Prevention of Venous Thromboembolism (VTE) is important in the treatment of stroke, including pharmacological and mechanical thromboprophylaxis. One of the post-stroke complications is Deep vein ...thrombosis (DVT), DVT can lead to pulmonary embolism (PE), and Venous thromboembolism (VTE) is manifested as DVT and PE. Stroke patients are at increased risk of developing DVT. This review aims to assess the clinical efficacy of mechanical prophylaxis for preventing venous thromboembolism in stroke patients. The articles were searched through PubMed, ScienceDirect, Sage Journals and ProQuest database. Keywords: "Stroke", "Prevention", "Deep Vein Thrombosis", “Venous Thromboembolism”, “Intermittent Pneumatic Compression”, and “Stocking Compression” combined using the Boolean operators AND or OR. The articles were full text, written in English, published in the last 10 years, and provided information about mechanical prophylaxis for preventing VTE in stroke patients. This review provides important information on VTE prevention in stroke patients. The use of IPC significantly reduces the risk of DVT and the addition of IPC in pharmacological prophylaxis provides moderate benefits in VTE, whereas the use of graduated compression stocking is less clinically significant in the prevention of VTE. The use of IPC is an effective method to reduce the risk of VTE in post-stroke immobilized patients, with fewer skin side effects compared to stocking compression.
BACKGROUND: Sexual dysfunction is a complication of terminal kidney failure. The problem of fulfilling sexual needs of men undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) is influenced by ...many factors.
AIM: This study aims to find out the most dominant factor affecting the sexual dysfunction of men who undergo CAPD.
METHODS: The design of this study was cross-sectional analysis with a sample of 70 men CAPD patients using a purposive sampling technique from February to May 2020. Data collection was carried out offline and online by filling in the questionnaire sheets for respondent characteristics, International Index of Erectile Function, and looking at laboratory result.
RESULTS: The results showed there was a correlation between age (p=0.0024), plasma urea (p=0.018), and albumin (p=0.001) with sexual dysfunction in male patients using CAPD. There was no significant correlation between length of time undergoing CAPD (p=0.678), fasting glucose (0.051), triglycerides (p=0.536), and cholesterol (p=0.183) with sexual dysfunction in male patients who undergo CAPD. The most dominant factor affecting is albumin, where patients who have albumin levels < 3.5 g/dL are at risk of experiencing sexual dysfunction 9.3 times greater than patients with albumin levels 3.5-5 g/dL after being controlled by age variables.
CONCLUSION: The recommendation of this study is protein intake of 1.2-1.5 g/kg body weight with at least 60% of protein with high biological value and evaluation of the ability of care and replacement of CAPD at home.
Introduction
Recurrent stroke is one of the concerns that not only causes functional disability but also economic and psychosocial problems. Self-management is one of the indicators to predict ...recurrent stroke. Field observations indicate there is currently no tool to increase the survivors' self-awareness.
Objective
The study aimed to investigate if an early detection tool and health education can improve patient self-awareness toward self-management in ischemic stroke patients in order to prevent recurrent ischemic stroke.
Methods
This study consisted of two stages. In the first stage, the study used research and development methods to develop a digital sensor tool named Sensor Digital Kariasa (SenDiKa). In the second stage, the study used a quasi-experimental design with a pretest–posttest control group involving 44 postischemic stroke patients who were selected by using consecutive sampling. The subjects were divided into intervention and control groups, and the length of the intervention was 12 weeks.
Results
This study found a significant difference between the two groups (P < .001). The intervention group who used the early detection tool and received health education showed better self-management compared to the control group. The use of SenDiKa early detection prototype and health education for self-management was perceived useful and gave positive effect to the improvement of self-management in poststroke patients to prevent recurrent stroke.
Conclusion
The combination of SenDiKa early detection prototype and health education for self-management can be used for patients to identify the major risk factors of recurrent stroke, such as blood pressure, blood sugar, and cholesterol.
