A Study on the Relationship between Care Burden, Depression, and Quality of Life among Families of Stroke Patients in Rehabilitation Hospital - Comparison between Integrated Nursing Care Service Ward and General Ward -

Kyung-Hee Kim,Hye-Kyung Lee,Hye-Sun Jeong,Suyon Baek 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8

Aim(s): The purpose of this study is to investigate the correlation between the burden of care, depression, and quality of life in the family of stroke patients admitted to the nursing care integrated service ward of a rehabilitation hospital and the family of stroke patients admitted to the general ward. Method(s): The data collection period was from December 2019 to March 2021. The subjects were 142 people who understood the purpose of this study and voluntarily agreed to participate among the families of stroke patients hospitalized at D and W Rehabilitation Hospital in D city. Data were analyzed using the SPSS/WIN 25.0 statistical program with t-test, and Pearson’s Correlation Coefficient. Result(s): As a result of this study, on a scale of 5 points, the care burden was an average of 3.60±0.34 for the families of stroke patients in the integrated nursing care service ward and 3.77±0.48 for the families of stroke patients in the general ward, and there was a significant difference in the burden of care between the two groups (t=-2.32, p=.022). Depression was scored out of 3, with an average of 0.39±0.28 for the families of stroke patients in the integrated nursing care service ward and 0.47±0.35 for the families of stroke patients in the general ward, and there was no significant difference between the two groups. The quality of life was 2.77±0.42 for the families of stroke patients in the integrated nursing care service ward out of a scale of 5, and 2.63±0.41 for the families of stroke patients in the general ward, indicating a significant difference between the two groups (t=2.06, p=.041). There was a significant correlation between the quality of life and depression in the families of stroke patients in the integrated nursing care service ward (r=-.362, p=.002). Among the families of stroke patients in the general ward, quality of life had significant correlations with burden of care (r=-.310, p=.011) and depression (r=-.599, p<.001). Conclusion(s): In both types of wards in the rehabilitation hospital, it was found that there was a correlation between the quality of life of the stroke patient's families and depression. In particular, in the families of stroke patients in the general ward, the burden of care was correlated with the quality of life. Therefore, when providing nursing care, it is necessary to provide nursing intervention for families that includes the burden of care and depression.

A Comparison Between Stroke Patients Admitted to Oriental Hospital in the Years 1987 and 1994

Lee Kyung-sup,Cho, Ki-ho,Kim, Young-suk,Ko, Chang-nam,Moon Sang-kwan,Bae Hyung-sup INSTITUTE OF ORIENTAL MEDICINE KYUNG-HEE UNIVERSIT 1998 JOURNAL OF ORIENTAL MEDICINE Vol.3 No.1

The characteristics of stroke slightly vary as time changes. To compare the characteristics of stroke between the 1980s and 1990s we investigated the clinical records of stroke patients in 1987 and 1994. The subjects of this study consisted of the 1971 patients who were admitted as stroke patients to the Kyunghee University Oriental Medicine Hospital during these two years. There were 1092 stroke patients admitted from May, 1987 to April, 1988 and 879 stroke patients admitted between May, 1994 and April, 1995. The results were as follows. The frequency of cerebral infarction was 77.9% in 1987 and 79.9% in 1994. The male to female ratio of stroke patients was 1.4:1 in 1987 and 1.6:1 in 1994. The occurrence rate of stroke in both 1987 and 1994 were highest in patients in their 60s, followed by those in their 50s, 70s and older, in their 40s, and finally their 30s and below. We especially found that the rate of patients in their 70s and over increased from 17.8% in 1987 to 25.3% in 1994, which was remarkable in cerebral infarction patients. The most common disease preceding a stroke was hypertension, followed by heart disease and diabetes in 1987, and in 1994 hypertension was the most common, followed by diabetes and heart disease. The rate of recurrence among cerebral hemorrhage, that was 12% in 1987 and 24.7% in 1994. The most frequent complications of stroke in 1987 and 1994 were pneumonia and urinary tract infection, respectively. The prescriptions used most frequently during admission were Chungpaesagan-tang followed by Sunghyangjungki-san, Yangyeksanhwa-tang etc. in both 1987 and 1994. When patients were getting better, prescriptions for invigorating Qi and enriching the blood(補氣血) were used more frequently. In conclusion, the most remarkable change of stroke patients from 1987 to 1994 was an increase in occupancy rate of aged patients, especially those in their 70s and older. So we suggest that more research are needed on the stroke of aged man, along with many other subjects on stroke.

