Alterações cognitivas e repercussões psicossociais do acidente vascular cerebral.

Abstract

Introduction: Stroke is one of the main causes of mortality in the world and the main cause of functional incapacity, considering as physical, cognitive, emotional and social sequelae, restricting the functionality and reflecting in partial or total dependence of one caregiver. In this context, Neuropsychology can supports in understanding of this issue, promoting the identification of damages, as well as the integrity of other functions and then, support for rehabilitation programs. Objective: To evaluate the cognitive alterations of stroke patients and the possible family and social repercussions after brain stroke. Method: This is a descriptive and qualitative study, based on the interview of the patients and their relatives, as well as on the results of the Neuropsychological Brief Evaluation Instrument - NEUPSILIN, which was applied to the patients. All participants were submitted to the same activities. The sample consisted of 30 participants, 16 patients (09 women and 07 men) and 14 relatives, of both sexes. Results: From the data collected through the Neuropsychological Brief Instrument - NEUPSILIN, it was possible to identify that the most affected domain was memory in 100% of the cases. Subsequently, the language, the praxes, the executive functions (81.25% each) and the attention (75%) were more affected. The temporo-spatial and the visual perception orientation were equally compromised (68.75%). Arithmetic skills presented the lowest damages (43.75%). The thematic content analysis was performed with 30 interviews. Two main themes were chosen - family implications and social implications. The thematic axis family implications revealed five nuclei of meaning: financial loss, overloading of responsibilities, psychoactive substance abuse, reduction of autonomy and change of roles. The other axis, social implications, evidenced three nuclei of meaning: interruption of the work activity, prejudice in the interpersonal relationship and expansion of the cycle of friendships. Discussion: the results indicate that the occurrence of stroke caused significant cognitive impairment for the patients, considering that 100% of the cases had more than one domain of cognition affected, a factor that had a greater dependence on the presence of a caregiver and in family and social implications. Final considerations: the repercussions of a brain stroke such as cerebrovascularaccident can be so devastating that knowledge about it is extremely relevant, so that actions focused at promoting the dissemination of knowledge about this subject can be implemented, and contribute to the minimization of its occurrence, as well as to the creation of rehabilitation strategies aiming at patient and caregiver care.