Why you think this patient's case is important

Patient’s case is important for the physiotherapist as through identifying the background of the patient including medical records, past medication, family environment and social factors of the patients, the health and social care professionals can acknowledge the actual condition of the patients and the history of the patient which is necessary for providing better treatment (Considine and Currey, 2015; Hagiwara et al., 2016). In order to provide better care and treatment, it is essential for the health and social care professionals and physiotherapist to understand the requirements of the patients and pathology of stroke so that the care professionals can deliver better care and treatment to the patients (Douglas et al., 2016).

Stroke is a cardiovascular accident due to acute neurological deficit of blood supply and it is considered as third leading cause of death (McClave et al., 2017). The ethology of the stroke is such as complication of several disorders, hypertension, smoking, diabetes, heart diseases, atrial fibrillation as well as other symptoms like trauma, fat embolism, tumour, infection and caissons disease. The case analysis of the stroke patients is also helpful for the care professionals, physiotherapist and health practitioners to maximise the expectations of the patients and help them to overcome their health issues and disabilities, which in turn provides a scope to the patients to improve their standard of living and they start living normal lives like others where the physiotherapists try to make the individuals independent through proper support and care (Kalra et al., 2017; Considine, J. and Currey, J., 2015).

Case presentation – The main clinical features and assessment findings, pertaining to the patient and their pathology including relevant social, and family history throughout the different stages of the patient’s presenting condition

Through pathology of stroke, it is possible for the physiotherapist to diagnose the patient and treat the patient who is suffering from stroke. There are two types of stroke, on is ischaemic and other is haemorrhagic stroke and these affect brain and it can have different symptoms (Considine, J. and Currey, J., 2015; McClave et al., 2017). The main cause of the ischaemic stroke is smoking, high blood pressure, diabetes, obesity, high cholesterol levels as well as excessive alcohol intake. another type of stroke is haemorrhagic stroke, which is less common like ischaemic stroke and it occurs when a blood vessel within the skull bursts and bleeds into and around the brain (Considine, J. and Currey, J., 2015). The main cause of this type of stroke is being overweight or obese, drinking excessive of alcohol as well as smoking, lack of exercise and stress which rise blood pressure of the person where the physiotherapist aim to assess, manage and treat the broad range of medical conditions of the patients suffering from stroke (McClave et al., 2017).

As per the family history, the patient lives with his parents with two elder brothers and elder sister. The age of the individual is 45 and he is unmarried. stress in life as well as lack of job satisfaction, he is suffering from depression and it leads him towards high consumption of alcohol. as per the social life, he suffered from social isolation as he is alcohol addicted and detached from the social functions and social integration which raise loneliness in his life. In the present case study, the parents of the patient are also suffering from high blood pressure and diabetes for which it is genetic for the patient to have diabetes and blood pressure. Negligence and lack of awareness in consuming medicine of diabetes and blood pressure leads the individual to suffer from stroke. In addition to these, high consumption of alcohol due to stress and depression in his life for unemployment and lack of job satisfaction is another reason of stroke. As per the International Classification of Functioning, Disability and Health (ICF), the person is suffering from any such disability, but he suffered a lot due top obesity, high blood pressure and diabetes and he is under treatment of diabetes and blood pressure.

Treatment and/or management – Detailing the actual treatment and/or management strategies employed at the present stage of their condition and outline those appropriate for the different stages of the patient’s presenting condition

The patient needs proper diagnosis and follow up assessment as well as treatment so that the physiotherapist can provide effective care and manage the patient efficiently. in this regard, According to American Heart Association and the American Stroke Association recommend that the health care providers must be concerned about FAST in recognising stroke which includes Face Drooping, Arm Weakness, Speech Difficulty and Time to call (Eskes et al., 2015). First considerations of the stroke patients are such as circulation, airway and breathing for blood pumping, neuro assessment, acknowledging no airway blockage and ensure that the patients can breathe with adequate blood pressure control. In this regard, these diagnose, and first-hand treatment of the patients reduce the death rate among the stroke patients, where the doctors and nurses are efficient to manage the stroke patients and provide efficient treatment to the patients carefully by understanding their capacity to accept the treatment and management procedure which in turn helps to improve follow up assessment of the patient. it is the role of the physiotherapist to provide efficient support to the patient so that they can get relief from pain and heal injuries from stroke.

