This essay looks at a patient who has had a stroke. It will entail a critical examination of the evidence supporting the patient's care. Furthermore, it will examine how the patient's health breakdown impacts them from a social, spiritual, psychological, and biological standpoint. It will then examine the major broader concerns that affect the individual patient and the care delivered by the health care profession. Some of the wider issues that will be discussed constitute public health issues and legal and ethical dimensions of the care (Jehle & Jurchak 2014, p. 8). Finally, it will examine the significance of a Multi-Disciplinary Team (MDT) and the impact it has on the patient and their experience.
Succinct Patient History
The stroke patient is a 41-year old woman with type 2 diabetes. She has been subjected to tablets due to the risks presented by the type 2 diabetes. The patient also suffers from a Migraine and Fibromyalgia. Fibromyalgia refers to a condition that basically contributes to the musculoskeletal pain through the entire body of an individual. The patient is also a smoking addict who smokes seven to eight cigarettes in a day. The patient is also employed as a casual work in an organization where she has been experiencing various challenges at workplaces. Nevertheless, she has a supportive partner who offers both emotional and financial support during the recovery process from the chronic condition.
Patient’s Long-Term/Chronic Condition
The long-term condition of the patient is the ischemic stroke. Ischemic Stroke is a chronic condition that occurs when the supply of blood to the parts of the brain is cut off. It is a common type of stroke that usually accounts for the majority of the strokes affecting patients. Atherosclerosis or blood clot might cause blocking of the flow of blood in the ischemic stroke. Atherosclerosis results in the narrowing of the human arteries after a certain period of time. It is important for a patient to seek a swift emergency treatment in order to survive the stroke as it can be disastrous to the brain and human body functioning (Pesce 2014, p. 537).
Ischemic Stroke is a chronic condition that presents various symptoms on the patient. Some of the symptoms of ischemic stroke included migraines and weaknesses on the right side of the body. In addition, the patient is suffering from type 2 diabetes, however, it did not affect the recovery process of the patient in the stroke. According to evidence from researches, the syndromes of stroke clinically present themselves as the neurologic discrepancy of the abrupt onset. The symptoms of stroke usually depend on the affected parts of the brain. This is usually defined by the anatomy of the type of artery involved. Whereas there are certain features that are less or more common with the hemorrhagic types of stroke, there is none that is effectively prejudiced to facilitate the clinical diagnosis of the specific type of stroke (Zeng 2012, p. 2892).
The detection of a syndrome of stroke is actually very easy since it constitutes sudden onset of the symptoms of acute neurologic. Nevertheless, the detailed management and diagnosis are very dependent on the clinical evaluation of patient physical assessment and medical history since the signs and symptoms vary greatly based on the affected part of the human brain. In the case of the U.S, 87% of all the over 700,000 strokes per year is the ischemic stroke (Zeng 2012, p. 2886). It is considered as the leading functional restrictions and cause of death on patients globally. It is vital to swiftly acknowledge the symptoms of stroke as it can help in the prevention and recovery process. According to the recent studies, they have indicated that there might be different symptoms of stroke presenting themselves in more women compared to men. For instance, in case women have symptoms that are nontraditional at the onset of stroke, it might result in the delay in the treatment and diagnosis of the chronic condition (Spyridoulias et al 2015, p. 963).
Linking Of Condition to Lifestyle or Background
Ischemic stroke is a chronic condition that has the direct link to the lifestyle and background of the patient. As a 41-year old female, the risk of suffering from stroke increases greatly. For instance, according to American Heart Association (AHA), women aged between 40 and 59 years old have the higher risk of suffering from stroke than men. This is evident in the case of the patient in which she has been diagnosed with ischemic stroke (Zeng 2012, p. 2888). Age is the most vital risk factor for stroke in individuals. With the ever-increasing rates of incidences of stroke in the advancement of age, the majority of patients who suffer from other diseases such as Fibromyalgia and Migraine have the high risk of suffering from the stroke. Nevertheless, the risk of suffering from stroke also increases in individuals aged above 40 years old. According to the lifestyle of the patient, she is a smoker who smokes seven to eight cigarettes per day hence subjecting herself to high risk of stroke. Smoking of cigarettes is a great risk factor for the different types of stroke affecting patients. Whereas the global healthcare system and the general public acknowledge the vascular risks linked with smoking by individuals, the extent of use of cigarettes has not changed within the previous 25 years. For instance, it is approximated that 20% of the U.S adults are categorized as habitual smokers. The patient has failed to recognize the link between smoking and stroke even it is one of the risk factors associated with the chronic condition. The risks of stroke can be increased by the plausible techniques by which there is exposure to the smoke of environmental and primary tobacco. Exposure to the environmental tobacco smoke has been associated with atherosclerosis. Smoking has also been linked to the arterial damage that contributes to increased risk factors for stroke (Zeng 2012, p. 2888).
