• Title/Summary/Keyword: 급성기 뇌졸중

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A Systematic Review on Accelerometer to Measure Activity of Daily Living of Patients with Stroke (뇌졸중 환자의 일상생활활동 평가도구인 가속도계에 대한 체계적 고찰)

  • Lee, Joo-Hyun;Park, Jin-Hyuck;Kim, Yeonju;Park, Hae Yean;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.5 no.2
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    • pp.57-69
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    • 2016
  • Objective: The purpose of this study was to systematically review the articles using accelerometer to measure activity of daily living of patients with stroke. Methods: Depending on selection criteria, 13 studies were searched for PubMed, EMBASE, and Cochrane library database from February 2014 to March 2014. A total of 331 papers were searched, and 13 of these were selected. Results: In studies of 13 selected, acute, subacute, and chronic patients with stroke were enrolled. The kind of accelerometer was uniaxial, biaxial, and triaxial, activity monitor. Measurement activities were mainly arm activity, walking activity, and attachment sites were also various depending on the measurement activities. A measured variable was the total number of activities, the movement speed of the patients, ratio between affected and non-affected, and motion analysis. The result indicated that significant correlation with the other assessment tools in all studies. Conclusions: Accelerometer will be applied with a tool for measuring activity of daily living of patients with stroke, depending on activities characteristics. Further, we need accelerometer studies to apply with a variety of assessment in clinical practice or community settings.

ICF Core Sets for Measuring Functional Status of Acute Stroke Patients (급성기 뇌졸중 환자의 기능상태 측정을 위한 ICF 핵심지표)

  • Park, Mi-Jin;Kang, Ji-Yeon
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.107-119
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    • 2012
  • Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.

Influencing Factors on the Family Caregivers' Burden of Inpatients with Acute Stroke (급성기 뇌졸중 입원환자 가족 간호제공자의 부담감 영향요인)

  • Lim, Jung Soon;Chung, Bok Yae
    • The Journal of Korean Academic Society of Nursing Education
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    • v.24 no.2
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    • pp.149-159
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    • 2018
  • Purpose: The purpose of this study was to explore the influencing factors on the family caregivers burden who have has inpatients with acute stroke. Methods: Subjects were 126 family caregivers who have has inpatients with acute stroke. Data were collected by questionnaires. The collected data were analyzed by t-test, ANOVA, Scheffe's test, Pearson's coefficients and multiple regression. Results: The Anxiety of family caregivers was identified as a determinant of family caregivers burden who have has inpatients with acute stroke by the multiple regression analysis (${\beta}=.58$, p<.001). Gender and low cognitive function of inpatients were significantly related to family caregivers burden. And knowledge about care (r=-.27, p=.002) was correlated with anxiety significantly. Conclusion: The family caregivers burden is not only an important issue for nursing but also major nursing problem to be addressed nurses. Family caregivers with acute stroke inpatients feel more anxiety than family caregivers with other illnesses. The anxiety of family caregivers is important especially to the family caregivers who have to care acute stroke inpatients to reduce their burden.

A Study on Evaluation of the Appropriateness of Hospitalization for Patients with Stroke (뇌졸중 환자의 재원 적절성 평가에 관한 연구)

  • Choi, Eun-Mi;Yoo, In-Sook
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.233-240
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    • 2012
  • This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.

An Effect of the Secondary Stroke Prevention Education Program on Self-care of Acute Ischemic Stroke Patients (뇌졸중 이차예방 교육프로그램이 급성기 허혈성 뇌졸중환자의 자가간호수행에 미치는 효과)

