Page 527 - Encyclopedia of Nursing Research

494 n STROKe

Once stroke survivors are stabilized, nursing practice as a clinical stroke assess-
they enter the rehabilitation phase of treat- ment tool. It is now widely used in stroke
S ment where they learn how to live with their centers across the nation. Recently, two AhA
disabilities from stroke. multidisciplinary Scientific Statements have been published
rehabilitation teams consist of physicians, that provide comprehensive overviews of
physiatrists, nurses, psychologists or psychia- nursing and interdisciplinary care of stroke
trists, counselors, and physical, occupational, patients across the care continuum (miller
recreational, and speech therapists (AhA, et al., 2010; Summers et al., 2009). Summers
2004). To reduce fragmentation of stroke care et al. (2009) provide levels of evidence for
across settings and to ensure that scientific nursing interventions directed toward the
knowledge is translated into practice, recom- care of acute ischemic stroke patients. miller
mendations have been developed to establish et al. (2010) provide levels of evidence for
stroke systems of care (Schwamm et al., 2005). rehabilitation care of stroke survivors and
These recommendations address how state their family members across inpatient reha-
and local communities can engage in efforts bilitation, outpatient, and chronic care set-
to promote primary stroke prevention, com- tings. These AhA Scientific Statements
munity education, emergency medical ser- provide a useful resource for practicing
vices, acute and subacute stroke treatment, nurses, and they identify areas for future
rehabilitation, and quality improvement nursing research to demonstrate best prac-
activities (Schwamm et al., 2005). tices in the care of stroke survivors and fam-
learning how to live with disabilities ily caregivers across the care continuum.
resulting from stroke is challenging not only A recent search of the RepORT expen-
for stroke survivors but also for their fam- ditures and Results (n.d.), a database of bio-
ily caregivers. After stroke, depression is a medical research funded by the national
major complication of stroke and can greatly Institutes of health, revealed two studies
impede recovery (AhA, 2004). Other qual- of interest funded by the national Institute
ity of life issues for stroke survivors include for nursing Research (nInR). pamela
disruption of personality and moods, mitchell has been funded to evaluate a
diminished self-care, changes in social and nurse-deli vered psychosocial/behavioral
family roles, and loss of work or productiv- intervention, which has been shown to be
ity, among others (Williams, Weinberger, effective in reducing post-stroke depression
harris, Clark, & Biller, 1999). Family care- (mitchell et al., 2009). Sharon Ostwald has
givers often experience negative changes in been funded to evaluate her intervention for
social functioning, subjective well-being, stroke survivors and spousal caregivers. It
and perceived health as a result of provid- is hopeful that these intervention programs
ing care (Bakas, Champion, perkins, Farran, will provide promise for the future care of
& Williams, 2006). Caregiver needs and con- stroke survivors. Another leader in stroke
cerns typically focus on finding informa- nursing research is patricia hurn, who has
tion about stroke, managing emotions and been funded by nInR since 1993 to study
behaviors of the stroke survivor, providing the role of estrogen in immunoprotection
physical and instrumental care, and dealing following stroke.
with one’s own personal responses to care- A search of the RepORT expenditures and
giving (Bakas, Austin, Okonkwo, lewis, & Results (n.d.) database also revealed many stud-
Chadwick, 2002). ies funded by nInR focused on family caregiv-
nurses are involved with the care of ers of stroke survivors. For example, patricia
stroke survivors throughout the continuum Clark has been funded to explore family func-
of care. Judith Spilker et al. (1997) integrated tion, stroke recovery, and caregiver outcomes.
the use of the nIh Stroke Scale into current Barbara lutz has been funded to develop a