In addition, the ischemic stroke of the 41-year old female patient is linked to her background of suffering from migraines. This is attributed to the fact that individuals with migraine headaches have risks of suffering from some of the typical types of stroke. Alternatively, the risk of suffering from stroke is tripped in smoking patients who suffer from migraines. This is related to the lifestyle of the patient since the patient suffers from migraines and at the same time she is still smoking. The risk of patients who use birth control pills and smoke while suffering from migraines have much higher risk of stroke. The risk of arterial claudication and heart attacks is increased by the migraine headaches. Various studies have illustrated that individuals suffering from migraines have the high prospect of suffering from ischemic stroke (Gallart & Canet 2015, p. 325).
The ischemic stroke of the patient is also linked to her health history of suffering from Fibromyalgia and type 2 diabetes. According to the American Heart Association, patients suffering from type 2 diabetes and Fibromyalgia have increased the risk of suffering from ischemic stroke. Diabetes is a serious disease since it can contribute to increased risks of patients who also suffer from Fibromyalgia. Therefore, with the 41-year old suffering from both type 2 diabetes and Fibromyalgia, she was at greater risk of stroke. Type 2 diabetes can increase the health conditions of the patient such as stroke. Generally, individuals suffering from diabetes have the higher risk of suffering from stroke than individuals without diabetes. This is attributed to the fact that diabetes leaves a lot of sugar in the patient blood since the body is not able to sustain the effective balance of the insulin. Insulin plays a vital role in assisting the blood cells to develop energy from the sugar. After some period of time, the excess amount of sugar can result in the increased deposits of fats or clotting of blood thus blocking the supply of blood to the brain and neck. Therefore, when the flow of blood to the brain is stopped then stroke occurs in the patient (Theofanidis 2016, p. 105).
The patient is employed as a casual worker, however, the job has lots of demand that usually give her too much stress. According to the assessment of numerous studies, job-related stress might be associated with the risk of stroke. This is attributed to the prospect that the high-stress jobs at workplace environment might result in some more unhealthy behaviours on the patient such as smoking, poor eating habits, and inadequate workout. For instance, the American Heart Association established that individuals with high stress at the workplace have a 22% higher risk of suffering from stroke compared to individuals who do not suffer from the stroke. On the other hand, individuals stressed at work have 58% risk of ischemic stroke (Zeng 2012, p. 2889). The blockage of the flow of blood is the major cause of ischemic stroke. Individuals without stress on the job do not have the high risk of stroke. Due to the fact that the patient has a supportive partner, the partner helps to reduce the risk of stroke in the patient. This is because the supportive partner can help the patient in the recovery process. Without any supportive partner, the risk of ischemic stroke increases greatly. It is therefore essential for the patient to continue having the support of the partner during the recovery process to help offer advice and positive life changes that might play a vital role in the life of the patient (Obrien et al 2011, p. 145).
Holistic Effect of the Condition on the Patient
The ischemic stroke has numerous holistic effects on the 41-year old female patient. For instance, the ischemic stroke leads to loss of hope, frustration, stress, and depression on the patient. The patient becomes depressed because of the increased risk of the stroke. The changes of lifestyle such as transferring her by a hoist in and out of the wheelchair because of body weaknesses contributed to increased depression and stress thus negatively affecting her life. Frustration might occur because of the feeling that she needs additional support on the things that she could have done previously before suffering from the stroke (Queralt-Tomas 2015, p. 171). She suddenly lost her independence since she has to be helped by the supportive partner. The future of the patient might also present serious frustrations and stress on her. This might be attributed to the fear of whether she would be independent or even walk. In addition, the stress might also be attributed to the fear of losing her employment since it would be very difficult to work in an organization. Various studies have also associated stroke to some of the recent stressful events in life. The socioeconomic status of the patient after suffering from the stroke might also present stress to the patient. Individuals who have lower socioeconomic status usually have the high risk of stroke thus leading to increased mortality rates in such patients. According to a Health Survey for England report, the psychological distress and economic status of the patient has synergistic effects on the rates of mortality of patients suffering from the stroke. Actually, the low and middle-income countries globally have the higher risk of stroke than the high-income countries (Stroup 2014, p. 155).
Stroke also has the psychological and emotional wellbeing of the patient. For instance, the patient does not have any social interactions when admitted to the hospital since it is only the partner who will be visiting her for a few hours. The patient also does not interact with the other patient hence negatively affecting her psychological and social wellbeing. The quality of life of the 41-year old patient is affected by depression and lack of appetite. Since stroke might occur due to poor lifestyle such as poor eating habit, lack of appetite might affect the recovery process of the patient hence leading to emotional, social and psychological problems on the patient. The patient does not have any motivation to recover from the chronic condition since she shall have lost hope if life (Zeng 2012, p. 2889).
