Background: After an acute stroke, 90% of patients have cognitive deficits; 50% remain impaired and 30% develop dementia within one year. Cognitive recovery may not occur without early and coordinated care. Many cognitive deficits, i.e. memory and neglect, are not addressed early, care is not coordinated, and depends on each institution’s guidelines. Nurses must consider all patient needs yet no holistic cognitive recovery model exists to guide them.
Purpose: To create a holistic, post-stroke, patient-centered cognitive recovery model capable of guiding care.
Methods: Concept synthesis is a new way of grouping or ordering information when relevant data is unclear or unknown. A concept synthesis was performed due to limitations in prior biomedical models, specifically in psychology and rehabilitation, which resulted in ill-defined terms and bias.
Results: Cognitive recovery is defined as a transitional state in which a person’s cognitive abilities can be modified to approach pre-injury levels, by the interactions of personal capabilities and four encompassing Environments. Personal capabilities (acceptance, agency and congruence) are internally oriented forces which control self-care behavior. The Environments (resources or forces interacting to help/hinder recovery) are depicted as the Physical (the body), External (social support, therapists, etc.), Internal (psychiatric or emotional forces), and Created (belief systems, attitudes, etc.).
Conclusions: When interactions between personal capabilities and Environments are adequate cognitive recovery will progress. Recovery should be comprehensive and nurses are uniquely qualified to ensure all aspects of the person are addressed. This model promotes collaboration among healthcare providers and guidance in identifying and addressing patient needs.