The Psychological Effects of a Cardiovascular Accident on a Patient

 he Psychological Effects of a Cardiovascular Accident on
a PatientT
A Case Study 
X.Y.
…. College
Month, Year
Our patient, Peter, is 42 years old. He is married and has two children, a daughter, who is 13
and a son, who is 11. Peter is highly qualified; whose job requires a lot of travelling and
human contact. He suffered a cardiovascular accident when he was at home with his family a
month ago. His life lacks certain risk factors, he does not smoke; drinks only socially and
frugally. He is emotionally stable and enjoys a happy marriage and family life.
In his life there are risks present, has one great source of stress, his work. He has a familiar
history of cardiovascular disease and his blood pressure is high as well.
The cardiovascular accident he suffered affected him in many ways. His emotional and
psychological well-being, his adjustment to the environment, his movement has changed. His
right side shows weakness and he has a mild expressive dysphasia. Certain therapeutic goals
have been set for him, e.g. improve walking, dressing practice, and work around the house.
His wife reported situations when he gets irritated with her or with the children. He has
difficulties to sleep and has occasional episodes of uncontrollable crying or laughter. The
psychologist working with him helps to set goals in the process of recovery. She tries to find
negative thoughts and unhelpful thinking styles and turn them into ones that are more
positive. The psychologist analyzes his behaviour for unproductive patterns and discusses
them with Peter. She involves the members of the family, particularly his wife to find the best
ways to help him. She encourages Peter to express his thoughts and feelings about his losses
and cooperates with him to explore new motivational pathways. She tries to teach him
effective strategies to manage his difficulty to sleep, to control his irritability and to cooperate 
more effectively with the persons in his environment. Peter has a changed relationship with
her wife; he feels their relationship lost some of the previous intimacy.
A cardiovascular accident is a life-changing event by most of the patients, not only for Peter.
Survivors require a lot of physical and emotional effort on the way of recovery every day.
Certain symptoms are more perceptible and obvious, but others are less evident even for the
patients and their families. (Thompson, Ryan, 2009) Cardiovascular accident patients can
have various symptoms and areas of problems. They could suffer from incontinence because
of limited ability to move and communicate. The inadequate nutrient intake is based on their
difficulty of eating. They are at risk of immobility syndrome due to paralysis and impaired
consciousness, as well as increased risk of accident. They show lower level of adjustment and
adaptation, have insufficient communication and their social relationships are weakened.
Lower self-esteem is also very characteristic, and problems with everyday tasks, e.g. dressing.
Dressing is a serious problem for cardiovascular accident survivors, because 54% of them are
unable to dress independently six months after the cardiovascular accident. (Walker, et al.
2011)
Post-stroke depression is the most common consequence of a cardiovascular accident; it is
also the most accessible for therapeutic intervention. Other frequently occurring symptoms
are dementia, anxiety disorders, emotional incontinence, paranoid disorders and mania. Poststroke symptoms and especially depression are left without recognition and therapy.
(Altindag, et al. 2008) The correlation between the localization of the cerebral lesion and
post-stroke depression is a much-debated issue. Biological factors are more important in the
early phases of cardiovascular accident, but in the late phase, social factors play a more
important role. After the cardiovascular accident, the situation of the patient changes 
dramatically in the social environment. Impairment, the limited ability of movement,
problems of communication and the accompanying somatic complications have a negative
impact and these factors strengthen each others effect as well.
The changes in the behaviour and mood of the surviving cardiovascular accident patients
present a great concern of their families. Depression is more likely to appear in hospitalized
patients than in patients recovering at home. Depression is associated with the loss of leisure
and social activities of the patient. Cardiovascular accident rehabilitation patients are
susceptible to abnormal illness behaviour or abbreviated AIB. (Clark, Smith, 1999) AIB refers
to maintaining sick role and illness behaviour when it is no more appropriate. Better family
functioning is associated with greater compliance with treatment programs and more patient
satisfaction with rehabilitation. We must be aware of the fact, that cardiovascular accident
survivors perceive their home to be the safest pl