The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certified nurses or certified nurse specialists. Their awareness of the importance of collaborating with therapists was low. On-the-job training can improve nurses’ competence and prevent worsening conditions in patients with CVA. An emphasis on enhancing practice experience toward patients with acute CVA and facilitating the deployment of certified nurses in SCUs can improve nursing care practice.

Background: Post-stroke hemiplegic patients of chronic phase often have troubles with their activities of daily life, because of the decrease in upper-limb joint range of motion and the pain of shoulder. Aim: To use a hair-brushing movement intervention with the assistance of a nurse as therapy for increasing the upper-limb joint range of motion in the acute phase in patients with hemiplegia following their first stroke. Method: This study analysed a control group and an intervention group of 26 patients each. The first measurements were made 1–2 days after stroke onset and again on the sixth day from the first measurements. The intervention comprised hair-brushing movements made by patients with the assistance of a nurse. Six joint movement angles were measured on the affected and unaffected sides. Results: Compared with the control group, the intervention group showed a significantly increased (p=0.002) passive joint range of motion in shoulder abduction and external rotation movements on the affected side. Conclusion: Hair-brushing intervention with assistance from nurses increased the joint range of motion of shoulder abduction and external rotation movements.

In patients with stroke, it has been proven that management by a specialized medical team for stroke treatment for several days immediately after stroke onset significantly reduces mortality, improves return-to-home rates, and positively impacts activities of daily living and quality of life after discharge. This chapter describes the key points of nursing care for patients with acute stroke, which include “Recognition of patients’ physical changes,” “Prevention of the worsening of acute stroke and related Symptoms,” “Reduction of patients’ physical distress,” “Appropriate management of patients’ physical conditions,” “Reacquisition of activities of daily living,” “Collaboration with rehabilitation therapists,” “Reduction of mental and social distress in patients and their families,” and “Reduction of the risk of recurrence and requirement of discharge support.” These points will have a positive impact on patients with stroke by improving the nurses’ competence to practice nursing and enhancing the quality of team care.

The purpose of this study was to explore experiences and feelings of patients who suddenly injured the cervical spinal cord to find what gives them empower their will to live, or what makes them to lose it on the contrary, and how the nursing care influences empower their will to live. The participants were 5 patients who were hurriedly transported to emergency hospital due to an unexpected accident and diagnosed as the cervical spinal cord injury. This study was intended to be the prospective, quantitative, and descriptive, in which the researcher obtained data by memorizing or recording speeches and behaviors of the participants while taking care of them. Moreover, this is a factor-search research that aims to find what factors may influence patients to regain living zest and how nursing care works to draw their vigor. Learning participants experiences within a few days after the injury, we have found it was even before physicians explained them about the body injury to be incurable when they began to think the injury was intractable and four out of 5 patients mentioned they thought they d rather be dead at that time. The factors that deprived the patients of empower their will to live were thought that the injury would be incurable, and aches from insomnia, restriction in bed, and suctioning, etc. On the other hand, the factors that strengthened empower their will to live were thoughts such as, I will be able to go back to my usual life, I can see things with a extensive view, my abilities of doing things have been improved, the pains are reduced,