Introduction
Stroke is among the key healthcare problems that is associated with severe long-term disabilities, increased morbidity. In addition, stroke is associated with higher incidences of death in the United States as well as the world in its entirety. In the recent years, incidences of stroke especially among the high risk middle age adults have escalated raising serious concerns among the healthcare professionals as well as the entire public. According to CDC, stroke is among the key causes of adult disabilities and is associated with higher incidences of death as well as increased morbidity among this population (Centers for Disease Control and Prevention, 2015). As such, the higher incidences of stroke especially among the middle-aged adults can largely be attributed to the increased prevalence of the modifiable risk factors associated with stoke such as hypertension, lack of physical activity, smoking, diabetes as well as dyslipidemia that are more prevalent among this population as compared to other groups such as the elderly (von Sarnowsk et al., 2013). As such, this underscores the need to come up with appropriate preventive measures so as to minimize incidences of cerebrovascular accident especially among this population.
Although, considerable efforts have been made in regard to preventing incidences stroke, incidences of stroke continue to escalate especially among the high risk middle-aged adults due to the higher prevalence of various risk factors among the group (Ridker & Cook, 2013). In addition, the etiology as well as the nature of stroke among the middle-aged adults differs from that of the other populations and greatly influences treatments as well as diagnostic evaluation of the disease (Smajlović, 2015). As such, this has raised serious concerns among the healthcare professionals as well as the general public due to the severe adverse events, economic as well a health consequences associated with the disease. Particularly, stroke among the middle-aged adults is associated with significantly higher economic consequences especially by disabling individuals during their peak years of productivity whereby this leads to shrinking of the workforce (Smajlović, 2015). Moreover, stroke is associated with higher mortality as well as morbidity rates whereby this affects results to serous economic consequences especially among families. According to CDC, stroke is associated with higher incidences of adult disability and about 130,000 individuals die as a result of the disease every year in the United States (Centers for Disease Control and Prevention, 2015). Additionally, the disease is associated with increased healthcare expenditures mainly due to the amounts of costs incurred in providing medications and other healthcare services to stroke patients. According to CDC, it is estimated that the United States incurs about $34 billion every years in providing medications as well as other healthcare services to stroke patients (Centers for Disease Control and Prevention, 2015). Hence, this emphasizes the need to develop suitable preventive measures to reduce incidences of stroke among this population (von Sarnowsk et al., 2013).
PICO question: “For high risk middle-aged adults does the use of stroke preventive measures as compared to usual stroke prevention strategies for general population help to reduce the potential of cerebrovascular accidents?”
As such, guided by the clinical question “Does the use of preventative measures in high risk middle age adults reduce the potential of a cerebrovascular accident?”, This paper seeks to describe the search strategies for identifying the relevant literature on the prevention of stroke aimed at gathering the appropriate evidence-based information that can be used in developing effective preventive strategies for stroke prevention among the high risk middle-aged adults.
Levels of evidence
Essentially, recognizing the domain of the clinical question is one of the most crucial aspects in EBP (Evidence-Based Practice) process that enables the investigator to determine as well as select the most suitable EBP tools and best evidence that can be used in answering the Question(Polit & Beck, 2013). More importantly, this helps to determine the appropriate search strategy to be used in identifying the relevant articles that can be used in answering the question and provide valuable information related to the topic.
Thus, the type of question involved is preventive since it intends to focus on identifying the preventive measures that can be used to minimize incidences of stroke among this population. In this regard, the EBP process shall mainly focus on determining the various modifiable risk factors and diagnostic procedures that be used in reducing stroke incidences among this group.
In regard to the best evidence to be used in answering the question, the EBP project shall utilize various types of evidence in answering the question. Among the key types of evidence to be utilized shall include; systematic reviews, RCT (Randomized Controlled trials) as well as prospective studies. As such, systematic reviews shall provide the best evidence to answer the question since they provide extensive literature related to the topic since the studies are usually reviewed, assessed and summarized in an appropriate manner in relation to the topic. On the other hand, RCTs shall also provide best evidence since they involve carefully designed experiments that focus on evaluating the effectiveness of a certain intervention while prospective studies describe and analyze the correlation between diseases and various other factors in specific populations (Polit & Beck, 2013).
Search strategy
The EBP project shall utilize various search terms whereby these terms will include; stoke, modifiable risk factors for stroke, middle-aged adults, stroke and high risk middle-aged adults, preventive measures and stroke prevention strategies. In addition, the literature search shall be limited to articles published within the last five years so as to come up with relevant and current evidence-based information related to the topic.
On the other hand, a comprehensive literature search shall be carried out on various databases so as to come up with extensive literature and evidence-based information pertain to the topic. Among the databases to be used in carrying out the literature search shall include; CINAHL, PubMed, Cochrane Library and EMBASE.
Basically, the search terms and date of publication shall be used to determine the relevant articles that provide valuable information related to the topic. In this regard, the search terms to be used shall be related to the topic while the literature search shall be limited to articles published within the last five years. In addition, some of the search terms shall be combined to form phrases so as to broaden the literature search (Polit & Beck, 2013). Moreover, the literature search shall be limited to studies conducted within the United States and the larger Europe.
Among the most relevant and helpful articles to be used in guiding the EBP project include;
Von Sarnowski, B., Putaala, J., Grittner, U., Gaertner, B., Schminke, U., Curtze, S., & Basic-Kes, V. (2013). Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the Stroke in Young Fabry Patients study. Stroke, 44(1), 119-125.
Smajlović, D. (2015). Strokes in young adults: epidemiology and prevention.Vascular health and risk management, 11, 157.
The above articles are the most helpful and relevant articles that will be used in guiding the EBP project since they provide valuable as well as relevant information related to the topic and meet the eligibility criteria to be used in selection of articles. On the other hand, the two articles present a high level of evidence that would help in answering this clinical question.
Conclusion
The continued increase in Incidences of stroke among middle-aged adults presents a huge problem especially in healthcare and is associated with various severe adverse events. Thus, it is crucial to come up with the most effective intervention strategies that can be to minimize stroke incidences among this population and reduce the burdens associated with this disease. In regard to this, it is imperative to identify the key modifiable risk factors that predispose individuals in this group so as to develop suitable interventions to address this problem among this population. More importantly, it is crucial to identify the relevant literature pertaining to this topic so as to garner valuable information and understand the various aspects that contribute to this problem and subsequently develop the suitable interventions to address the problem. Overall, prevention is the key primary approach for reducing stroke incidence rates and enhancing the health outcomes among this population.
References
Centers for Disease Control and Prevention. (2015). Stroke Facts | cdc.gov. Retrieved from http://www.cdc.gov/stroke/facts.htm
Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
Ridker, P. M., & Cook, N. R. (2013). Statins: new American guidelines for prevention of cardiovascular disease. The Lancet, 382(9907), 1762-1765.
Smajlović, D. (2015). Strokes in young adults: epidemiology and prevention.Vascular health and risk management, 11, 157.
Von Sarnowski, B., Putaala, J., Grittner, U., Gaertner, B., Schminke, U., Curtze, S., & Basic-Kes, V. (2013). Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the Stroke in Young Fabry Patients study. Stroke, 44(1), 119-125.
