Self Management in Stroke Patients and the Importance of Stroke Prevention in Health Policies

Abstract

Stroke is a cerebrovascular dissease that occurs as a result of sudden decrease or cessation of blood flow to the brain. Mortality or morbidity may occur after acute stroke. Stroke patient's self management, care, treatment process, preventions against stroke determine the patient's life expectancy and quality of life. In order to increase the physical, social and psychological functionality of stroke patients, self management interventions are recommended in the presence of health professionals. Stroke has an important place in the health policies of countries, as stroke prevention and self-management interventions create a healthcare burden and economic burden. In this study, a literature review was conducted in developed and developing countries about stroke, self management of stroke patients, prevention against stroke, the burden of healthcare services resulting from stroke, and the impact of stroke on health policy. Literature information obtained from reviews and systematic reviews published in English between 2009 and 2023 in Pubmed, Google Scholar, Scopus, Web of Science was used. This study aimed to investigate the selfmanagement of stroke patients, the importance of prevention against stroke and their impact on health policy, and the service burden in terms of health management. This study; it was produced from the master's degree project titled "Quality of Life of Stroke Patients, Stroke Prevention and Its Place in Health Policies" by Adil Uğur Yavuz, who graduated from Istanbul Beykent University Graduate Education Institute, Department of Business Administration, Department of Health Institutions Management.

Keywords

• Stroke
• self management
• health policy

Project Number

Yok.

İnme Hastalarında Öz Yönetim ve İnmeden Korunmanın Sağlık Politikalarındaki Önemi

Abstract

İnme, beyne giden kan akımının aniden azalması veya durması sonucu oluşan serebrovasküler olaydır. Akut inme sonrası mortalite veya morbidite gelişebilir. İnme hastasının öz yönetimi, bakımı, tedavi süreci, inme gelişmesine karşı alınan koruyucu önlemler hastanın yaşam süresine ve yaşam kalitesine yön vermektedir. İnme geçiren hastaların fiziksel, sosyal ve psikolojik olarak işlevselliklerini artırmak için hastalara sağlık profesyonelleri eşliğinde öz yönetim müdahaleleri önerilmektedir. İnmeden korunma ve öz yönetim müdahaleleri, sağlık hizmeti yükü ve ekonomik yük oluşturduğundan inme ülkelerin sağlık politikalarında önemli bir yere sahiptir. Bu çalışmada gelişmiş ve gelişmekte olan ülke toplumlarında yapılmış inme, inme hastalarının öz yönetimi, inmeye karşı koruyucu önlemler, inme sonucu meydana gelen sağlık hizmeti yükü, inmenin sağlık politikasına etkisi ile ilgili literatür araştırması yapıldı. Pubmed, Google Scholar, Scopus, Web of Science’ da İngilizce dilinde 2009-2023 yılları arasında yayınlanmış olan derlemeler ve sistematik derlemeler üzerinden elde edilen literatür bilgilerinden yararlanıldı. Bu çalışmada inme hastalarının öz yönetimi, inmeye karşı koruyucu önlemlerin önemi ve sağlık politikasına olan etkisi ve sağlık yönetimi açısından hizmet yükünün araştırılması amaçlandı. Bu çalışma; İstanbul Beykent Üniversitesi Lisansüstü Eğitim Enstitüsü, İşletme Anabilim Dalı, Sağlık Kuruluşları Yöneticiliği Bilim Dalı'ndan mezun olan Adil Uğur Yavuz‘un "İnme Hastalarının Yaşam Kalitesi, İnmeden Korunma ve Sağlık Politikalarındaki Yeri" başlıklı yüksek lisans bitirme projesinden üretilmiştir.

Keywords

• İnme
• öz yönetim
• sağlık politikası

Project Number

Yok.

