was measured with Item 3 on the Hamilton Depression Rating Scale (Suicide), which inquires specifically whether the patient thinks "life is not worth living." The results showed that hopelessness was present in 10% (n = 9) of the sample. Patients with these cognitions evidenced greater psychological symptoms of mood disturbance and more insight into their cognitive and functional impairments. Unrelated factors included age, education, Mini-Mental State Examination score, neurovegetative signs of depression, affective expressions of depression, agitation/disinhibition, and psychosis. Although indifference is frequent in AD, these results indicate that thoughts of hopelessness are also a common phenomenon, occurring in approximately 10% of our probable AD cohort. These thoughts appear to be related to the subjective expressions of depression and anxiety rather than the neurovegetative or affective signs and are more prominent among patients with greater deficit awareness.
 ...
PMID:"Life is not worth living": hopelessness in Alzheimer's disease. 1193 42

The risk of attempted or completed suicide is increased in patients with migraine with aura, epilepsy, stroke, multiple sclerosis, traumatic brain injury, and Huntington's disease. Contrary to the general perception that the risk of suicide among patients with Alzheimer's disease and other dementing conditions is low, several reports suggest that the risk of suicide in these patients increases relative to the general population. Some patients at risk for neurologic disorders are also at increased risk for suicide; in particular, the risk of suicide is increased among persons at risk for Huntington's disease, independent of the presence or absence of the Huntington's gene mutation. The risk of attempted or completed suicide in neurologic illness is strongly associated with depression, feelings of hopelessness or helplessness, and social isolation. Additional suicide risk factors in persons with neurologic illness include cognitive impairment, relatively younger age (under 60 years), moderate physical disability, recent onset or change in illness, a lack of future plans or perceived meaning in life, recent losses (personal, occupational, or financial), and prior history of psychiatric illness or suicidal behavior. Substance dependence, psychotic disorders, anxiety disorders, and some personality disorders (eg, borderline personality disorder) may also contribute to increased risk of suicide among persons with neurologic illnesses. Identification and aggressive treatment of psychiatric problems, especially depression, as well as reduction of modifiable suicide risk factors among patients with neurologic illness is needed to reduce the risk of attempted and completed suicide in this population.
 ...
PMID:Suicide in Neurologic Illness. 1235 72

Hope and hopelessness are multi-dimensional concepts. Both can be investigated from an aggregate or individual emotional response to life events. Globally, there are many concerns about conflicts, poverty and illness that have led to collective feelings of hopelessness. Yet, some people still hope for a better future. Hope as an individual response, following illness and disability, has received little empirical investigation. Even so, it is believed that hope is an important mediating factor in the coping process that is imperative to optimal recovery. The purpose of this study was to describe the influence of hope in the recovery process of 50 patients who had suffered a stroke. Hope was measured approximately 10 days following a stroke (Time 1) and 3 months later after discharge from a hospital or rehabilitation facility (Time 2). For purposes of this paper, recovery outcomes were examined in two domains, physical functioning and social activities. Understanding hope and hopelessness, is salient to nurses worldwide since fostering hope is an important nursing intervention.
 ...
PMID:"Hope" in the recovery from stroke in the U.S. 1268 40

Post-stroke depression is a potentially persistent complication of stroke. Electroconvulsive therapy (ECT) is an effective treatment for depression, but with limited data regarding safety in stroke patients. We report the case of a 30-year-old woman with a history of stroke and antiphospholipid syndrome, who became depressed and suicidal. Neurologic and Internal Medicine consults did not reveal any contraindications to ECT, but stroke risk factor management was identified as an important measure for patient safety. The patient tolerated ECT well, reporting improvement of mood and abatement of hopelessness. This case suggests that ECT may be a safe and well-tolerated treatment for post-stroke depression.
 ...
PMID:Successful use of ECT in post-stroke depression. 2193 20

Patients with stroke-related disabilities are at risk of depression and social isolation. This can make it difficult for the patient to cope with his or her disease and increase caregiver burden. While good at dealing with physical illness, nurses are often poor at attending to patients' mental and spiritual needs. In this paper, the authors introduce their experience using a spiritual care model to care for a stroke patient. The patient, a 69 year-old retiree, was admitted to our hospital due to an acute stroke. During hospitalization, he suffered from acute confusion and persistent focal weakness. His disability resulted in physical dependence, which did not improve during rehabilitation. We used a model of spiritual care and in-depth evaluation to identify several underlying psychological issues. These included feelings of hopelessness and loss of control and motivation. The authors established trust through active listening. In addition to standard nursing education and physical care, we, in cooperation with the patient's children, provided encouragement and support to help the patient cope with his disease burden and actively participate in rehabilitation. We applied a multi-dimensional spiritual care approach to help the patient shift from hopelessness to hopefulness. This enhanced his motivation to participate in rehabilitation and improved his self-care abilities. We hope this case report on the application of a spiritual-care model is useful reference for nurses responsible to care for stroke patients.
 ...
PMID:[An experience applying a spiritual care model to a first-time stroke patient]. 2266 Oct 40

Hope and hopelessness are important psychological constructs that physiotherapists should consider when working with patients who have experienced a stroke. The view of hope in rehabilitation is often focused around the concept of goals and how hope works within this framework. However, the current paper proposes a broader framework for hope and the importance of a more generalised view of understanding why a certain hope exists or is identified by a patient. A narrative review using an a priori thematic analysis was undertaken to consider how more generalised hopes are expressed by individuals who have suffered a stroke. An electronic search of 4 databases from inception until April 2014 was undertaken. Qualitative articles were included if they considered the concept of hope for patients who had suffered a stroke. The results identified three themes which included (1) consideration of the patient's identity/identities, (2) meaningful activities, experiences, and interactions, and (3) the experience of suffering and need for relief. An awareness of patients' generalised hopes should be a priority for HCPs. Detailed implications for HCPs are identified within the discussion.
...
PMID:Identifying a Framework for Hope in Order to Establish the Importance of Generalised Hopes for Individuals Who Have Suffered a Stroke. 2655 12


1 2 Next >>