• 한국산학기술학회논문지
• /
• 제13권11호
• /
• pp.5337-5344
• /
• 2012

본 연구는 지역사회에 거주하는 55세 이상의 건강한 집단과 뇌졸중 집단의 보유 활동 및 수준을 분석하고 후속 연구를 위한 집단 특이성을 알아보고자 하였다. 연구 자료 수집을 위하여 한국형 활동분류카드를 사용하였고, 기술통계 방법을 이용하여 건강한 집단과 뇌졸중 집단에서 활동보유수준을 확인하였으며, 스피어만 상관계수를 이용하여 일반적 정보와의 활동보유수준의 상관성을 분석하였고, 다중회귀분석을 사용하여 활동 보유 수준에 영향을 미치는 변인을 분석하였다. 건강한 집단의 구성원들이 수행하는 활동들이 뇌졸중 집단에서는 감소함를 확인할 수 있었으며, 상관관계 분석과 회귀분석 시 건강한 집단과 뇌졸중 집단에서 활동보유수준과 대상자의 일반적 정보간에 통계학적으로 유의미한 변인이 달랐다. 결과를 통하여 55세 이상의 건강한 집단과 뇌졸중 집단에서 활동보유수준과 집단별 특이성을 확인할 수 있었으며 결과 자료에 기초하여 해당 집단의 활동 참여 조정과 대치 시에 기초 자료로 사용할 수 있을 것이다.

• 한국임상약학회지
• /
• 제32권1호
• /
• pp.37-46
• /
• 2022

Background: Non-valvular atrial fibrillation (NVAF) is associated with ischemic stroke risk in the aging population. Observational studies have indicated beneficial effects of direct-acting oral anticoagulant (DOAC) against ischemic stroke compared to warfarin. This study aimed to investigate ischemic stroke incidence and bleeding risk in patients on DOAC therapy. Methods: Using the database of Korean Health Insurance Review and Assessment-Aged Patient Sample 2015, we conducted a retrospective cohort study. Study subjects with NVAF diagnosis and prescribed anticoagulants were enrolled. Propensity score (PS) matching by age, sex, comorbidities, and medications were used. The clinical outcomes were major adverse cerebro-cardiovascular events (MACCEs, ischemic stroke/systemic embolism, myocardial infarction, cardiac death) and bleeding events. A cox proportional hazard model analysis was performed to compare the outcomes with hazard ratio (HR) and 95% confidence interval (CI). Results: Total 4,773 elderly patients with NVAF were initially included. Four PS-matched groups including rivaroxaban vs. warfarin-only (n=1,079), dabigatran vs. warfarin-only (n=721), rivaroxaban vs. dabigatran (n=721), and switchers of warfarin to rivaroxaban vs. warfarin-only (n=287) were analyzed. Every group showed statistically similar results of MACCEs and bleeding events, except for the group of rivaroxaban vs. dabigatran. Rivaroxaban users showed higher risks of bleeding events than dabigatran users (HR 2.25, 95% CI 1.01-4.99). Conclusion: In the elderly patients with NVAF, efficacy and safety outcomes among oral anticoagulants including DOACs and warfarin were similar, while rivaroxaban are more likely to have higher bleeding risks than dabigatran. Further research using large size sample is needed.

• 성인간호학회지
• /
• 제13권2호
• /
• pp.262-276
• /
• 2001

The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative 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 physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, 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 aided 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 Correlation 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 shown to be age, final academic status, 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. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (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 among 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.

• 국제물리치료학회지
• /
• 제8권2호
• /
• pp.1128-1134
• /
• 2017

The purpose of this study is to identify the effects of two trunk stability exercise types on the gait factors of stroke patients. We randomly divided 24 old elderly patients with hemiplegia, who were hospitalized due to stroke, into a two groups, each with its own six-week exercise program: one that used of a dynamic trunk stability exercise using with physio-balls(n=12) and a group of one that used a static trunk stability exercise using on mats(n=12). After measuring the participants gait ability a sin a pre-test, we again measured their ability again as in a posttest after two-for both types of six-week exercise programs for each group. The analysis of the data analysis showed that both ball and mat exercise programs significantly improved the participants' gait velocity and stride length; cadence, however, was significantly changed only by the ball exercise program. In conclusion, both types of trunk stability exercise may be useful in improving the gait ability of stroke patients, and, in particular, the former can be used as an exercise method that effectively significantly affects more various other gait factors.

• Journal of Preventive Medicine and Public Health
• /
• 제45권5호
• /
• pp.309-315
• /
• 2012

Objectives: Changes in air temperature and its relation to ambulance transports due to heat stroke in all 47 prefectures, in Japan were evaluated. Methods: Data on air temperature were obtained from the Japanese Meteorological Agency. Data on ambulance transports due to heat stroke was directly obtained from the Fire and Disaster Management Agency, Japan. We also used the number of deaths due to heat stroke from the Ministry of Health, Labour and Welfare, Japan, and population data from the Ministry of Internal Affairs and Communications. Chronological changes in parameters of air temperature were analyzed. In addition, the relation between air temperature and ambulance transports due to heat stroke in August 2010 was also evaluated by using an ecological study. Results: Positive and significant changes in the parameters of air temperature that is, the mean air temperature, mean of the highest air temperature, and mean of the lowest air temperature were noted in all 47 prefectures. In addition, changes in air temperature were accelerated when adjusted for observation years. Ambulance transports due to heat stroke was significantly correlated with air temperature in the ecological study. The highest air temperature was significantly linked to ambulance transports due to heat stroke, especially in elderly subjects. Conclusions: Global warming was demonstrated in all 47 prefectures in Japan. In addition, the higher air temperature was closely associated with higher ambulance transports due to heat stroke in Japan.