Background: Educational interventions about stroke have been carried out by the health workers, one of which is by the nurse. However, the majority of the interventions focus more on the stroke ...patients than the stroke caregivers. Meanwhile, post-stroke patient care education interventions are urgently needed by the caregivers. Therefore, the author intends to review current literature about post-stroke patient care education interventions on stroke caregivers. Objective: This literature review aims to identify the effectiveness, methods, and impacts of daily care educational interventions for post-stroke patients on stroke caregivers. Methods: The method utilized was by analyzing online databases about the related topics from reputable sources. Seven articles that met the inclusions criteria considering Randomized Controlled Trial (RCT) and Quasi-experimental design, time of publication, and English full text were obtained, and the results were presented. Result: Educational intervention could be carried out by several methods, including direct education at the patient's bedside, lectures followed by questions and answers, and booklets, home visits or telephone follow-up. Educational interventions could improve caregiver knowledge and skills in providing daily care for post-stroke patients, reduce burdens, reduce anxiety and improve the caregiver's quality of life. Educational interventions also positively impacted post-stroke patients, including improving the quality of life, functional abilities and the ability to do daily activities (ADL), reducing cognitive impairment, anxiety, and depression.Conclusion: Daily care education interventions for post-stroke patients can reduce the burden on the caregiver, either physical, psychological or social burdens.
Background: Improving awareness in patients with stroke to detect risk factors of recurrent stroke has recently become a major challenge for all health professionals in preventing recurrence among ...stroke survivors. Utilization of advanced technology, such as digital sensors, (a non-invasive device) is among the breakthroughs in detecting the risk of disease and promotes more effective prevention and improves quality of care. This study aims to conduct a systematic review on studies addressing early detection of the risk factors of recurrent stroke through the utilization of digital sensors.
Methods: A literature search was carried out on articles published between 2011 - 2018 on EBSCO, Elsevier, Science Direct, ProQuest, Springer link, PubMed, MEDLINE, PLoS, and the Journal of Community Nursing. The search identified quantitative research studies on the utilization of digital sensors in cases of hypertension, diabetes mellitus, hypercholesterolemia, and cardiac disorders that contributed to stroke recurrence. Each study's bias was assessed using Review Manager 5.
Results:
Ten articles were analyzed through data extraction. Robust assessment of independent risk factors which provoke recurrent stroke such as hypertension, diabetes mellitus, hypercholesterolemia, and heart diseases could lead to conservation of health resources. It is very important to monitor these factors. With the development of technology, the potential use of non-invasive monitoring for hypertension, diabetes mellitus, hypercholesterolemia, and heart diseases as risk factors for recurrent stroke events is considered effective because it is easy, simple, low cost, sensitive, and does not cause additional suffering for patients.
Conclusion: A practical and non-invasive method for early detection and monitoring of risk factors may reduce the risk of stroke recurrence among stroke survivors.
Background
Improving awareness in patients with stroke to detect risk factors of recurrent stroke has recently become a major challenge for all health professionals in preventing recurrence among ...stroke survivors. Utilization of advanced technology, such as digital sensors, (a non-invasive device) is among the breakthroughs in detecting the risk of disease and promotes more effective prevention and improves quality of care. This study aims to conduct a systematic review on studies addressing early detection of the risk factors of recurrent stroke through the utilization of digital sensors.
Methods
A literature search was carried out on articles published between 2011 - 2018 on EBSCO, Elsevier, Science Direct, ProQuest, Springer link, PubMed, MEDLINE, PLoS, and the Journal of Community Nursing. The search identified quantitative research studies on the utilization of digital sensors in cases of hypertension, diabetes mellitus, hypercholesterolemia, and cardiac disorders that contributed to stroke recurrence. Each study's bias was assessed using Review Manager 5.
Results
Ten articles were analyzed through data extraction. Robust assessment of independent risk factors which provoke recurrent stroke such as hypertension, diabetes mellitus, hypercholesterolemia, and heart diseases could lead to conservation of health resources. It is very important to monitor these factors. With the development of technology, the potential use of non-invasive monitoring for hypertension, diabetes mellitus, hypercholesterolemia, and heart diseases as risk factors for recurrent stroke events is considered effective because it is easy, simple, low cost, sensitive, and does not cause additional suffering for patients.
Conclusion
A practical and non-invasive method for early detection and monitoring of risk factors may reduce the risk of stroke recurrence among stroke survivors.
Dysphagia is a complication that often occurs and triggers the occurrence of aspiration pneumonia and death from stroke. Neuromuscular electrical stimulation (NMES) is a muscle strengthening therapy ...and sensorimotor recovery with electrical stimulation that can improve swallowing function. This study aims to find evidence of the effectiveness of NMES therapy on swallowing function in stroke patients with dysphagia. The method used in this research is a systematic review through online databases, namely: PubMed, ProQuest, Sciencedirect, and Wiley Online Library, on articles with full text criteria, using Indonesian or English, publications in the last 5 years, and a quasi-experimental research design and randomized controlled trials. Search articles using keywords "stroke", "cerebrovascular accident", "dysphagia", "neuromuscular electrical stimulation", "swallowing function", and "deglutitions function" combined using the boolean operator AND or OR. The search results found 10 articles that match the inclusion criteria. From 10 articles, there was 1 quasi-experimental article and 9 randomized controlled trial articles. The results showed that NMES could be an optional intervention to improve swallowing function after a stroke. Based on the reviews, NMES is effective in improving swallowing function in stroke patients with dysphagia; more high-quality evidence is needed to determine the proper procedure and other treatments that can be combined with NMES therapy.
