In most of the developed states, cerebrovascular accident or shot is a common cause of decease and disablement. Stroke ranks 3rd as a cause of decease after bosom disease and malignant neoplastic disease in U.S.A and U.K. The one-year economic disbursal due to cerebrovascular accident has been estimated to transcend 7 billion dollars in U.S.A. Prevalence rates reported for cerebrovascular accident universe broad vary between 500 to 800 per 1,00,000 population. ( Nolen,2008 )
Stroke is the 3rd prima cause of decease in the United States. It accounts for about 1,64,000 mortalities yearly. An estimated 5,50,000 people experience stroke each twelvemonth. Stroke is besides a chief cause of grownup disablement. In United States more than 4 million shot subsisters are populating with changing grade of disablement.
Stroke is socio economically really important in older people. Harmonizing to WHO, shot was the 2nd commonest cause of world-wide mortality in 1990 and the 3rd commonest cause of mortality in more developed states ; it was besides the ground for about 4A·4 million deceases worldwide. In 1999, the figure of deceases due to stroke ailing 5A·54 million worldwide, and two-thirds of these occurred in less developed states. Stroke was found to be a major cause of long-run disablement and, has potentially tremendous emotional and socioeconomic effects for patients, their households, and wellness services. The case-fatality rate due to stroke varies from 11.7 % to 32.4 % . An estimated 15 million people worldwide survived minor shot each twelvemonth and about 4,800,000 in the USA, in which 50 % of instances each twelvemonth are in adult females. ( Health Statistics for US,2002 )
The incidence of shot in the U.S has declined, but there is no diminution in the badness. Harmonizing to background information it is a taking neurological cause of long term disablement. ( Davidson,2008 ) .
Annually an estimated 50,000 individuals in Canada suffer from shot. There is 5.4 million persons who have a history of shot and up to 3,00,000 shot subsisters in Canada. Each twelvemonth about 16,000 dice from shot in Canada. ( Hock ‘s article, 2003 )
The prevalence of shot varies. Over the last 30 old ages at that place has been a definite addition in the prevalence and incidence of shot in India ( The Hindu, March 2008 )
The prevalence of shot in India scopes from 40 to 270 per 100 000 population. Approximately 12 % of all shots occur in the population of greater than 40 old ages of age. Major hazard factors are high blood pressure, hyperglycaemia, baccy usage, and low haemoglobin degrees. In major infirmaries 2 per centum of infirmary enrollments, 1.5 per centum of medical enrollments and 9 to 30 per centum of neurological admittances histories for stroke.The National Commission on Macroeconomics and Health has pointed out that instances of shot would increase from 1,081,480 in 2000 to 1,667,372 in 2015. The ICMR survey on Burden of Disease ( 2005 ) has found that there has been an addition in the figure of shot instances in India during the last one and a half decennaries by 17.5 % . There was besides an addition in mortality rate by 7.8 %
Dr. Ashok cites that statistically India may be seeing every bit many as 200 shots for every 100,000 cross subdivision of the population.
Dr. RK Srivastava ( 2008 ) estimated that 3 million adult females and 2.5 million work forces worldwide dice from shot every twelvemonth, and in developed states it is the 3rd commonest cause of decease. In China it is the taking cause of long term disablement since about two-thirds of patients require rehabilitation. Almost 10 % of shot patients recovered wholly, 25 % showed minor damage, 40 % had moderate to severe damages that required particular attention.
Dr. D Nagaraj ( 2007 ) discussed on the quickly increasing shot load due to altering population with increasing life anticipation. There is a broad fluctuation in the incidence ( 13-105/100,000 ) , prevalence ( 52-842/100,000 ) of shot across the state and in the past decennaries. Case human death ranges from 11.7 % -32 % .The ischaemic shots account for 70 % to 80 % . The surveies nevertheless, have reported a higher per centum of haemorrhagic shots. The individual most of import hazard factor is found to be high blood pressure.The prevalence of smoking baccy varies from 28 % to 50 % in different surveies and of intoxicant usage ranged from 1.5 % to 47 % . Hypercoagulopathies accounted for 6 % of shot, hyperhomocysteinemia was recorded to be high in 40 % of storke clients. 57 % of diability have been recorded in most surveies.