  • Kang, Sun Mi;Yeun, Eun Ja
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.646-655
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    • 2005
  • Purpose: This study was conducted to examine the effects of the secondary stroke prevention education program to inhibit the recurrence of the acute ischemic stroke patients, and to maintain and promote knowledge about stroke, self-efficacy and self-care. Method: This study was designed to take a quasi-experimental pre- and post-test with the nonequivalent control group. The experimental group consists of 20 patients and control group consists of 20 patients. The experimental group was applied the secondary stroke prevention education program. In order to verify the effects of the secondary stroke prevention education program, knowledge about stroke, self-efficacy and self-care scale were measured before the intervention and 4 weeks, 12 weeks after discharge. The tools for measuring knowledge about stroke, self-efficacy and self-care are developed by the researcher. The data was analyzed by SPSS win 10.0 program using $x^2-test$, Fisher's Exact Test, t-test, Kolmogorov-Smirnov Z, and Repeated Measures ANOVA. Result: There was a statistically significant difference in knowledge about stroke (F=4.021, p=.026), self-efficacy(F=6.096, p=.018), and self-care(F=8.026, p=.007) between the experimental and the control group after intervention. Conclusion: It is considered that the program can be used as an effective nursing intervention in clinical practice.

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Benefit Payment Trends of the Health Insurance, Covering Critical Illiness (3대 특정질병 진단보험금 지불현황)

  • Kim, Yong-Eun
    • The Journal of the Korean life insurance medical association
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    • v.19
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    • pp.109-117
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    • 2000
  • 연구배경 : 3대 특정질병 진단보험금지급의 양상과 경향을 평가하고자 하였다. 방법 : 1997년 7월${\sim}$1999년 3월까지 당사의 한 건강보험가입자 중 1998년 1월${\sim}$1999년 9월 기간동안 당사 약관상의 정의에 의한 악성종양, 급성심근경색증, 뇌졸중으로 진단보험금이 지불된 총 411건에 대해 조사하였다. 결과 : 3대 특정질병 진단보험금 지급건 총 411건의 구성을 보면 악성종양이 290건(70.6%), 급성심근경색이 25건(6.1%) 그리고 뇌졸중이 96건(23.3%)이었다. 남녀비율은 남자 280건(68.1%), 여자 131건(31.9%)이었다. 3대 특정질병 진단급여금 지급건의 평균연령은 $3.88{\pm}5.9$이었다. 3대 특정질병 진단보험금 지불건은 $30{\sim}39$세 연령대에서 187건(45.4%)으로 가장 많았고, 그 다음으로 $40{\sim}49$세 연령대 178건(43.2%)의 순이었다. 계약시점에서 3대 특정질병 진단보험금 지급 시까지 평균진단확정 기간은 325.2일${\pm}$184.9일 이었다. 계약 후 12개월 내에 진단지급보험금 발생건은 총 193건(55.3%)이었고, 12개월 이후에 지급된 건은 156건(44.7%)이었다. 계약 후 12개월 내에 진단지금보험금 발생건 193건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)로 가장 많았다. 악성종양의 신체계통별로 보면 소화기관>유방>여자생식기>호흡기계 순이었다. 악성종양을 장기별로 보면 위암>유방암>간암 및 담도계암>결장암과 직장암, 자궁경부암의 순이었다. 남자의 경우 위암>간암 및 담도계암>결장암과 직장암의 순이었고 여자의 경우 유방암>자궁경부암(상피내암 제외)>결장암, 직장암의 순이었다. 뇌졸중의 종류별 빈도를 보면 뇌경색증(47.9%)>뇌내출혈(34.4%)>거미막하출혈(9.4%)의 순이었다. 결론 : 3대 특정질병 중 악성종양이 다수를 차지하고 있었고, 남자가 여자보다 훨씬 많았고 주로 $30{\sim}39$세 연령대, $40{\sim}49$세 연령대였다. 계약 후 12개월 내에 진단지급보험금 발생건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)으로 가장 많았다는 것은 역선택의 가능성 그리고 제척기간 중 발생한 3대 특정질환이 3개월 이후 특히 3개월 이상${\sim}$4개월 미만 사이에 지급청구되었을 가능성을 시사하는 것으로 사료된다.