Background: The quality of life of patients with primary brain tumor in Indonesia is poorly understood. Therefore, this study aimed to investigate the health‐related quality of life of patients ...admitted to the Neurosurgery Department of Dr. Hasan Sadikin Hospital, Bandung, Indonesia, up to 3 months after discharge. Methods: Baseline data were collected from patients aged ≥18 years who were admitted to the hospital between October 9, 2015, and February 17, 2016. In‐person interviews were then conducted 1–2 days pre‐discharge (n = 65) and follow-up telephone interviews were made 1, 2, and 3 months post-discharge (n = 58, 55, and 54, respectively) to collect socio-demographic data, clinical characteristics, and EQ‐5D‐5L data. Results: Prior to discharge, one‐third or less of the 65 patients interviewed reported “no problems” with mobility (32%), self‐care (32%), usual activities (18%), and pain/discomfort (43%), whereas 74% reported “no problems” with anxiety/depression. By contrast, at 3 months post-discharge, an increased proportion of patients reported “no problems” with mobility (61%), self‐care (67%), usual activities (56%), and pain/discomfort (76%), with little change in anxiety/depression (“no problems” 70%). Conclusions: While there was improvement, many patients were still reporting problems at 3 months post-discharge, highlighting the need for ongoing support and care to ensure the best possible outcomes.
Chiari malformation is a structural defect in the skull that causes part of the brain to push into the spinal canal. Chiari malformations are almost always present at birth, though symptoms may not ...develop until later in childhood. In adult years, problems can include persistent headaches, neck pain, and weakness and/or numbness and tingling in the arms and legs, which makes it a disease of interest to present as a clinical case with a nursing model care plan.
This is a 43-year-old female patient with type I Chiari malformation. She has neck and shoulder pain, stiffness in the hands, as well as hypotonus and hypotrophy in the upper limb. The patient underwent foramen magnum decompression surgery.
We used Roy's adaptation model for the nursing care plan. The main needs we find are respiration (risk for ineffective breathing pattern), mobility (impaired physical mobility), sensation (acute pain), protection (risk for infection, and risk for bleeding), fluid and electrolyte (risk of fluid and electrolyte imbalance), and self-concept (anxiety).
The Roy's adaptation model approach was useful in this case as it focuses on the patient's adaptability and is suitable for use in perioperative nursing management of type I Chiari malformation in adults. A collaborative approach is essential for planning and carrying out care.
La malformación de Chiari es un defecto estructural en el cráneo que hace que parte del cerebro empuje hacia el canal espinal. Las malformaciones de Chiari casi siempre están presentes al nacer, aunque es posible que los síntomas no se desarrollen hasta más tarde en la infancia. En la edad adulta, los problemas pueden incluir dolores de cabeza persistentes, dolor de cuello y debilidad y/o entumecimiento y hormigueo en brazos y piernas, lo que la convierte en una enfermedad de interés para presentar como caso clínico con un plan de cuidados modelo de enfermería.
Se trata de una paciente de 43 años con malformación de Chiari tipo I. Experimenta dolor de cuello y hombros, rigidez en las manos, así como hipotonía e hipotrofia en el miembro superior. La paciente fue sometida a una cirugía de descompresión del foramen magnum.
Usamos el plan de cuidados de enfermería del Modelo de Adaptación de Roy. Las principales necesidades que encontramos son respiración (riesgo de patrón respiratorio ineficaz), movilidad (movilidad física alterada), sensación (dolor agudo), protección (riesgo de infección y riesgo de hemorragia), líquidos y electrolitos (riesgo de desequilibrio de líquidos y electrolitos) y autoconcepto (ansiedad).
El enfoque del Modelo de Adaptación de Roy fue útil en este caso, ya que se centra en la adaptabilidad del paciente adecuada para su uso en el manejo perioperatorio de enfermería de la malformación de Chiari tipo I en adultos. Un enfoque colaborativo es esencial para planificar y llevar a cabo la atención.
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