HOLISTIC NURSING APPROACHES INSTROKE MANAGEMENT: ACUTE CARE TOCOMMUNITY REINTEGRATION

Abstract

Stroke remains a major global health burden because its consequences extend beyond mortality to substantial loss of healthy life through disability. The Global Burden of Disease (GBD) 2023 analysis estimated approximately 157 million disability-adjusted life years (DALYs) attributable to stroke in 2023, while the corresponding analysis of causes of death confirmed that stroke continues to make a substantial contribution to global mortality (GBD 2023 Disease and Injury and Risk Factor Collaborators, 2025; GBD 2023 Causes of Death Collaborators, 2025). These measures capture different dimensions of disease burden: mortality reflects loss of life, whereas DALYs incorporate both premature mortality and years lived with impaired health. Accordingly, the success of stroke care cannot be judged solely by survival through the acute phase.

Survival, moreover, does not necessarily signify complete recovery. In a prospective study of 1,765 patients with mild ischemic stroke or transient ischemic attack and National Institutes of Health Stroke Scale (NIHSS) scores of 0–5, Romano et al. (2021) reported that 37% of participants remained disabled at 90 days and 25% had not regained independence. These figures should not be interpreted as prevalence estimates for the broader stroke population because the study specifically involved patients presenting with relatively mild neurological deficits. Nevertheless, the findings illustrate an important clinical point: limited neurological severity at presentation does not guarantee complete functional recovery