Thebrain is the most complex organ in the body. Stroke is caused by no oxygen tothe brain, without no blood flow to the brain it causes the cell to die. When thestroke happens on the right side of the brain, the left side of the body gets impact.The patient will have issues with speech and languages, loss of motion on the leftside; their behavior might alter. Majority of patients who suffers Ischemic stroke symptoms such assuddenly confusion, the trouble of speaking, blurred vision or dizziness. Ischemicstroke can last from 2-15 minutes.

Depressionafter stroke is a genuine neuropsychiatric confusion with a high rate ofpredominance following a stroke. The side effects of gloom after stroke arelike those of endogenous dejection; discouragement after stroke is portrayed by the fast improvement andbeginning of manifestations, a nonattendance of response to external components and restraint that caninfluence a few territories (Sugawara et al.,2015).Emotionalchanges following a stroke are once in a while tended to at the intense,restoration or outpatient phases of intercession. To be sure, they regularlystay undiscovered and therefore untreated, unless they are seen by medicinalstaff as sufficiently serious to warrant the mental audit. The care ofindividuals with extreme enthusiastic issues is then overseen by specialistsand, where analyze are made, pharmacological and psychotherapeutic medicineshave been accounted for (George, Wilcock & Stanley 2001). Theseuplifted horribleness and mortality dangers, in conjunction with the generalincrement in restorative usage recorded for geriatric depressive patientswithout stroke, recommend that patients with Post Stroke Depression maylikewise be in danger for higher therapeutic services use after stroke thanthose without post-stroke depression. Furthermore, although sorrow isthe most well-known emotional well-being condition after stroke, littleconsideration has been given to another post-strokeemotional well-being disorder.

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One reason for this is the high comorbidity ofother emotional wellness determined to have anxiety( Ghose, Williams & Swindle 2005).Confidencehas been recommended to be a possibly essential variable in the enthusiasticchange and practical result of beginning period survivors of stroke. Past workhas suggested that stroke negatively affects the survivor’s confidence andlower confidence evaluations have been related to more prominent levels ofrevealed depressive and uneasiness side effects self-consciousSC1  (Vickery et al.,2009) Depressionin stroke patients, when contrasted and the individuals who are notdiscouraged, have brought down survival rates; demonstrate less inspiration toexperience restoration; have more extensive healing facility stays and pooreruseful recuperation; and neglect to take part in recreational furthermore,social interests. As the dominant part of recovery is accomplished at abeginning period and as discouragement can weaken this recuperation, it isproverbial that early finding and treatment of sorrow is imperative (Watkins etal.

, 2007).     MethodDesign Before the study conducts the patient magnetic resonance brain imaging (MRI) will illustrationwhere the stroke appears in the patient brain.Physical strength will be measured byTime Up and Go Time (TUG). The damage left from the stroke might causethe patient to suffer from an emotional problemsuch as anxiety.  The Hospital Anxietyand Depression Scale will be used to forthe 150 stroke patients that are inpatientto complete seven questions asking themabout their anxiety levels. Also, 150outpatient post-stroke will complete ninequestions of their anxiety levels.

The Patient Health Questionnaire depression scale(PHQ-9) will be used. The total ofthe duration of the study will beapproximately one year, from December 2017 until December 2018.Participant A total of 300 stroke patients who suffers from ischemic were conducted from thestudy.  Stroke survivors will be a divided intotwo groups. There will be a study that will beconducted for inpatient and outpatient. 150 inpatient post-strokeanxiety who are compared to 150outpatient post-stroke anxiety.  In inpatient, there will be 85 male and 65females, and outpatient there will be 95 male and 55 females. The age range ofthe stroke patients are 23- 45 years old.

A cross section questionnaire and interview survey will be conducted byinpatient and outpatient stroke survivors. Hypothesis                 Outpatientpost-stroke patient will suffer more anxiety than inpatient post-stroke sincethey are in the rehab they are getting 24 hours care their mind is occupied ofgetting better, the therapist and doctors are keeping them busy. Description Post-stroke anxiety influences roughly two-thirds of ischemic stroke survivors, anxietyfrequently undiagnosed and insufficiently treated, andis related with increased conditionand fatality after stroke. Anxiety screening after stroke is critical also it can be challenged by lack of cognitive and physical. A stroke patient that comes throughthe emergency room the doctor will check to see what type of stroke the patientis having.

CT scan is a very crucial testfor the patient. The CT scan detects whatkind of stroke the patient has. The moment the doctor bust the blood clot inthe patient brain, the patient should start therapy immediately. The patientonly stays in the hospital for four days, if the patient remains longer than four days that’s mean theyhave other medical complication.  Theywill transfer the patient to inpatient rehabilitation.In inpatient rehabilitation, the patient will stay there fora month to get thread for physical therapy, occupation therapy, and speech therapy.

Therapy beings in the acutecare after the patient overall condition has been stabilized. The first thingthey should do is promote independent movement because the patient might beparalyzed or have serious weakness. While the patient is in inpatient rehabilitation, the therapist will measure thepatient progress of balance, sit to stand and walking. While the patient is inrehabilitation it will helps the stroke patient with relearn new skill of whatthey lost. Doctors primary responsibility isto care for the patient general health and provide guidance. Sometime doctorsoverlook the patient psychological wellbeing.

The doctors only worrying aboutthe patient physical wellbeing they are neglecting the psychological apart. Ifthe patient is feeling frustrated and angry that stroke survivor will not beable to improve his physical wellbeing. While the stroke patient is layingin the hospital bed feeling frustrated and angry, thinking what is next forthem. Now they are getting comprehended what happened to them. The stoke survivorsare thinking when I am going back to work. If the patient cannot go back to theirold job, what are they going to do for money. How they going to support theirfamily. they don’t want to be a burned to anyone.

