A systematic review of nursing rehabilitation of stroke patients with aphasia.
OBJECTIVE
To explore the evidence on rehabilitation of stroke patients with aphasia in relation to nursing care, focusing on the following themes: (1) the identification of aphasia, (2) the effectiveness of speech-language interventions.


BACKGROUND
Patients with poststroke aphasia have higher mortality rates and worse functional outcome than patients without aphasia. Nurses are well aware of aphasia and the associated problems for patients with stroke because they have daily contact with them. The challenge is to provide evidence-based care directed at the aphasia. Although rehabilitation stroke guidelines are available, they do not address the caregiving of nurses to patients with aphasia.


METHODS
Systematic review.


METHODS
Published studies were reviewed, focusing on identification and treatment of aphasic patients after stroke in terms of the consequences for nursing care. Also, data concerning effective speech-language interventions were extrapolated into nursing practice with respect to the classification of nursing interventions.


RESULTS
Intensive speech-language therapy, which was initiated in the acute stage post stroke, showed the best rehabilitation outcomes. Trained persons other than speech-language therapists provided effective speech-language interventions. Speech-language therapy included several types of intervention that met nursing intervention classifications.


CONCLUSIONS
The contribution of nursing to the rehabilitation of patients with aphasia is relevant. The use of screening instruments by nurses can increase early detection of aphasia, a precondition for initiating timely speech-language therapy. Collaboration between speech-language therapists and nurses is of the utmost importance for increasing the intensity and functionality of speech-language exercises, which may enhance the quality of treatment.


CONCLUSIONS
The findings of this study can be used to develop nursing rehabilitation guidelines for stroke patients with aphasia. Further research is necessary to explore the feasibility of using such guidelines in clinical nursing practice and to examine the experiences of patients with nursing interventions directed at aphasia.
Poslawsky
Irina E
IE
Division of Neuroscience, Rudolf Magnus Institute, University Medical Center Utrecht, Utrecht, The Netherlands. i.e.uitewaal@umcutrecht.nl
Schuurmans
Marieke J
MJ
Lindeman
Eline
E
Hafsteinsdóttir
Thóra B
TB
D000368:Aged; D001037:Aphasia / Q000209:etiology / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000150:complications / Q000451:nursing*; D000071939:Stroke Rehabilitation