Nurses vital in stroke aftercare

National 2 minutes, 16 seconds


MANAGING impairments and disabilities among stroke survivors become increasingly important as stroke mortality rate in Brunei is steadily declining, according to a lecturer from Universiti Brunei Darussalam (UBD).

A literature review led by Assistant Lecturer Mursidi Hj Ali said there is evidence suggesting that “community-based stroke rehabilitation can reduce stroke-related disabilities” and can significantly reduce the likelihood of disabilities experienced within the first year after surviving stroke.

The review was published in “Brunei Darussalam Journal of Health” in April.

Stroke cases in Brunei have declined from 99 in 2010 to 70 in 2012. Demographic studies found those between 31 and 50 as the most susceptible, with men affected more than women.

Mursidi said nurses hold the key to unlocking the potential success of any thorough community-based rehabilitation programme, which Brunei is yet to have.

“The roles of rehabilitation for Brunei nurses seem to have been embedded in their daily care activities. This suggests a potential merit in advancing this ‘hidden’ role (aftercare) forward,” he said.

He added that he has no doubt that nurses have the ability to branch out from their traditional practice to more specialist professions.

Assessing, planning, implementing and evaluating which are the focus on existing models of nursing have guided the nurses’ daily practices. However, these activities are often viewed by patients, family or allied health professional as “non-therapeutic”.

“This is largely because nurses are seen as a ‘caring’ profession. Activities designated as ‘therapeutic’ and ‘treatment’ usually refer to structured therapy such as those undertaken by occupation therapists.

“For this reason, the contribution of nurses in rehablitation may be considered as an invisible and underappreciated therapy.”

Community-based rehabilitation services are defined by the World Health Organisation as a strategy focusing on rehabilitation, equal opportunities and social inclusion within the community.

The review said that the provision of community nursing services to support stroke survivors is at present assumed by the Home-based Nursing Unit.

“Given the variety of disabilities cases and the nature of care activities, the emphasis in stroke rehabilitation is questionable,” the review added.

It argued that “the lack of focus of stroke care can be due to issues surrounding the clarity of the nurses’ roles”. It also listed lack of stroke guidelines in post-stroke care and stroke rehabilitation knowledge as some of the contributing factors.

According to a 2013 publication by the South East Asian Medical Information Centre, Brunei has the fourth highest stroke mortality rate after Indonesia, Philippines and Singapore.

Ministry of Health also said stroke is one of the four leading causes of death among Bruneians for the past decade after cancer, heart disease and diabetes.

World Stroke Day is observed today by the World Stroke Organisation. This year’s theme is “I am woman: Stroke affects me”.

The Brunei Times