닫힌 사슬운동과 슬링운동프로그램 병행이 뇌졸중 편마비환자의 균형과 보행 및 등속성근기능에 미치는 영향

조완주(Cho, Wan-Ju) 한국체육과학회 2015 한국체육과학회지 Vol.24 No.2

This study conducted closed kinetic chain and sling exercise with 16 patients with hemiplegia after stroke for 12 weeks to examine the effects of closed kinetic chain and sling exercise on balance, walking, and isokinetic muscle function. The subjects were male patients who were diagnosed as hemiplegia caused by stroke in J University Hospital of G Metropolitan City and had chronic hemiplegia over 12 months after a stroke attack. They should participate in exercise based on physiatrist’s opinion, walk independently using walking assistance devices, and not have subcutaneous atrophy and orthopedic-diseases of lower extremity. Their consents to the whole process of experiment were obtained and they were willing to participate in the study. The subjects were randomly assigned to the exercise group(n=10) and the control group(n=8). 2 participants of the exercise group dropped out. The purpose of this study was to examine how closed kinetic chain and sling exercise for 12 weeks made a difference to balance, walking, and isokinetic muscle function in patients with hemiplegia after stroke. The results of analysis and comparison were as follows. First, for the change of balance ability, patients with hemiplegia after stroke who participated in closed kinetic chain and sling exercise showed improved balance. It suggests that closed kinetic chain and sling exercise had a positive effect in patients with hemiplegia after stroke. Second, for the change of walking ability, patients with hemiplegia after stroke who participated in closed kinetic chain and sling exercise showed improved walking in both TUG and 10MWT. It suggests that closed kinetic chain and sling exercise had a positive effect in patients with hemiplegia after stroke. Third, for the change of isokinetic muscle function, patients with hemiplegia after stroke who participated in closed kinetic chain and sling exercise showed the improvement of affected extension, unaffected extension, affected flexion, and unaffected flexion. It suggests that closed kinetic chain and sling exercise had a positive effect in patients with hemiplegia after stroke. Based on the findings, closed kinetic chain and sling exercise had a positive effect on the improvement of balance, walking, and isokinetic muscle function in patients with hemiplegia after stroke. However, it is difficult to generalize the findings for all patients with hemiplegia after stroke because the number of the subjects of this study was small. It is considered that more various exercise programs should be applied to patients with hemiplegia after stroke who are usually limited in exercise.

노인층과 청ㆍ장년층 뇌졸중 환자가족의 건강상태ㆍ부담감 및 삶의 질과의 관계

김귀분,이경호 성인간호학회 2001 성인간호학회지 Vol.13 No.2

The purpose of this study is to investigate the correlation among the stroke patient family's upon the oomparative appreciation of the adult stroke patient's family and elderly stroke patient's family For this purpose, data were collected from the family care-givers for two groups of stroke Patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physital health and Young-hee(1992), the tool fort measuring the sense of burden by S대, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews added by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Corretation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 4. The rate of correlation between the burden and the Quality of life appealed to be the of correlation between the psychological health and the burden of a similar (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372). The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation the stroke Patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

Serum 25-Hydroxyvitamin D Deficiency in Ischemic Stroke and Subtypes in Indian Patients

Jaydip Ray Chaudhuri,K. Rukmini Mridula,Suvarna Alladi,A. Anamika,M. Umamahesh,Banda Balaraju,A. Swath,VCS Srinivasarao Bandaru 대한뇌졸중학회 2014 Journal of stroke Vol.16 No.1

