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Transcript
Anxiety Management Toolkit Community Stroke Service 3rd Year Occupational Therapy / Nursing students Dec 2013 1 Introduction Why do we need a toolkit? The purpose of this toolkit is to provide members of the service with Information and resources that help identify and effectively manage anxiety problems experienced by stroke patients. How patients cope with the symptoms of anxiety after a Stroke plays a huge role in determining their current and future health and wellbeing, and their success in the rehabilitation/recovery process. When a patient is informed and educated about their anxiety(s) they are often more able to manage the symptoms and keep the effects of excessive anxiety to a minimum. Educating and empowering our patients by facilitating learning and the practice of helpful coping strategies is an essential part of selfmanagement. To be successful at self-management people with an anxiety disorder need to be able to recognize their anxiety symptoms when they occur. To make self-management easier, this toolkit includes information about the common characteristics of anxiety after a stroke, the main types of associated anxiety disorders, effective treatment options, and basic self-management strategies that can help reduce symptoms of anxiety. “Although 67% had experienced anxiety and 59% felt depressed, over half of those who responded to our survey did not receive any information, advice or support to help with anxiety or depression.” 2 Stroke Association 2013:5 Patient Information – Anxiety What is anxiety? Anxiety is a feeling of unease, such as worry or fear that can be mild or severe. Anxiety is common after stroke; it may continue for some months. Anxiety can affect people in different ways; physically, emotionally and behaviourally. Learning to recognise your symptoms will allow you to be more in control of them and understand what is happening. Psychological Symptoms: Anxiety can cause a change in your behaviour and the way you think and feel about things. Physical Symptoms: restlessness a sense of dread feeling constantly "on edge" difficulty concentrating irritability impatience being easily distracted Fight or Flight Response: This is an automatic response we experience when anxious, it is the body preparing to fight or escape a threatening situation. Heart rate and blood pressure increase Pupils dilate Muscles tense up Produce more sweat Blood-glucose levels increase Veins narrow dizziness drowsiness and tiredness pins and needles irregular heartbeat (palpitations) muscle aches and tension dry mouth excessive sweating shortness of breath stomach ache nausea diarrhoea headache excessive thirst frequent urinating painful or missed periods difficulty falling or staying asleep (insomnia) 3 Self-Talk This is being self-aware of your thoughts and managing them. Positive thoughts will create positive feelings When you have a negative thought you can change it into a positive thought. Examples of self-talk are; I can deal with this I am in control My coping powers are good I am calm I am relaxed These statements will help you see your goal more clearly and be able to achieve that goal. 4 Breathing Exercises This exercise will work on our breathing. This can be very relaxing. It can be helpful for those who feel dizzy or light headed when they feel stressed. You can use this exercise to help you relax at any time. Find a comfortable place. Work out a breathing rhythm, try to breathe in for 3 seconds, hold this breath for 2 seconds, and then breathe out for 3 seconds. It can be helpful to count as you do this (e.g. IN: 1-2-3, HOLD: 1-2, OUT: 1-2-3, HOLD: 1-2). Repeat this action for a few minutes. You should soon begin to feel more relaxed. 5 Cognitive Behavioral Approach CBT will help challenge beliefs and thoughts to develop coping strategies. Education about stroke as a condition Identifying issues and talking through these with family, friends, and professionals Reflection- Analyse the situation (refer to reflective cycle) Goal Setting- Set yourself some small achievable goals Diary keeping – Keep a note of thoughts, feelings, questions and anything that comes to mind. Graded exposure to fears- Take small steps within daily living activities 6 References Anxiety UK (2013). Post-Traumatic Stress Disorder. [online] available at <http://www.anxietyuk.org.uk> [22/11/2013] National Institute for Health and Clinical Excellence (2013). Social Anxiety Disorder Recognition, Assessment and Treatment. London: The British Psychological Society and the Royal College of Psychiatrists NHS (2013). Conditions. [online] available at <http://www.www.nhs.uk/conditions> [22/11/2013] Stroke Association (2013) Feeling Overwhelmed: The emotional impact of Stroke. London: Stroke Association Payne, R (2000) Relaxation Techniques: A Practical Handbook for the Health Care Professional. Churchill Livingstone, Edinburgh 7