References

1. 1. Murphy SJX, Werring DJ. Stroke: causes and clinical features. Medicine. 2020;48(9):561-566.
2. 2. Zhou Y, Wang Y, Wang J, Anne Stetler R, Yang Q-W. Inflammation in intracerebral hemorrhage: From mechanisms to clinical translation. Prog Neurobiol. 2014;115:25-44.
3. 3. Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci. 2020;21(20):7609-7632.
4. 4. Johnson CO, Nguyen M, Roth GA, Nichols E, Alam T, Abate D. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439-458.
5. 5. Yew KS, Cheng EM. Diagnosis of acute stroke. Am Fam Physician. 2015;91(8):528-536.
6. 6. Richard AA, Shea K. Delineation of Self-Care and Associated Concepts. Journal of Nursing Scholarship. 2011;43(3):255-264.
7. 7. Taylor SJ, Pinnock H, Epiphaniou E, Pearce G, Parke HL, Schwappach A, Purushotham N , Jacob S, Griffiths CJ, Greenhalgh T, Sheikh A. A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions. Health Services and Delivery Research. 2014;2(53):1-580.
8. 8. Fryer CE, Luker JA, McDonnell MN, Hillier SL. Self management programmes for quality of life in people with stroke. Cochrane Database of Systematic Reviews. 2019;2016(3):1-72.

