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Mindful minutes

Thursday February 20, 2014
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Practicing mindfulness can help patients cope with the physical and emotional changes they face after experiencing stroke

Ninety percent of stroke survivors suffer cognitive deficit, along with 40% who experience moderate to severe physical impairments, according to a 2013 report from the American Heart Association. Nearly one-third of stroke survivors suffer from depression and many report feeling a loss of sense of self. Caregivers, too, are likely to struggle with difficult emotions and may influence how the stroke survivor copes.

Mindfulness-based interventions have shown promising results in the treatment of a variety of conditions in individuals with traumatic brain injury and stroke, including improvements in depression, anxiety, mental fatigue and an improved perception of health and quality of life, according to a recent study. The RN or APN has an opportunity, whether at the bedside or in a clinic or home visit, to introduce the concept of mindfulness to stroke survivor patients and their caregivers. It may provide a brief respite and plant a seed for future practice.

Mindful intervention tips

Create a safe environment
Give the patient and/or caregiver a brief explanation about mindfulness and its significance in improving quality of life. Ask if they’d be interested in trying an exercise. Consider the environment and do what you can to make their surroundings quiet and softly lit.

Play follow the leader
Guide your patient in exercises that can demonstrate the simplicity of mindfulness. These exercises are outlined in-depth in “Advanced Practice of Psychiatric Nurses: Integrating Psychotherapy, Psychopharmacology, and Complementary and Alternative Approaches” by Kathleen Tusaie, APRN-BC, PhD, and Joyce J. Fitzpatrick, RN, PhD, MBA, FAAN.

• Guide your patient in a deep breathing exercise. Repeat “I am relaxed” — “I am” (inhale), “relaxed” (exhale) — to help focus and slow a patient’s breathing.
• Take your patient through a progressive muscle relaxation exercise, a process of systemically tensing and releasing muscles throughout the body to bring both the body and mind to a more relaxed state.
• Facilitate a guided imagery session to help the patient use his or her imagination to find peace and relaxation. HealthJourneys.com offers a variety of guided meditation recordings, including a free 15-minute guided imagery audio for download.

Encourage exploration
Your patients might be interested in hearing about other mindfulness-based activities, such as yoga or tai chi, both of which have been shown to help stroke survivors improve physically and emotionally. You also can recommend some further reading, such as Jon Kabbat-Zin’s “Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life” or Mark Nepo’s “The Book of Awakening: Having the Life You Want by Being Present to the Life You Have.” Both provide short readings and exercises that can assist in the journey toward a more mindful approach to illness and recovery.

To see what else is trending in stroke, visit www.Nurse.com/Stroke.

References

“Meditation can help symptoms of anxiety, depression, study says”
— Nurse.com/Article/Meditation

CE 385 - “Research reveals the benefits of meditation”
— CE.Nurse.com/Course/CE385-60

“Considerations and strategies for educating stroke patients with neurological deficits”
— Journal of Nursing
Education and Practice

“A systematic review of the benefits of mindfulness-based interventions following transient ischemic attack and stroke”
— International Journal of Stroke

“A systematic review of qualitative studies on adjusting after stroke: lessons for the study of resilience”
— Disability & Rehabilitation

“Mindfulness in nursing: An evolutionary concept analysis”
— Journal of Advanced Nursing



Meaghan O’Keeffe, RN, BSN, is a freelance writer. Read her blogs at Scrubs.Nurse.com. Post a comment below or email specialty@nurse.com.