In this case, the physiotherapists cooperate with the physical therapist, occupational therapist and speech pathologists who are able to treat the patients by providing him proper information to lead a normal life through daily exercise, regular medicine consumption and heathy diet which will be effective for the patient to improve wellbeing and live safely as well as the patients can increase mobility, build strength, improve balance in their lives to enhance the cardiopulmonary performnace (Kunz et al., 2016). Physiotherapist is also necessary to take active part in the intervention process, and the therapist plays a crucial role in treating the stroke patients where daily exercise and motivational approach through yoga are effective for the patient to improve the health condition and live a safe life. In this case also, the physiotherapist is necessary where the patient is suffering from laziness and he does not get strength to do daily activities. Daily exercise and yoga must be included in the care plan for the patient through which he can overcome his difficulties and improve his health condition as well as mental health property. In this present case also, the speech pathologist is also required to motivate the patient as he is depressed for his family life and lack of job satisfaction which leads him toward stressful life and the tendency of self-harm also raises due to existing problems.

For follow up assessment of the patient, the physiotherapists monitor him with regular interval and evaluate the outcome of his health condition. through proper X-ray and CT scan as well as interaction with the patient. It has been explored that, the patient is not interested in doing regular exercise which may raise difficulties in his health condition as well as the patient feel demotivated after the stroke attack which deteriorate his mental health and physical health condition, and in this regard, the physiotherapists play a crucial role to motivate the patients, provide training and posture corrections as well as collaborate with the patient for maintaining proper muscle and joints exercise for increasing patient’s mobility.

Discussion – Using contemporary evidence available, justify why the particular assessment and treatment and/or management strategies were selected in the acute and chronic (or persistent) stage of the patient’s condition. You will also reflect upon the success of the chosen assessment and treatment strategies employed with your chosen patient case study

In order to treat the stroke patient with appropriate treatment and quality care, it is necessary for the physiotherapists to make effective patient assessment as well as develop appropriate treatment or management strategy for treating the patient with care and proper support so that the individual can overcome the trauma or health issues (Considine and Currey, 2015). Hereby, both the patient assessment and the management process of treating the stroke patient with medication, exercise and tPA are effective for the physiotherapists to provide the best possible treatment and care to the patients. In this patient’s case, the assessment of the patient includes family, social, personal and medical assessment through which the care providers can acknowledge the actual needs and preferences of the patients. The family assessment is effective for understanding the family background, culture as well as communication at the home of the patient as these factors affects the lifestyle and mental condition of the patient (Wardlaw et al., 2015).

After first-hand treatment, the patients will have thrombolytic therapy (tPA) which is an effective for clot busting or clot retrieval which is necessary for the stroke patient. in the present case study, the patient is diagnosed properly by the doctors and the nurses who are proficient in managing the patient with proper treatment and quality care (Faria et al., 2016). Apart from tPA, the patient will have rehabilitation on order to manage the individual with care and support where the patient can lead a normal life like previously which is the major role of the physiotherapist where the physiotherapists aim at assessing, managing and treating the [atinet and lead them towards a normal life. In this case also, rehabilitation is necessary for managing the patient with care and support for controlling his anxiety, depression and the tendency of self-harm. In addition to these, the care providers are concerned about speech, arm and strength of the patients in order to recognise stroke among the patients. After initial assessment, the patients are diagnosed through x-ray and CT scan in order to identify blood clots in the patient’s body through which the doctors and care professionals can understand the internal condition of the patients.