9. 9. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, Mac- Kay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD. Guidelines for Adult Stroke Rehabilitation and Recovery. Stroke. 2016;47(6):98-169.
10. 10. Parke HL, Epiphaniou E, Pearce G, Taylor SJC, Sheikh A, Griffiths CJ, Greenhalgh T , Pinnock H. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review. PLoS One. 2015;10(7):e0131448.
11. 11. Strilciuc S, Alecsandra Grad D, Radu C, Chira D, Stan A, Ungureanu M, Gheorghe A, Muresanu F. The economic burden of stroke: a systematic review of cost of illness studies. J Med Life. 2021;14(5):606-619.
12. 12. Thrift AG, Vickrey BG. Advances in Health Policy and Outcome 2010–2011. Stroke. 2012;43(2):300-301.
13. 13. Heiman H, Smith L, McKool M, Mitchell D, Roth Bayer C. Health Policy Training: A Review of the Literature. Int J Environ Res Public Health. 2015;13(1):20-31.
14. 14. Kristine Stage Pedersen S, Lillelund Sørensen S, Holm Stabel H, Brunner I, Pallesen H. Effect of Self-Management Support for Elderly People Post-Stroke: A Systematic Review. Geriatrics. 2020;5(2):38-58.
15. 15. Sarikaya H, Ferro J, Arnold M. Stroke Prevention - Medical and Lifestyle Measures. Eur Neurol. 2015;73(3-4):150-157.
16. 16. Owolabi MO, Thrift AG, Mahal A, Ishida M, Martins S, Johnson WD, Pandian J, Abd-Allah F, Yaria J, Phan HT, Roth G, Gall SL, Beare R, Phan TG, Mikulik R, Akinyemi RO, Norrving B, Brainin M, Feigin VL; . Primary stroke prevention worldwide: translating evidence into action. Lancet Public Health. 2022;7(1):74-85.
17. 17. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(7):e1000097.
18. 18. Lau SCL, Judycki S, Mix M, DePaul O, Tomazin R, Hardi A, Wong AWK, Baum C. Theory-Based Self-Management Interventions for Community-Dwelling Stroke Survivors: A Systematic Review and Meta-Analysis. The American Journal of Occupational Therapy. 2022;76(4): 7604205010.
19. 19. Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Patel T, Ho CH, Packer TL, Lofters AK, Hahn-Goldberg S, McCarthy LM, Guilcher SJT. Medication self-management interventions for persons with stroke: A scoping review. PLoS One. 2023;18(5):e0285483.
20. 20. Allegrante JP, Wells MT, Peterson JC. Interventions to Support Behavioral Self-Management of Chronic Diseases. Annu Rev Public Health. 2019;40(1):127-146.
21. 21. Horrell LN, Kneipp SM. Strategies for recruiting populations to participate in the chronic disease self-management program (CDSMP): A systematic review. Health Mark Q. 2017;34(4):268- 283.
22. 22. Pearce G, Pinnock H, Epiphaniou E, Parke HL, Heavey E, Griffiths CJ, Greenhalgh T, Sheikh A, Taylor SJC. Experiences of Self-Management Support Following a Stroke: A Meta- Review of Qualitative Systematic Reviews. PLoS One. 2015;10(12):e0141803.
23. 23. Morais HCC, Gonzaga NC, Aquino P de S, Araujo TL de. Strategies for self-management support by patients with stroke: integrative review. Revista da Escola de Enfermagem da USP. 2015;49(1):136-143.
24. 24. Ruksakulpiwat S, Zhou W. Self‐management interventions for adults with stroke: A scoping review. Chronic Dis Transl Med. 2021;7(3):139-148.
25. 25. Saunders D H, Sanderson M , Hayes S, Johnson L, Kramer S, Carter D D, Jarvis H, Brazzelli M, Mead G E. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2020; 20;3(3):CD003316.
26. 26. Plow M, Mangal S, Geither K, Golding M. A Scoping Review of Tailored Self-management Interventions among Adults with Mobility Impairing Neurological and Musculoskeletal Conditions. Front Public Health. 2016;4:165-175.
27. 27. Hwang N-K, Park J-S, Chang M-Y. Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review. Healthcare. 2021;9(4):472-490.
28. 28. Boger EJ, Demain S, Latter S. Self-management: a systematic review of outcome measures adopted in self-management interventions for stroke. Disabil Rehabil. 2013;35(17):1415-1428.
29. 29. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener H, Sacco RL, Ryglewicz D, Czlonkowska A, Weimar C, Wang X, Yusuf S. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet. 2010;376(9735):112-123.
30. 30. Hankey GJ. Nutrition and the risk of stroke. Lancet Neurol. 2012;11(1):66-81.
31. 31. Yu J-G, Zhou R-R, Cai G-J. From Hypertension to Stroke: Mechanisms and Potential Prevention Strategies. CNS Neurosci Ther. 2011;17(5):577-584.
32. 32. Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci. 2016;351(4):380-386.
33. 33. Strazzullo P, D’Elia L, Kandala N-B, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009;339:45-67.
34. 34. Lieber A, Hong E, Putrino D, Nistal D, Pan J, Kellner C. Nutrition, Energy Expenditure, Dysphagia, and Self-Efficacy in Stroke Rehabilitation: A Review of the Literature. Brain Sci. 2018;8(12):218-229.
