Permanent death of neurons caused by inadequate perfusion of a region of the brain or brainstem.

This disturbance is due to either ischemia (lack of blood flow) or hemorrhage.

Ischemic stroke.

Hemorrhagic stroke

The term major stroke is used to distinguish a full-blown stroke from a minor stroke, or transient ischemic attack (TIA).

Pathophysiology and Neuroprotective Strategies in Hypoxic-Ischemic Brain Injury and Stroke 1).

A common complication after stroke is development of Cognitive disorder and dementia

Effective strategies for reducing the risk of developing problems after stroke remain undefined. Potential strategies include intensive lowering of blood pressure (BP) and/or lipids.

A systematic review and data synthesis of randomized controlled trials and quasi-experimental studies was conducted. Papers were included according to the following criteria: 1) before-after design, 2) all types of stroke patients, 3) interventions that can be delivered by nurses, and 4) the primary outcome(s) were psychosocial. PubMed, Embase, PsychInfo, CINAHL, and Cochrane Library were searched (August 2019-April 2022). Articles were selected based on title, abstract, full text, and quality. Quality was assessed using Joanna Briggs Institute checklists and a standardized data extraction form developed by Joanna Briggs Institute was used to extract the data.

Results: In total 60 studies were included, of which 52 were randomized controlled trials, three non-randomized controlled trials, four quasi-experimental studies, and one randomized cross-over study. Nineteen studies had a clear psychosocial content, twenty-nine partly psychosocial content, and twelve had no psychosocial content. Thirty-nine interventions that showed positive effects on psychosocial well-being after stroke were identified. Effective intervention topics were mood, recovery, coping, emotions, consequences/problems after stroke, values and needs, risk factors and secondary prevention, self-management, and medication management. Active information and physical exercise were identified as effective methods of delivery.

Discussion: The results suggest that interventions to improve psychosocial well-being should include the intervention topics and delivery methods identified as effective. Since the effectiveness of the intervention can depend on the interaction of intervention components, these interactions should be studied. Nurses and patients should be involved in the development of such interventions to ensure it can be used by nurses and will help improve patients' psychosocial well-being.

Funding and registration: This study was supported by the Taskforce for Applied Research SIA (RAAK.PUB04.010). This review was not registered 2)

Meloni BP. Pathophysiology and Neuroprotective Strategies in Hypoxic-Ischemic Brain Injury and Stroke. Brain Sci. 2017 Aug 22;7(8). pii: E110. doi: 10.3390/brainsci7080110. PubMed PMID: 28829350.
van Nimwegen D, Hjelle EG, Bragstad LK, Kirkevold M, Sveen U, Hafsteinsdóttir T, Schoonhoven L, Visser-Meily J, de Man-van Ginkel JM. Interventions for improving psychosocial well-being after stroke: A systematic review. Int J Nurs Stud. 2023 Mar 28;142:104492. doi: 10.1016/j.ijnurstu.2023.104492. Epub ahead of print. PMID: 37084476.
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