In addition to these, the treatment and management strategy through exercise are also effective for treating the patient with care and support through which the patient can overcome his problems and health issues and live a normal life like others where the physiotherapists cooperates with the patient for give relief to him from physical pain and injuries. The treatment of tPA is one of the effective ways to treat the patient in this stage where the patient is going through depression, anxiety and stress due to of job satisfaction and poor finance which deteriorate the quality of life of the patient. In this regard, the tPA approach of treatment provides a scope to the health care professional to treat the stroke patient and reduce blockage as well as motivate him to control diabetes and blood pressure by intaking medicines in a regular basis. The problem list includes lack of concern about doing regular exercise, intaking the prescribed medicines on right time, lack of awareness about regular diet to the doctors and lack of communication which are the main difficulties for which the regular follow up assessment cannot be conducted by the physiotherapists but it is the role of the physiotherapists to make effective follow up assessment during the treatment provided to the patients and in this regard, the physiotherapists tries to assess the patient and acknowledge his current health issues and personal preferences to develop proper care plan. In this regard, it is necessary for the physiotherapists to intervene proper process to treat and manage the patient with care and treatment. In this regard, the physiotherapist tries to visit his home regularly and communicate with him on a regular interval so that it is possible for them to motivate him by speech and sharing views. this is SMART goal where the care professionals aim at enhancing the mental and physical health condition of the patient through improving communication. This is specific and measurable goals as the physiotherapists can visit his house for discussion his health condition and the way of medicine intake and exercise. the gaol is also achievable and reliable where the doctors can fulfil it within proper time through regular monitoring, motivating him with motivational speech, encouraging him to take medicines and doing regular exercise.

Additionally, counselling and rehabilitation is one of the effective ways to manage the stroke patient with care and help him to improve health and mental condition (Considine and Currey, 2015). In this regard, motivational speech by the speech pathologists and counselling is also necessary where the professionals can treat the patient and guide him with proper medication and motivate him to control his blood pressure and diabetes by intaking proper education daily and it would be beneficial for him to avoid stroke in future. These are the major management strategies for the patient where the physiotherapists are proficient in supporting the patient with proper medication, exercise, techniques to maintain therapy of muscles and joints and treatment. Through interacting with the patient, it is easy to acknowledge his needs and preferences as well as positive communication also provides an opportunity to the staff members doctors and nurses to diagnose the patient and conduct follow up assessment as well as encourage him to do regular exercise, motivate him for healthy diet and medicine intake daily. Counselling is effective to share information as well as empower the patient in the care plan where the patient can choose the treatment and express his feelings and thoughts regarding specific treatment. This management strategy of enhancing communication with the patient and rehabilitation are hereby beneficial for the physiotherapists to provide the best possible care and efficient services to the individual for helping him to get back to the normal life, imporve cardiopulmonary performnace, make the individual independent and improve activities in daily life of the patient by reducing alcohol consumption and smoking as well as raising concern of healthy diet, exercise and medicine consumption.

Reflective learning points – 2 bullet points detailing what you have learnt from the assessment of a patient with this condition and 2 bullet points detailing what you have learnt from the treatment and/or management of a patient with this condition

Patient assessment is beneficial for me to improve understanding about the patient’s case and from the assessment, I have learnt that, the condition of the patient depends on the family background and the social value of the individual which have significant impacts on the patient where he is consuming high level of alcohol and smoking which are the major cause of his stroke. The treatment and management strategy are important, and it helps me to improve my understanding about the treatment and management strategic planning of the stroke patient.

• Enhancing communication:

  Enhancing communication for rehabilitation and counselling is necessary for me as a physiotherapist in the health and social care to treat the stroke patient with care and quality support. I came to know that, through communication, it is also possible to interact with the patient and build strong bond so that the patient can rely on the nurses and express their feelings. From the present case, I also came to understand that, through communication, it is easy to understand the problem faced by him in his life as well as it is also possible to improve trust and loyalty. In addition to this, I came to know that, enhancing communication is important for improving cooperation and developing working in partnership practice for treating the stroke patient carefully and fulfil the aim of rehabilitation and counselling. I also came to know that, managing the patient is necessary where direct face to face interaction helps the patient to express his thoughts and feelings and discuss about his personal preferences and needs.