The techniques behind the occurrence of stroke due to psychological factors are still not known. Depression or psychosocial distress might play a major role in the risk of stroke because of the high activity of the sympathetic nerve and cortisol. For instance, studies have illustrated that arteriosclerosis and endothelial dysfunction increases psychosocial stress in different animals such as monkeys. According to Chicago Community Adult Health Study, it established that hopelessness was linked to the dysfunction of the endothelial cells. Activation of the platelet activity might be stimulated by depression resulting to stroke on individuals. As a matter of fact, researchers have established that depressed patients have the high rate of platelet activity. On the other hand, activation of the platelet activity in depressed patients is prevented by the antidepressant agents. The risk of stroke in patients who suffers from diabetes is affected by the feelings of general low well-being. Diabetes is also linked to the increase in the acts of geriatric syndromes such as cognitive impairment, urinary incontinence, fall, depression, and functional disabilities. Having a positive attitude towards the elderly by the supportive partner can help the 41-year old to adapt to the aging. Great resilience, low depression, and good emotional and physical function are linked to the positive attitude by the elderly towards the life. Improvement of the protective psychosocial factors on the patient might help to prevent the risk of stroke. Nevertheless, it is important for the supportive partner to offer additional support that would prevent the patient from having depression and stress in life. The supportive partner can help regulate the emotional wellbeing of the patient by providing all the necessary needs to the patient at the right time (Zeng 2012, p. 2890).
Evidence behind the Care That Was Provided
Stroke has numerous side effects on the patient that require proper care to be provided. The provision of palliative care is essential in the comprehensive care of patients suffering from the stroke. There are certain patients who lose life as a result of stroke during the first stage of hospitalization while there are other individuals who might be disabled hence requires palliative care to manage some of the effects of the chronic condition such as frustrations, anxiety, and depression. For instance, in the case of the 41-year old patient, patient care was provided to address the psychosocial problem of depression (Queralt-Tomas 2015, p. 166). In the case of the patient, the nurses at the healthcare facility carried out mood screening in order to establish the extent of depression on the patient. The nurse providing healthcare services to the patient first listened and asked open-minded questions to the patient in order to understand her feelings and emotions. Stroke affects the emotional wellbeing of the patient hence it was vital for the nurse to communicate to the patient to understand her feelings. The nurse then offered medication such as the antidepressants in order to help treat the stroke on the patient. The antidepressants medications integrate with different chemicals in the patient brain so as to enhance her mood. In addition, mental health therapy might also be offered together with the medication so as to help enhance the mood of the patient. The mental health therapy is offered by a counsellor, social worker, psychiatrist, or psychologist. There are other factors that might increase depression in the patient such as aphasia or spasticity. Depression can be managed through speech or physical therapy. The cognitive behavioural therapy concentrates on assisting to identify the emotional feelings and thoughts that results to the undesirable behaviours on the patient (Queralt-Tomas 2015, p. 167).
The stroke usually leads to lack of appetite in the patient. It requires effective strategies to care for the patient during the recovery process. The lack of appetite on the patient will be addressed by advising the patient to eat healthy diets in order to help nourish the body. This helps to offer energy that will be vital in the recovery process. Rehabilitative therapy can be conducted on the patient to help manage the lack of appetite on the patient. The lack of appetite on the patient can be cared by seeing a speech therapist who can assist the patient on how to improve the mouth, throat, lips, and tongue muscles to allow her to swallow food. Lack of appetite might be attributed to the weak muscles in the mouth hence strengthening them will help to improve the appetite. A therapist might also recommend the electrical stimulation of the neuromuscular so as to send electrical impulses that will help to support the muscles for swallowing food (Zeng 2012, p. 2886).
The modern patient care of individuals suffering from ischemic stroke starts by establishing a system that develops the provisions of rehabilitative, acute treatment, and preventive services. For instance, in the case of the 41-year old patient, the initial assessment is essential at swiftly creating a diagnosis of stroke by disregarding the mimics of stroke. It also involves determination if the female patient should be subjected to the intravenous tissue plasminogen activator treatment. The post-acute depression on the patient might also be managed through the provision of education services. After the emergency treatment of a patient suffering from stroke, the patient care concentrates on regaining the strength and return to the independent living (Bergh et al 2013, p. 523). The effects of stroke usually depend on the part of the brain affected as well as the extent of destruction on the body tissues. In case the left part of the body is affected by the stroke, then the sensation and movement might also be affected on the right part of the body. Registering for a rehabilitation program is an effective patient care that can help in the recovery process (Sulosaari et al 2010, p. 464).
