Symptom Clusters of Stroke Patients By Rehabilitation Stages

Purpose: The individuals with stroke would suffer from disease associated symptoms which influence their functioning in everyday life. These symptom clusters were usually known to be sharing similar underlying mechanisms. The purpose of this study was to explore specific symptom clusters of stroke patients to categorize them according to their stages of acute (3 months), sub-acute (3-6 months), and chronic conditions (6-12 months, or longer than 12 months) during rehabilitation process.

Methods: Total of 27 patients at each rehabilitation stage were invited to have in-depth interview to explore their experience of stroke related symptoms. The questions were formulated to their experience of various symptoms from the acute stage within 3 months, from 3 to 6 months, from 6 to 12 months, and after 12 months. The interview contents were transcribed into the text to further analyze the category and severity of symptoms by each rehabilitation stages, and consequently to develop the checklist of symptom cluster among stroke patients.

Results: Seven to eight participants in each stages of rehabilitation agreed to participate in the in-depth interview. The transcribed texts revealed stroke patients have experienced various symptoms classified as the areas of cognition, movement, sensory, language, memory, emotion, and others. The symptom clusters were also assessed according to their stage of rehabilitation. The analysis with in-depth interview transcription showed that the patients experienced more symptoms in physical (ie., pain) and movement area during acute and sub-acute stages, and more symptoms in cognition and memory area during chronic stages. Symptoms related to sensory or language areas were usually developed according to the injury area, and tend to be alleviated as time passes.

Conclusion: The findings of the study would provide various symptoms experienced by stroke patients, and the severity of each symptom clusters was different according to their rehabilitation process. The effective nursing intervention designed to improve quality of life for stroke patients should be developed based on their symptom clusters as well as their stage of rehabilitation. Further study is warranted to analyze the data quantitatively to measure the effect of specific nursing intervention program on symptom management and quality of life in this population.