Background and Purpose Vitamin D deficiency is common across all age groups and may contribute to cardiovascular diseases. Serum 25-hydroxyvitamin D deficiency causing ischemic stroke has been documented in recent reports. Aim To investigate the association of serum 25-hydroxyvitamin D deficiency with ischemic stroke and subtypes. Methods We recruited 250 consecutive ischemic stroke patients and 250 age and sex matched controls attending the Department of Neurology, at Yashoda hospital, Hyderabad, India, from January 2011 to December 2012. All ischemic stroke patients underwent stroke subtyping. We measured 25-hydroxyvitamin D by chemiluminescence test, serum calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP) in cases and controls. Results Out of 250 stroke patients, 190 (76%) were men and mean age was 58.4±11.1 years (age range-26-89 years). 25-hydroxyvitamin D deficiency was observed in 122 (48.8%) stroke patients and 79 (31.6%) controls (P=0.001). Among stroke patients, serum 25-hydroxyvitamin D deficiency was found in 54.9% (50/91) of patients with large artery atherosclerosis, 54% (20/37) in cardioembolic stroke, 44.4% (20/45) in small artery diseases, 42.8% (15/35) in stroke of other determined etiology and 40.4% (17/42) in stroke of un-determined etiology. Multiple logistic regression analysis showed an independent association of 25-hydroxyvitamin D deficiency with ischemic stroke (odds ratio: 1.6; 95% CI 1.2-2.8). The association was strongest with large artery atherosclerosis (odds ratio: 2.4; 95% CI 1.6-3.5) and cardioembolic stroke (odds ratio: 2.0; 95% CI 1.0-3.2). Conclusions We found that 25-hydroxyvitamin D deficiency had an independent association with ischemic stroke. The association was established in large artery arthrosclerosis and cardioembolic stroke.

응급환자 추이예측 분석 : AMI, Stroke, ICISS 기반 중증질환자

정재연 ( Jeong Jaeyeon ),정지윤 ( Jeong Jiyun ),이해종 ( Lee Haejong ) 경희대학교 경영연구원 2021 의료경영학연구 Vol.15 No.1

Purpose: The purpose of this study is to identify the trends and seasonality of the three major emergency diseases(Acute myocardiac infarction, Stroke, Severe trauma) and to use them to establish efficient resources and evidence-based physicians to predict the number of patients. Methodology: From 2014 to 2018, the number of patients who received emergency medical care for acute myocardial infarction, stroke, and severe trauma (based on ICISS 2008) was predicted using Emergency Medical Status Statistics provided by the National Medical Center. Based on the Autoregressive integrated moving average model, the increasing trend and seasonality of patients by disease were confirmed and the number of patients was predicted. Findings: Since 2014, the number of patients with emergency diseases has steadily increased, with the highest number of patients in the order of Severe trauma (based on ICISS 2008), Stroke, and Acute myocardiac infarction. Patients with cerebrovascular disease, such as Acute myocardiac infarction and stroke, increased rapidly in winter(Oct-Jan), and patients with severe trauma increased mainly in summer or autumn(May-Oct) and number of patients will increase with seasonality. Practical Implications: The number of major emergency patients is expected to increase steadily over time, so it is important to be prepared for this. Therefore, providing emergency care with limited resources is a very important issue, and in order to prepare for the growing elderly population, emergency medical patients, and unpredictable infectious diseases, it is necessary to keep track of the number of patients for each emergency disease.

TOAST 분류에 의한 급성기 중풍(뇌중풍) 입원 환자 분석 (경원인천한방병원)

정기용,고호연,정승민,하유군,정희,최유경,김동우,한창호,조기호,박종형,전찬용,Jung, Ki-Yong,Go, Ho-Yeon,Jeong, Seung-Min,Hsia, Yu-Chun,Jung, Hee,Choi, You-Kyung,Kim, Dong-Woo,Han, Chang-Ho,Cho, Ki-Ho,Park, Jong-Hyung,Jun, Chan-Yong 대한한방내과학회 2006 大韓韓方內科學會誌 Vol.27 No.4

Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.