Challenges Providing Care to the Stroke-Patient
During the provision of care to the patient, there were various challenges that were experienced. Inadequate resources and lack of staff for the stroke patients presented a major challenge during the provision of care to the 41-year old patient. This is mainly because it led to the collaboration of the smaller stroke units in the healthcare centre with the larger neighbouring hospitals in order to form a strong team that can offer services to the stroke patients. In addition, lack of adequate staff members to offer care to the stroke patients resulted in nurses not having adequate time to spend with the patients (Queralt-Tomas 2015, p. 169). In the case of stroke, it requires regular patient care from nurses, however, lack of adequate staff members led to patients not getting an adequate number of patients.
In addition, there are certain barriers to the adoption of patient care who suffers from the stroke. According to the various local protocols, they recommend the transfer of the patients suffering from the stroke. There are certain instances in which the patient would like to move from one healthcare centre to the other and thus they cannot be able to recover fully from the stroke (Kendall-Gallagher & Blegen 2010, p. 106). As a result, it would result in the diversion of the various protocols that make it very hard to recover fully. It, therefore, compels the medical personnel such as nurses to determine the real benefits for the transportation of other patients in the healthcare sector. The inadequate staff members have to weigh the various risks associated with the transfer of the patient that constitutes patient discomfort and long wait (Diedler, Sykora, & Hacke 2011, p. 1008). Despite the fact that timely and effective communication between nurses is very essential, lack of adequate nurses presented a serious challenge in the preventive care of the patient. At times, it would not be easy for the nurses to offer quality services to the patient due to the limited number of nurses (Zeng 2012, p. 2886).
Involving of partners in the care also presented a serious challenge due to the fact that the patient had only one supportive partner hence it made it difficult for her to get full support of the partners. As a result, it made the patient to feel depressed from the loneliness. It is therefore important for the patient to get the adequate help from the supportive partners to ensure that she would not feel anxious and depressed. Collaborative teamwork is essential between the secondary and primary health providers in order to ensure that the workload is effectively distributed among all the individuals involved in the recovery process (Markle-Reid 2008, p.85).
Ethical/Legal Aspects of the Patients Care
Clinical ethics offers essential resources for the patients, however, the healthcare specialists continues to experience the dilemmas and difficult decisions during the patient care after stroke. The right act is a legal aspect of the patient care for patients suffering from the stroke due to the fact that it determines the outcome in the treatment of patients suffering from the stroke. Within the various theoretical perspectives, the principle of utilitarianism helps to enhance the happiness of the actions that need to be examined in creating positive values. Therefore, the provision of the right act for by the supportive partners and healthcare professionals present a serious ethical dilemma in the healthcare sector (Zeng 2012, p. 2889).
Public Health Feature in the Patients Care
As a matter of fact, public health featured in the patient care of the 41-year old stroke patient. For instance, the general cleanliness of the patient contributed to the increased chances of the patient recovering from the disease. Stroke is a disease that associated with the public health due to the fact that various studies have established that maintenance of the public health helps in the patient care (Zeng 2012, p. 2890).
Members of the MDT Involved with the Patient
During the stroke patient care process, there were various members of the MDT who were involved. For instance, the physiotherapist carried out an assessment and helped the patient to restore the function and movement that was affected by the stroke. Nevertheless, due to the high level of pain resulting from other diseases such as migraines and fibromyaligia, the physiotherapist opted to carry out small sessions so as to help the patient from feeling too much pain. The physiotherapist established a physiotherapist program to help treat the pain. Finally, the physiotherapist helped to improve the mood of the patient by providing mood-enhancing medications in order to reduce the effects of depression and anxiety (Vernon et al 2012, p. 55).
Besides the physiotherapist, the dietician also played a major role in the recovery process of the patient. For instance, the dietician helped to recommend various food products that could help to regain the appetite of the patients. The dietician proposed the intake of too many vitamins in order to help regain the appetite. The dietician also prepared a healthy eating program that would help the patient to improve her lifestyle (Vernon et al 2012, p. 57).
In addition, nurses and doctors played a major role in the recovery process of the patient. For instance, nurses provided patient care to the patient by ensuring that the 41-year old got the best medication and healthcare services at the right time. The doctor carried out an extensive examination of the patient to ascertain the extent of the stroke on the patient. This would involve conducting x-ray on the patient (Zeng 2012, p. 2888).
Due to the fact that the patient suffered psychological depression and anxiety, the psychologist played a major role in the post-stroke process. For instance, the psychologist offered counselling services on the best ways to live a positive life without getting stressed from stress, anxiety, and depression contribute to increased depression. The psychological care provided to the patient was essential in helping the patient to enhance their lives effectively. Without a psychologist, it would be very hard for the patient to recover fully since emotional and psychological wellbeing is essential in the recovery process (Vernon 2012, p. 55).
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