Psychosocial aspects of adaptation after a stroke

Abstract

A sudden and severe illness is stressful for patients, especially at the stage of early rehabilitation. Therefore, it is important to provide psychological assistance to patients undergoing rehabilitation (Ermakova 2022; Grigorieva, Tkhostov 2009). Rehabilitation after a stroke is a complex general biological and psychosocial issue which requires a biopsychosocial approach (Kadykov, Shakhparonova 2017). The versatility of assistance provided to the patient undergoing rehabilitation is possible to achieve through multidisciplinary teams (MDT). MDT includes, along with the attending physician, a neurologist, a physiotherapist, an occupational therapist, a physical therapy methodologist, a speech therapist and a psychologist. The purpose of the study is to explore the possible focus of psychological assistance in an MDT at a clinic. Psychological assistance aims to find out the patient’s attitude to the disease and treatment, assess the patient’s emotional state, the formation of adherence to treatment and adaptation at home. We observed 115 patients undergoing outpatient care at home after a stroke in 2016–2019. Their rehabilitation was facilitated by a clinical MDT. As part of the rehabilitation, the psychologist conducted a clinical interview; adjusted the patients’ attitudes towards themselves, the disease and treatment; facilitated the formation of a positive perspective on life, treatment and adherence to treatment. At the level of a microsociety, counseling aimed at improving the interaction between the relatives, helpers and the patient. The post-rehabilitation period showed positive trends in self-care indicators on the Barthel scale, cognitive function on the MMSE scale, and anxiety and depression on the HADS scale.