• Patient centred care:

  I have learnt from the treatment that; it is necessary for the physiotherapists to empower the patient so that the individual can express his feelings and thoughts in front to the social carers and health professional. Through patient centric care, it is possible to develop a cooperating working practice with proper cooperation with the patient. I also come to know that, it is necessary in the health and social care to develop patient centric care in order to maximise wellbeing of the patient by providing them proper care and treatment according to the patient’s preferences and health needs. In this present case also, I have seen that, empowering the patient in the care plan including medication, doing exercise and other training for improving muscles and joint of the patient which are affected by stroke, conducting diagnosis through CT scan and blood tests, tPA therapy as well as counselling and rehabilitation is necessary to encourage the patent to take active part for improving his health condition and mental health. Hereby, patient centric care through empowering the patient is necessary for the physiotherapists as well as speech pathologist, and occupation therapist for cooperation, communication and developing effective care plan for the stroke patient.

Reference List

• Breitenstein, C., Grewe, T., Flöel, A., Ziegler, W., Springer, L., Martus, P., Huber, W., Willmes, K., Ringelstein, E.B., Haeusler, K.G. and Abel, S., 2017. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting. The Lancet, 389(10078), pp.1528-1538.
• Considine, J. and Currey, J., 2015. Ensuring a proactive, evidence‐based, patient safety approach to patient assessment. Journal of Clinical Nursing, 24(1-2), pp.300-307.
• Douglas, C., Booker, C., Fox, R., Windsor, C., Osborne, S. and Gardner, G., 2016. Nursing physical assessment for patient safety in general wards: reaching consensus on core skills. Journal of clinical nursing, 25(13-14), pp.1890-1900.
• Eskes, G.A., Lanctôt, K.L., Herrmann, N., Lindsay, P., Bayley, M., Bouvier, L., Dawson, D., Egi, S., Gilchrist, E., Green, T. and Gubitz, G., 2015. Canadian stroke best practice recommendations: mood, cognition and fatigue following stroke practice guidelines, update 2015. International Journal of Stroke, 10(7), pp.1130-1140.
• Faria, A.L., Andrade, A., Soares, L. and i Badia, S.B., 2016. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients. Journal of neuroengineering and rehabilitation, 13(1), p.96.
• Hagiwara, M.A., Nilsson, L., Strömsöe, A., Axelsson, C., Kängström, A. and Herlitz, J., 2016. Patient safety and patient assessment in pre-hospital care: a study protocol. Scandinavian journal of trauma, resuscitation and emergency medicine, 24(1), p.14.
• Kalra, L., Irshad, S., Hodsoll, J., Simpson, M., Gulliford, M., Smithard, D., Patel, A., Rebollo-Mesa, I. and STROKE-INF Investigators, 2015. Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial. The Lancet, 386(10006), pp.1835-1844.
• Kunz, W.G., Hunink, M.M., Sommer, W.H., Beyer, S.E., Meinel, F.G., Dorn, F., Wirth, S., Reiser, M.F., Ertl-Wagner, B. and Thierfelder, K.M., 2016. Cost-effectiveness of endovascular stroke therapy: a patient subgroup analysis from a US healthcare perspective. Stroke, 47(11), pp.2797-2804.
• McClave, S.A., Taylor, B.E., Martindale, R.G., Warren, M.M., Johnson, D.R., Braunschweig, C., McCarthy, M.S., Davanos, E., Rice, T.W., Cresci, G.A. and Gervasio, J.M., 2016. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). Journal of Parenteral and Enteral Nutrition, 40(2), pp.159-211.
• Wardlaw, J.M., Brazzelli, M., Chappell, F.M., Miranda, H., Shuler, K., Sandercock, P.A. and Dennis, M.S., 2015. ABCD2 score and secondary stroke prevention: meta-analysis and effect per 1,000 patients triaged. Neurology, 85(4), pp.373-380.