Shymal K. Das and Tapas K. Banerjee ( 2003 ) conducted a population based survey on shot in Kolkata to happen out the prevalence, incidence and instance human death hazards. The findings shows that, the prevalence and incidence rates of shot in this survey are similar to or higher than many surveies conducted in western states. The entire instance human death rates in India is among the highest class of shot human death in the universe.
In 2006,105 instances were detected in 6 months in Tamil Nadu, among which 36 % were of age less than 40yrs,39 % were of 40-60yrs of age. The survey shows that 26 % of clients had a old history of shot. 8 out of 11 screened for homocysteinemia.
Epidemiologic surveies on shot published on equal reviewed diaries during the past 10 old ages were identified utilizing MEDLINE and pubmed hunts and were reviewed utilizing the construction of WHO ‘s shot compound Infobase. Harmonizing to WHO, the figure of stroke events is proposed to increase from 1.1 million per twelvemonth in 2000 to more than 1.5 million per twelvemonth in 2025. ( World Health Organisation 2007 )
In 2005, estimations indicated that 58 million people died, in which chronic diseases accounted for 35 million deceases ( 60 % ) . Cardiovascular diseases, chiefly bosom disease and shot caused 17A·5 million deceases Stroke is the 2nd prima individual cause of decease, with 5A·8 million fatal instances per twelvemonth, 40 % of which are in people of age less than 70 old ages. About 15 million new instances occur every twelvemonth, and about 55 million people have experienced shot in the yesteryear, either with or without residuary disability.By 2025, four out of five shot events will happen in people populating in these parts. ( International Stroke Surveillance, 2005 )
Around half of shot subsisters suffer with important disablement. Physiotherapy will help in recovering every bit much motion and map as possible. Neurological shot physical therapy helps to better balance and walking, increases ability to execute simple to complex undertakings, cut down cramp, hurting and stiffness. It besides helps to increase strength, to retain normal forms of motion, additions affected appendages map and increases energy degree. ( Samuel.J et.al,2008 )
The research workers besides observed that most of the patients were dependent in run intoing the ego attention activities. Nurses are frequently in the forepart of stroke instruction. Health instruction is a critical measure in accomplishing conformity. Patients understanding may find the ultimate success of the rehabilitation and better the ability.Since shot with unilateral paralysis is a major job, the ego attention abilities of a patient should be identified and should be taught to be independent in run intoing their ain demands.
The research worker from her short period of clinical experience has observed that most of the shot patients have unequal cognition sing causes, direction and bar. Therefore people should be encouraged to cognize about these facets.
Sing the big figure of patients admitted in the infirmary, the research worker is of the sentiment that the wellness instruction booklet needs to be prepared which will assist the patients to acquire cognition on cause, direction, bar and to better their ego attention ability.
STATEMENT OF THE PROBLEM
“ A survey to measure the cognition and to place the ego attention abilities of shot patients in Senthil Multi Speciality Hospital, Erode, Tamil Nadu ” .
OBJECTIVES OF THE STUDY
To measure the cognition of patients sing shot.
To place the ego attention abilities of shot patients.
To happen out the relationship between cognition and self attention abilities of shot patients.
To find the association of cognition and self attention abilities with selected socio demographic variables of shot patients.
To fix a wellness instruction booklet on shot.
It refers to statistical measuring of cognition of patients about shot
It refers to patients awareness sing significance, causes, hazard factors, marks and symptoms, diagnostic steps, direction and bar of secondary shot onslaught.
It refers to a neurologic alterations caused by an break in the blood supply to a portion of the encephalon.
It refers to neurological shortage in which there is functional disablement of one side of the organic structure.
It refers to a action or procedure of finding the ego attention abilities of shot patients.
SELF CARE ABILITIES
It refers to those activities that the patient is able to execute independently.
It refers to clients admitted with shot and receiving intervention for more than 3 hebdomads.
HEALTH EDUCATION PAMPHLET
It refers to information in a written signifier sing definition, causes, hazard factors, clinical manifestations, hospital direction and place attention direction of shot.
