The Experience of Post-Stroke Pain and The Impact on Quality of Life: An Integrative Review.
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ABSTRACT:
SUBMITTER: Payton H
PROVIDER: S-EPMC7464541 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
The Experience of Post-Stroke Pain and The Impact on Quality of Life: An Integrative Review.
Payton Hannah H Soundy Andrew A
Behavioral sciences (Basel, Switzerland) 20200807 8
<i>Background</i>: Many people experience post-stroke pain (PSP). It is a long-term consequence of stroke that commonly goes unrecognised and untreated. As a result, an integrative review is needed to identify the primary factors that affect PSP and determine the impact on quality of life (QOL). <i>Methods</i>: An integrative review using a quantitatively led data synthesis, supported by qualitative evidence, was conducted. <i>Results</i>: Fourteen studies were identified and 2415 (968 females, ...[more]
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Project description:BackgroundCognitive impairment can complicate minor stroke, but there is limited information on risk factors including peak cognitive ability earlier in life.MethodsWe recruited patients with clinically-evident lacunar or minor non-lacunar ischaemic stroke, recorded clinical features, vascular risk factors, magnetic resonance imaging-detected stroke sub-type and small vessel disease burden. At 1-3 and 12 months after stroke, we assessed educational attainment (years of education), current cognition (Addenbrooke's Cognitive Examination-Revised), pre-morbid intelligence (National Adult Reading Test) and dependency (modified Rankin Scale).ResultsWe recruited 157 patients (87 lacunar, 64 non-lacunar ischaemic strokes), median age 66 (inter-quartile range 56-74) years, 36/157 (23%) patients had a Addenbrooke's Cognitive Examination-Revised score < 82 at one to three months, 29/151 (19%) had a Addenbrooke's Cognitive Examination-Revised < 82 at one year. Lower National Adult Reading Test score (cognitive impairment per point on National Adult Reading Test odds ratio 0.91, 95% confidence interval 0.87, 0.95) and older age (per year of age odds ratio 1.04 (95% confidence interval 1.01, 1.08) predicted one-year cognitive impairment more than stroke severity (per point on National Institute of Health Stroke Scale odds ratio 0.96 (95% confidence interval 0.0.68, 1.31)) or vascular risk factors e.g. hypertension (odds ratio for diagnosis of hypertension 0.52 (95% confidence interval 0.24, 1.15). Cognitive impairment was associated with having more white matter hyper-intensities (odds ratio per point increase in Fazekas score 1.42, 95% confidence interval 1.11, 1.83).DiscussionThis observational study provides evidence that pre-morbid intelligence quotient and education predict cognition after stroke, and confirms the association between cognitive impairment and small vessel disease.ConclusionPre-morbid intelligence should be considered in future studies of post-stroke cognition.
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Project description:BackgroundPost-stroke pain is common after a stroke and might be underreported. We describe Persistent Facial Pain (PFP) developed in post-stroke patients.Methodology: This was a prospective hospital-based cohort study of stroke patients, and patients were followed up. Out of 415 stroke patients, 26 developed PFP.ResultOut of all PFP patients, six patients had an ischemic stroke, and 20 had a hemorrhagic stroke. 57.7% of patients had hypertension, while 34.6 patients had diabetes. The stroke location was left-sided in 12 patients and right-sided in 14 patients. 46.15% of patients responded to venlafaxine, 30.77% responded to amitriptyline, and 23.08% responded to pregabalin.ConclusionPersistent facial pain is a pain syndrome that might be missed in patients post-stroke. It might be more common in hemorrhagic stroke patients than in ischemic stroke patients. It responds adequately to antidepressants. A high index of suspicion is required to diagnose and appropriately manage these patients.
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Project description:Review-based research is needed which can establish the psychosocial outcomes and mechanisms of "storytelling and sharing" interventions for people with stroke. This information will act to inform the value and development of such interventions. An integrative review was conducted in three stages: (a) a systematic search strategy was undertaken to focus on articles between 2009 until January 2020 to locate articles the considered storytelling and sharing interventions for people diagnosed with stroke; (b) critical appraisal was undertaken to assess study quality; and (c) synthesis within three stages including data reduction, data display and conclusion. Fourteen articles (including 727 participants) were identified that met the eligibility criteria. Five themes were identified that represented the outcome and mechanisms that appeared to be associated with a stroke intervention. These included introducing the concept of hope and learning to be positive, the enhanced ability to cope, the impact of loneliness and social interaction, impact on emotions, depression and related emotions such as fear. Storytelling interventions appear to impact loneliness, introduce positivity and hope and enable coping through knowledge exchange. The main mechanisms which appeared to influence these outcomes were social comparisons and social control.
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