35. 35. Clarke R, Halsey J, Lewington S, Lonn E, Armitage J, Manson JE, Bønaa KH, Spence JD, Nygård O, Jamison R, Gaziano JM, Guarino P, Bennett D, Mir F, Peto R, Collins R. Effects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals. Arch Intern Med. 2010;170(18):1622-1631.
36. 36. Spence J. Nutrition and Risk of Stroke. Nutrients. 2019;11(3):647-659.
37. 37. Preis SR, Stampfer MJ, Spiegelman D, Willett WC, Rimm EB. Lack of association between dietary protein intake and risk of stroke among middle-aged men. Am J Clin Nutr. 2010;91(1):39- 45.
38. 38. Tziomalos K, Athyros V, Karagiannis A, Mikhailidis D. Dyslipidemia as a Risk Factor for Ischemic Stroke. Curr Top Med Chem. 2009;9(14):1291-1297.
39. 39. Zhao L, Wang R, Song B, Tan S, Gao Y, Fang H, Lu J, Xu Y. Association between Atherogenic Dyslipidemia and Recurrent Stroke Risk in Patients with Different Subtypes of Ischemic Stroke. International Journal of Stroke. 2015;10(5):752-758.
40. 40. Rajamani K, Chaturvedi S. Stroke Prevention-Surgical and Interventional Approaches to Carotid Stenosis. Neurotherapeutics. 2011;8(3):503-514.
41. 41. Polivka J, Polivka J, Pesta M, Rohan V, Celedova L, Mahajani S, Topolcan O, Golubnitschaja O. Risks associated with the stroke predisposition at young age: facts and hypotheses in light of individualized predictive and preventive approach. EPMA Journal. 2019;10(1):81-99.
42. 42. Bailey RR. Lifestyle Modification for Secondary Stroke Prevention. Am J Lifestyle Med. 2018;12(2):140-147.
43. 43. Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20(10):795- 820.
44. 44. Rudd AG, Williams LS. Advances in Health Policy and Outcomes. Stroke. 2009;40(5):301-304.
45. 45. Demaerschalk BM, Hwang H-M, Leung G. US cost burden of ischemic stroke: a systematic literature review. Am J Manag Care. 2010;16(7):525-533.
46. 46. Johnson B, Bonafede M, Watson C. Short- and longer-term health- care resource utilization and costs associated with acute ischemic stroke. ClinicoEconomics and Outcomes Research. 2016;8:53-61.
47. 47. Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, Dodel R, Ekman M, Faravelli C, Fratiglioni L, Gannon B, Jones DH, Jennum P, Jordanova A, Jönsson L, Karampampa K, Knapp M, Kobelt G, Kurth T, Lieb R, Linde M, Ljungcrantz C, Maercker A, Melin B, Moscarelli M, Musayev A, Norwood F, Preisig M, Pugliatti M, Rehm J, Salvador-Carulla L, Schlehofer B, Simon R, Steinhausen H, Stovner LJ, Vallat J, Bergh PV, Os J, Vos P, Xu W, Wittchen H, Jönsson B, Olesen J. Cost of disorders of the brain in Europe 2010. European Neuropsychopharmacology. 2011;21(10):718-779.
48. 48. Thayabaranathan T, Kim J, Cadilhac DA, Thrift AG, Donnan GA, Howard G, Howard VJ, Rothwell PM, Feigin V, Norrving B, Owolabi M, Pandian J, Liu L, Olaiya MT. Global stroke statistics 2022. Int J Stroke. 2022 Oct;17(9):946-956.
49. 49. Nugem R, Bordin R, Pascal C, Schott-Pethelaz A-M, Trombert- Paviot B, Piriou V, Michel P. Stroke Care in Brazil and France: National Policies and Healthcare Indicators Comparison. J Multidiscip Healthc. 2020; 13:1403-1414.
50. 50. Yaria J, Gil A, Makanjuola A, Oguntoye R, Miranda J, Lazo- Porras M, Zhang P, Tao X, Ahlgren JA, Bernabe-Ortiz A, Moscoso-Porras M, Malaga G, Svyato I, Osundina M, Gianella C, Bello O, Lawal A, Temitope A, Adebayo O, Lakkhanaloet M, Brainin M, Johnson W, Thrift AG, Phromjai J, Mueller-Stierlin AS, Perone SA, Varghese C, Feigin V, Owolabi MO. Quality of stroke guidelines in low- and middle-income countries: a systematic review. Bull World Health Organ. 2021;99(09):640-652.
51. 51. Norrving B, Davis SM, Feigin VL, Mensah GA, Sacco RL, Varghese C. Stroke Prevention Worldwide - What Could Make It Work. Neuroepidemiology. 2015;45(3):215-220.
52. 52. Feigin VL, Norrving B, George MG, Foltz JL, Roth GA, Mensah GA. Prevention of stroke: a strategic global imperative. Nat Rev Neurol. 2016;12(9):501-512.
53. 53. Hu S, Cui B, Mlynash M, Zhang X, Mehta KM, Lansberg MG. Stroke epidemiology and stroke policies in China from 1980 to 2017: A systematic review and meta-analysis. Int J Stroke. 2020;15(1):18-28.
54. 54. Jeyaraj D Pandian, Seana L Gall, Mahesh P Kate, Gisele S Silva, Rufus O Akinyemi, Bruce I Ovbiagele, Pablo M Lavados, Dorcas B C Gandhi. Prevention of stroke: a global perspective. Lancet. 2018;392(10154):1269-1278
55. 55. Ohannessian R, Dhote-Burger P, Chauvin F, Colin C, Nighoghossian N, Moulin T, Schott A. Health policy for telestroke in France: A retrospective description from 2003 to 2016. Rev Neurol (Paris). 2019;175(6):390-395.
56. 56. Feigin VL, Brainin M, Norrving B, Gorelick PB, Dichgans M, Wang W, Pandian JD, Sheila Martins SCO, Owolabi MO, Wood DA, Hankey GJ. What Is the Best Mix of Population‐Wide and High‐Risk Targeted Strategies of Primary Stroke and Cardiovascular Disease Prevention? J Am Heart Assoc. 2020;9(3): e014494.