Patients will hold unequal cognition sing shot.
Patients who had stroke face assorted self attention shortage in their recovery period.
Study was limited to stroke patients with unilateral paralysis who are admitted for more than 3 hebdomads in one peculiar infirmary, so the findings can non be generalized.
Patients who are in the age group of 35-65 old ages.
Study was limited merely to 40 patients.
Study was limited to those who are willing to take part in the survey.
A conceptual model is a set of constructs and propositions that spell out the relationship between them. The overall intent is to do scientific findings meaningful and generalisable. Concepts are the mental images of phenomena and are the edifice blocks of the survey.
Polit and Hungler ( 1999 ) states that the conceptual model is an interconnected construct of abstractions that are assembled together in some strategy by their relevancy to a common thing. This is a device that helps to excite research and the extension of cognition by supplying both way and drift.
The present survey is aimed at measuring the ego attention ability and cognition of shot patients in Senthil Multi Speciality Hospital, Erode.
The conceptual model selected for the survey is based on Orem ‘s self attention shortage theory ( 1985 ) . Orem defined self attention as learned, end oriented activity directed toward the ego in the involvement of keeping life, wellness development and good being.
Major CONCEPTS AND DEFINITIONS
Orem labels her ego attention theory of nursing as a general theory composed of three related constructs.
THE CONCEPT OF SELF CARE
Describes and explains self attention. What the client should execute to keep hygiene. In this survey it is the ego attention activities performed by the client like bathing, dressing, combing, eating, ambulation, lavatory usage and placement.
THE CONCEPT OF SELF CARE DEFICIT
Describes and explains why people can be helped through nursing.In this survey it is the province in which the client is non able to execute the ego attention activities ( bathing, dressing, eating, ambulation, intestine and bladder control ) or the dependence degree that require aid in run intoing the ends.
THE CONCEPT OF Nursing SYSTEM
It is a uninterrupted series or actions that are directed to run into individual ‘s curative ego attention demand.
There are three types of nursing system:
WHOLLY COMPENSATORY SYSTEM
If the client is unable to execute actions, the system is entirely compensatory that is the nurse performs all actions. In this survey, it refers to the to the full dependent shot clients or those requires assistance to execute their activities of day-to-day life like bathing, dressing, combing, eating, vesica and intestine control, ambulation and placement.
PARTIALLY COMPENSATORY SYSTEM
If the nurse and patient portion the duty, the system is partly compensatory. In this survey, it refers to the partly independent and partly dependent shot clients those who requires moderate aid by the important others or nurse in executing the activities of day-to-day life like feeding, bathing, ambulation, placement.
SUPPORTIVE EDUCATIVE SYSTEM
When a patient provides all self care necessitating motions and lone instruction is required as a grid to activity so it is supportive educative system. In this survey, it refers to the to the full independent shot clients, those who are able to make the ego attention activities and requires wellness instruction sing bar of accidents, safe bed to chair and chair to bed transportation techniques, importance of early rehabilitation to better the societal activities and steps to forestall the secondary shot onslaught.
SELF CARE AGENCY
It is the person ‘s ability to execute self care activities. It consists of two agencies.s
SELF CARE AGENT:
The individual who provides the ego attention. In this survey, the ego attention agent is client ‘s with shot.
DEPENDENT CARE AGENT:
The individual other than the person who provides attention. In this survey, the dependant attention agent is the research worker, who assesses the cognition sing significance, hazard factors, causes, marks and symptoms, direction and bar of secondary shot onslaught.
THERAPEUTIC SELF CARE DEMAND:
Curative ego attention demand is the summing up of ego attention actions to be performed for some continuance of clip and in some location to run into self care necessities particularized for a individual.In this survey, it refers to the impart cognition sing significance, causes, hazard factors, marks and symptoms, direction and bar of secondary shot onslaught and do the patient to execute self attention sing personal lavatory, eating, lavatory usage, vesica and intestine control, ambulation.
This chapter dealt with the debut, demand for the survey, statement of the job, aim of the survey, operational definitions, premises, restriction and conceptual model.