The patient start gettinganxiety attack by thinking about their new life. The stroke survivor stopsprogressing in therapy and stop eating. The therapist will the gave the patientthe hospital anxiety depression scale it depends on the result the mightprescribe medication.The stroke survivor is out ofinpatient rehabilitation, now the patient is home. They are going to outpatientrehab three days a week.

When they are in therapy their mind is focus ongetting better.  When they are at homethey are worrying about their health and how they going to resume their lives.The patient is in the house grief about their physical and mental health, andplaying the blaming game. The patient will start crying they don’t want to eatthey just want to lay in bed not doing anything. In their mind they think theywill never be normal. Now patient been home for threemonths, no more therapy the patient been discharge from outpatient therapy forthe last two months. Now he or she are in denial. They are in the house allday, only time the patient goes outside is when they are going to doctor’sappointment.

In their mind they cannot see any progress they have made because thestroke survivors speech still has the slurred, they can’t feel the sensation intheir left hand and they not able to walk without a walker. The stroke patientsget angry because he or she have lost their independent, they must dependent onsomeone to help them do the basic of essential such as getting dress and beating.The patient will be trying to speak but not able to put word together. Thepatient start getting frustrated and the middle of nowhere they start crying.five months pass the patients onlygain 50 percent muscle strength on their life side. The stroke survivor ishappy to see that they are regain some type of muscle strength.

The strokepatient start feeling sad because they are seen people going back to theirnormal activities, they are not able to regain their normal activities back.the stroke patient used to like doing home exercise to rebuild their musclestrength back. As time goes by they lost interest in the home exercise.  The patient used to enjoy playing with theirchildren, suddenly they stop playing with the kids.  Now only thing the wants to do is sit by thewindow and stare at the window.

The patient energy start decreasing and theyhaving difficult time going to sleep. The patient is stressing about finances,how they going to pay for medical bill and how they going to support theirfamily because they are not able to go back to work yet. Even though the car isin the drive way they are not able to drive it. Every major move they made theyneed someone assistance. The patient seen all this limitation they must gothrough, they are feel worthless.   Nine months after the post strokethe patient wants to resume work. Before the patient need to go back to workthey need to be aware of their limitation, the work they used to do, they mightnot to be able to complete the task.

When the patient resumes back to work itwas not easy getting around the company. The patient will try to type a simple sentence in the computer theirleft arm gets tired quickly, patient often become exhausted when they are doingsimple task.  While the patient is backat work, the patient will have issue communicate with their coworker. Viceversa the patient is having difficulty understanding what the coworkers aresaying to them.Now the patient had to resign fortheir job position because they are not able accomplish their duties.

Nowanxiety step in, the patient feels like a failure. They are asking themselvesquestion why are they still alive they should have die. The patient does notwant to be bothering to do anything. They withdraw of the things they like todo. The patient start getting jitteriness and loss of appetite. Patient islosing weight to fast in a short period of time. When the patient sees othersare going to work, the patient will start throwing up. The patient is notsleeping so there is dark stress under patient eyes.

The patient is fear thatthey might never work again. Patient is worrying about they can get anotherstroke again. The men are afraid to have sex they might get a stroke duringsex.    Patientfamily see how the patient withdraw themselves from activities and all they dois stare at the window. The family can set up and find support group. Strokesupport group will help the patient to see they are not alone their others inthe same position as them.

They will hear other people stories.  From their stories they will find strengthand they will be able to make friends. They have a haven to go to.Two month later patient is feelingbetter, the patient has a better understand of their condition.

The patient isvolunteering at the center where they attend support group. The patient isworking part time job three days a week. Now patient is feeling better, thepatient stops watch their diet, stop exercising and stop taking the medication.  The patient will skip doctor’s appointmentand sometimes they might even go. Three weeks later the patient had anotherstroke in the right side of the brain. This time is going to take them longerto recover.ResultTotal of 300 patients were enrollin the study, 150 are outpatients and 150 are inpatient. The age range of the strokepatients is 23 to 45 the majority of patient are males.

Females who are married(60%) male who are married (40%), stroke patient who live alone (20%) andpatient that lives in the urban areas (55%). Seventy percent of the strokepatients has highest level of education, twenty percent of stroke patients has ahigh school education. Ten percent of the stroke patients has no education. Fortyfive percent of the stroke patient had a current job and the rest of the strokepatient had no job. Analysis results will primary bebase on the sign of the stroke symptom with only 75 patients have CT scan done.85% of the CT scans will confirm ischemic stroke, while 1% will show sign of hemorrhagicstroke.  Inpatient Thirty-five percent of the strokepatient will be able to recognize their anxiety of the stroke, by respondingyes or no to the question. Seven-five strove survivor will perceive theiranxiety as being serious.

Forty percent will mention lack of energy, withdrawfrom love one and fear. Other factors will mention by the patient how long isthe recovery are will they be able to go back to normal life. Twelve percent ofthe stroke patient mention other alternative medicine and faith.  Outpatient                Sixtypercent of the stroke patients will be able to recognize their anxiety of thestroke patients by responding yes or no to the question. Twenty percent will perceivetheir anxiety as being serious. Fifty percent will mention loss of interest,lack of energy, low self-esteem, sadness, lack of concentration and weightloss.

Other factors will mention by the patient when are they going back towork. Patient will ask will they be able to drive again, and will they be ableto speak clearly? Forty percent of the stroke survivor mention other alternativetreatment such as therapy and faith healing and other.  SC1