뇌졸중 환자의 병원 전 의식수준에 따른 119구급대원의 병원 전 뇌졸중 평가 결과 분석

정영주,이선영,박정호,김기홍 대한응급의학회 2023 대한응급의학회지 Vol.34 No.1

Objective: Stroke detection at the prehospital stage is critically important for the provision of rapid treatment to stroke patients. This study aimed to evaluate the effect of patient consciousness level on prehospital stroke screening (PSS) by the emergency medical service (EMS) provider. Methods: This retrospective cross-sectional study was conducted using data collected from a linked database of NEDIS (National Emergency Department Information System) and the EMS database in three hospitals. Adult stroke patients who were admitted into the emergency department (ED) using 119 EMS ambulances from 2014 to 2018 were included. The prehospital level of consciousness of patients was evaluated by the EMS provider, and they were divided into two treatment groups: an alert group and a non-alert group (verbal, painful, and unresponsive). The study outcomes were positive results of PSS: the Los Angeles Prehospital Stroke Scale (LAPSS) and Cincinnati Prehospital Stroke Scale (CPSS). Logistic regression analysis was conducted to evaluate the effect of prehospital consciousness level on the PSS result. Results: A total number of 3,422 stroke patients were included. The positive rate of LAPSS was 17.0% in the alert group and 8.8% in the non-alert group. The positive rate of CPSS was 35.7% in the alert group and 21.3% in the non-alert group. In the adjusted logistic regression model, in the non-alert group, the adjusted odds ratio (AOR) for LAPSS was 0.47 (95% confidence interval [CI], 0.38-0.59) and the AOR for positive CPSS was 0.49 (95% CI, 0.42-0.57). Conclusion: Low consciousness level patients had lower detection of stroke by the EMS provider. EMS provider employees need additional training to achieve more effective detection of stroke in low consciousness level patients.

Impact of the Dedicated Neurointensivists on the Outcome in Patients with Ischemic Stroke Based on the Linked Big Data for Stroke in Korea

Tae Jung Kim,Lee Ji Sung,Yoon Jae Sun,오미선,Kim Ji-Woo,정근화,유경호,이병철,고상배,윤병우,Clinical Research Collaboration for Stroke (CRCS) investigators 대한의학회 2020 Journal of Korean medical science Vol.35 No.21

Background: Neurocritical care by dedicated neurointensivists may improve outcomes of critically ill patients with severe brain injury. In this study, we aimed to validate whether neurointensive care could improve the outcome in patients with critically ill acute ischemic stroke using the linked big dataset on stroke in Korea. Methods: We included 1,405 acute ischemic stroke patients with mechanical ventilator support in the intensive care unit after an index stroke. Patients were retrieved from linking the Clinical Research Center for Stroke Registry and the Health Insurance Review and Assessment Service data from the period between January 2007 and December 2014. The outcomes were mortality at discharge and at 3 months after an index stroke. The main outcomes were compared between the centers with and without dedicated neurointensivists. Results: Among the included patients, 303 (21.6%) were admitted to the centers with dedicated neurointensivists. The patients treated by dedicated neurointensivists had significantly lower in-hospital mortality (18.3% vs. 26.8%, P = 0.002) as well as lower mortality at 3-month (38.0% vs. 49.1%, P < 0.001) than those who were treated without neurointensivists. After adjusting for confounders, a treatment without neurointensivists was independently associated with higher in-hospital mortality (odds ratio [OR], 1.59; 95% confidence intervals [CIs], 1.13–2.25; P = 0.008) and 3-month mortality (OR, 1.48; 95% CIs, 1.12–1.95; P = 0.005). Conclusion: Treatment by dedicated neurointensivists is associated with lower in-hospital and 3-month mortality using the linked big datasets for stroke in Korea. This finding stresses the importance of neurointensivists in treating patients with severe ischemic stroke.

뇌졸중 환자의 재활 과정에서 환자와 물리치료사가 요구하는 기능에 대한 조사연구

채정병,정주현,Jung-Byung Chae,Ju-Hyeon Jung 대한고유수용성신경근촉진법학회 2024 PNF and Movement Vol.22 No.2

Purpose: In this study, 100 stroke patients and 205 physical therapists were surveyed to determine the essential functions needed in the rehabilitation process of stroke patients. Methods: This study involved 100 stroke patients and 205 physical therapists. Sixteen functions suggested in the previous study as necessary in the rehabilitation process of stroke patients were selected, and a revised questionnaire was prepared and distributed to several institutions. A frequency analysis of the collected data was conducted to aggregate the functions required in rehabilitation, and a scoring process was used to determine their ranking among the 16 functions. Results: The functions required in the rehabilitation process, as selected by stroke patients, were ranked as follows: walking, toileting, eating, using products and technology for communication, and washing oneself. The functions required in the rehabilitation process, as selected by physical therapists, were ranked as follows: muscle power functions, maintaining body position, muscle tone functions, attention functions, and walking. Conclusion: The results of the study confirm the importance of an agreed goal between the stroke patient and the therapist regarding the functions required for the rehabilitation. This understanding plays a significant role in achieving the patient's expectations and the therapist's predicted performance, thereby providing reassurance and confidence in the impact of the research.