Análisis descriptivo sobre los estilos de aprendizaje

The stroke epidemic is projected to worsen in the developing countries over the next two decade by World Health Organization‘s report (WHO, 2008). Its rehabilitation and hindrances to rehabilitation is a problem to the world at large however, a specific problem to these developing countries and especially Nigeria because of her size, neglect of rehabilitation developmental projects through heavy governmental corruption and lack of efforts by the government and professional bodies, thereby having a heavy reliance on foreign rehabilitation programs which are not suitable for this environment.

Another significant relevance of this study is the development of Psychological Impairment Index Scale for the use among stroke survivors. This

words and be able to offer help in these specific domain. Another, significant thrust of this research is in its theoretical and knowledge relevance because it will bring out the bio-psychophysical factors that affect the development of post-stroke psychopathology especially depression in stroke populations. There had been a dearth of research in this area because the available researches had been focused on the biological aspects and physiological sides of stroke patients, but this study is looking at providing useable / step by step manual modules for treatment of stroke survivors in Nigeria and the world at large. The studies done in these areas before are in the western cultures and they had been carried out by nurses and other health workers who do not have prior training in psychological interventions which brings in major flaws in the method of carrying out the research. Although studies have documented the efficacy of problem solving and cognitive behavioural therapy (in separate usages) in the western cultures (Kneebone & Dunmore, 2000; Mitchell et al., 2008; Busko, 2008) and conflicting results using cognitive behavior therapy alone but not cognitive rehabilitation therapy. These studies did not assess the physical disabilities as precipitating factors for post – stroke depression and more importantly, no study had been done in the area of psychotherapeutic intervention for Post-stroke depression patients in Nigeria. Continuing advances in cognitive neuroscience have broadened our understanding of the anatomy and neurophysiology of cognitive function and its disruption after brain injury. Recent work in basic neuroscience has also enhanced knowledge of learning and brain reorganization after injury, especially in response to the highly structured treatment provided in rehabilitation. Further research will continue to provide the underpinnings for theory and design of effective rehabilitation, including treatment for cognitive dysfunction (Brain Injury Association of America, 2006).

The importance of taking care of a special population of stroke survivors cannot be overemphasized in terms of reduction in the burden of care, higher quality of life of survivors and care givers, better health outcomes and adherence to treatment regimes which will chart a blueprint for the care of the stroke survivor population.

Therefore, there is significant potential benefit for effective prevention, diagnosis, and treatment of Post-stroke depression. The use of the practical and follow-able modules will further enhance the understanding of psychological dysfunction in plain medical/physical illness and how this can be tackled. It will also assist in the development and evaluation of further developments of new treatment approaches. In addition, this study will empirically determine the influence of bio-psychosocial factors on post – stroke depression, providing better understanding of the dynamics at play, so that the neuro – multidisciplinary team members can predict more accurately who is likely to be depressed after a stroke episode and the designing of the functional analysis in treatment and its evaluation.

Treatment services for post – stroke survivor population are haphazard to say the least in many LAMIC (Low and Medium Income Country) countries like Nigeria, despite the availability of professionals who can provide this services and efficacy of their service delivery packages either because the primary physicians are not promoting the use of these services or because of the unawareness of the availability and efficacy.

This is a major hurdle this research work is crossing in bringing the empirical and evaluating the evidence in the scientific podium.

Finally, although Psychotherapeutic interventions had not always been accessible to patients in the neurological clinics in Nigeria, involvement of clinical psychologists can help patients in thorough assessment, enhance coping strategies and

mind the specific needs of these patients. These clinicians can facilitate coping processes whenever they treat their patients to understand what part of the illness is under their control (e.g. by supplying them the resources that they can draw from in the process of rehabilitation and by teaching them constructive cognitive rehabilitation strategies and social skills training).

Considerable progress has been made in the development of cognitive rehabilitation methods that improve practical, daily life function in stroke patients.

Overall, support exists for the effectiveness of cognitive rehabilitation of neglect and aphasia in stroke. However compensatory strategies are the mainstay of managing patients with memory disturbances. Cognitive scientists and rehabilitationists must work ever more closely to fulfill their potential for furthering scientific understanding of the brain and improving the lot of patients.

CHAPTER TWO LITERATURE REVIEW 2.0 Theoretical Background

This chapter deals specifically with the review of relevant theories and empirical literatures. It will be approached thus: Explanations on medical model, application of the medical model to the study, criticism of the medical model, bio-psycho-social model, application of the bio-psychosocial model to the study, criticism of the bio-psychosocial model, cognitive theory of depression, application of cognitive theory of depression, criticisms of the cognitive theory of depression, Levin‘s conservation model (Levin,1967), application of the Levin‘s theory, criticisms of the Levin‘s theory, Ruminative response styles theory(Nolen-Hoeksema,1991), application of ruminative response styles, criticisms of ruminative response styles, Health belief theory (Hochbaum, Rosentock, and Kegels,1958), applications of health belief model theory, criticisms of health belief model, Ecological theory (Brofenbrenner, 1994), Application of ecological theory and criticisms of the ecological theory.