Task-oriented training in rehabilitation after stroke
https://doi.org/10.25016/2782-652X-2023-0-85-51-59
Abstract
Relevance. After a stroke, patients encounter problems to adapt to living conditions and perform self-care. Moreover, they have to accept a new social role, as well as develop new attitudes to transformed value orientations and the meaning of life, which compels practitioners to develop a psychological assistance program to develop coping behaviors.
The objective is to study dynamics of self-attitude, as well as attitudes to the disease and treatment in patients after a stroke in the course of task-oriented group training.
Methodology. We studied 110 stroke patients (50 men and 60 women) aged 40 to 75 years with mild post-stroke cognitive impairment who underwent comprehensive post-stroke rehabilitation in a rehabilitation hospital before and after group training. The Spielberger-Khanin Personality and Reactive Anxiety Scale, as well as Hospital Anxiety and Depression Scale (HADS) were used; in addition, patients were rated on Mini-Mental Status Examination (MMSE), Barthel Self-Service Scale, Quality of Life (QoL) scale, and the scale of attitudes towards illness and treatment.
Results and analysis. Psychological modification training raised patients’ awareness regarding the importance of their own efforts in the treatment process and acceptance of a new social role. This helped to increase control over emotions, relieve fear of disease recurrence, resolve depression and resentment and boost self-care efforts to adjust the rate physical and neuropsychic stress. Having completed the training program, patients demonstrated significantly decreased reactive and personal anxiety, as well as decreased anxiety and depression according to HADS, together with improved QoL, Barthel Self-Service and MMSE score. The results of cluster analysis indicate a shift in selfesteem emphasis towards self-centeredness, holistic self-perception, and self-sufficiency from social frustration before the training; improved outcomes after training also include perception of health as a value (self-caring attitudes) and restructured hierarchy of life values.
Conclusion. Task-oriented training at later stages of post-stroke rehabilitation can help to strengthen compliance and positive self-attitude.
About the Author
N. G. Ermakova
Herzen State Pedagogical University of Russia
Russian Federation
Russian Federation
Natal’ya Georgievna Ermakova – Dr. Psychol. Sci., Prof., Department of Clinical Psychology and Psychological Assistance
48, Moika River Emb., St. Petersburg, 191186
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Review
For citations:
Ermakova N.G. Task-oriented training in rehabilitation after stroke. Bulletin of psychotherapy. 2022;(85):51-59. (In Russ.) https://doi.org/10.25016/2782-652X-2023-0-85-51-59
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