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A Systematic Review on Intervention to Improve Executive Function in Stroke Patients (뇌졸중 환자 집행 기능 향상을 위한 중재에 대한 체계적 고찰)

  • Ko, Seok-Beom;Kim, Moon-Young;Oh, Yun-Taek
    • Therapeutic Science for Rehabilitation
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    • v.4 no.2
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    • pp.33-50
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    • 2015
  • Objective : This study was conducted to determine various interventions in accordance with the recovery and cognitive processes in order to improve executive function in stroke patients through a systematic review. Methods : The literature search focused on Level I-IV studies published between January 1996 and April 2015 for 20 years in electronic databases(e.g. MEDLINE, SCOPUS, RISS). The keyword search terms were 'Stroke', 'Executive function', 'Executive function deficit', 'Occupational therapy', 'Rehabilitation', 'Remedial', 'Compensatory' and 'Education'. Result : A total of 13 articles were appraised using the hierarchy of levels of evidence-based practice and 6 Level I evidence articles, 1 Level II articles, 2 Level III articles and 4 Level IV articles. Each intervention improved executive function but was different in degree of generalization. Conclusion : Through this systematic review, we found that there are a variety of applied interventions improving executive function in stroke patients and are different in effect depending on methods of interventions. This study provided evidences to occupational therapists for the clinical practice of interventions to improve executive function in stroke patients.

The Effects of Trunk Stability Exercise on Dynamic Balance in the Persons with Chronic Stroke. (체간의 안정화운동이 뇌졸중 환자의 동적 균형에 미치는 효과)

  • Shin, Won-Seob;Kim, Chang-Young;Lee, Dong-Yeop;Lee, Suk-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2509-2515
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    • 2009
  • This study compared the relative effectiveness of trunk stability exercise with general balance exercise on dynamic balance for patients with chronic patients. Thirty eight subjects were recruited and randomly divided into two groups. One group was trained trunk stability exercise and the other group was trained general balance exercise. This process was carried out three times a week for seven weeks. Dynamic balance was measured prior to commencement of the exercise programs, and again after seven weeks, when the programs were completed, in order to establish the effectiveness of both exercise programs. Both the trunk stability exercise and the general balance exercise increased BBS and TUG(p<.001). The trunk stability exercise was more effective at increasing BBS(p<.05). We suggest that trunk stability exercise is effective in the improvement of balance ability in the persons with chronic stroke. Therefore, the trunk stability exercise is considered to important when the stroke patients are trained. Further studies of effectiveness of trunk stability exercise should be carried out to increase our understanding of this area of study.

Research on the Xiafa(下法) used at the acute stages of Stroke (뇌졸중(腦卒中) 급성기(急性期)에 응용되는 하법(下法)에 대한 연구)

  • Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.19 no.1
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    • pp.385-391
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    • 1998
  • Stroke is badly demaged for patient, family, society and country. To reduce a sequelae and return rapidly to society, treatment at acute stages is very important. In the research on xiafa(下法;diarrhea technique) used at the acute stages of stroke, the results were as follows. On the treatment of stroke, we are to control qi(氣) For it, sweeting technique(汗法), vomitting technigue(吐法) and diarrhea technique(xiafa ;下法) are used. For treatment on biaoshizheng(標實 reyufushi, 熱鬱腑實) at acute stages, tongfuxiexiafa(通腑瀉下法) is in general use. At acute stages, mental state is very important. Therefore, Xiafa(下法) have to conduct by zangfu(臟腑)'s law. At the acute stages, xiafa(下法) improved a whole body problems by treatment on a constipation and dysuria. We think that xiafa(下法) clinically effect on the cerebral edema and increased intracranial pressure. In the future, experimental study is needed.

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Clinical characteristics of acute renal failure of rhabdomyolysis in children (소아에서 횡문근융해증을 동반한 급성신부전의 임상양상)

  • Kim, Jae Hui;Goo, Min Ji;Yeom, Jung Sook;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.277-283
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    • 2007
  • Purpose : Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. Methods : A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. Results : Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. Conclusion : Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.