• 한국실내디자인학회논문집
• /
• 제24권3호
• /
• pp.165-175
• /
• 2015

Korean medical welfare facilities for the elderly provide the conveniences to care geriatric illness such as dementia and stroke. The medical welfare facility categorizes elderly care facilities, nursing homes, and geriatrics hospitals based on the Korean welfare of the aged act. The government makes an effort to secure feed rate and finances of medical welfare facilities. However, the qualitative improvement of facilities is inadequate. The purpose of this study is to analyze the conditions and problems of existing facilities using an environmental evaluation and to discuss the improvement direction related to the daycare centers for the elderly. The method of this study is literature review and field survey. Firstly, we analyzed the previous studies to develop the tool, evaluating the environment of day care centers for the old. Secondly, the items of environmental evaluation are deduced. Thirdly, we select the facilities to conduct field survey and analyze the results of field survey. Lastly, We discussed the problems and improvement directions through the results. It is judged that this study is an useful as the basic guideline to strengthen the minimum legal standards of day care center for the elderly due to the suggestion of insufficient environmental evaluation items.

• 보건행정학회지
• /
• 제23권1호
• /
• pp.90-100
• /
• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

• Journal of Preventive Medicine and Public Health
• /
• 제55권4호
• /
• pp.334-341
• /
• 2022

Objectives: This study was conducted to develop the Mobility to Participation Assessment Scale for Stroke (MPASS) and assess its content validity, internal consistency, inter-rater and intra-rater reliability, and convergent validity in people with stroke living in the community. Methods: The MPASS was developed using published data on mobility-related activity and participation timing in elderly individuals, and then reviewed by community physical therapists. Content validity was established by reaching a consensus of experienced physical therapists in a focus group. The MPASS was scored for 32 participants with stroke (mean age 61.75±4.92 years) by 3 individual testers. Reliability was examined using the intraclass correlation coefficient (ICC), internal consistency using the Cronbach alpha coefficient (α), and convergent validity using the Pearson correlation coefficient (r) to compare the MPASS to the Modified Rivermead Mobility Index as a referent test of mobility. Results: The MPASS consists of 8 items, and its scoring system provides information on the ability of people with stroke to reach a movement level enabling them to live in society, including interactions with other people and safe living in the community. The interrater and intra-rater reliability were excellent (ICC, 0.948; 95% confidence interval [CI], 0.893 to 0.982 and ICC, 0.967; 95% CI, 0.933 to 0.989, respectively). Internal consistency was good (α=0.877). The convergent validity was moderate (r=0.646; p<0.001). Conclusions: The newly developed MPASS showed acceptable construct validity and high reliability. The MPASS is suitable for use in people with stroke, especially those who have been discharged and live in the community with the ability to initiate sitting.

• 대한신경집중치료학회지
• /
• 제11권2호
• /
• pp.102-109
• /
• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Journal of Korean Neurosurgical Society
• /
• 제64권1호
• /
• pp.51-59
• /
• 2021

Objective : Several studies have reported inconsistent findings among countries on whether off-hour hospital presentation is associated with worse outcome in patients with acute stroke. However, its association is yet not clear and has not been thoroughly studied in Korea. We assessed nationwide administrative data to verify off-hour effect in different subtypes of acute stroke in Korea. Methods : We respectively analyzed the nationwide administrative data of National Emergency Department Information System in Korea; 7144 of ischemic stroke (IS), 2424 of intracerebral hemorrhage (ICH), and 1482 of subarachnoid hemorrhage (SAH), respectively. "Off-hour hospital presentation" was defined as weekends, holidays, and any times except 8:00 AM to 6:00 PM on weekdays. The primary outcome measure was in-hospital mortality in different subtypes of acute stroke. We adjusted for covariates to influence the primary outcome using binary logistic regression model and Cox's proportional hazard model. Results : In subjects with IS, off-hour hospital presentation was associated with unfavorable outcome (24.6% off hours vs. 20.9% working hours, p<0.001) and in-hospital mortality (5.3% off hours vs. 3.9% working hours, p=0.004), even after adjustment for compounding variables (hazard ratio [HR], 1.244; 95% confidence interval [CI], 1.106-1.400; HR, 1.402; 95% CI, 1.124-1.747, respectively). Off-hours had significantly more elderly ≥65 years (35.4% off hours vs. 32.1% working hours, p=0.029) and significantly more frequent intensive care unit admission (32.5% off hours vs. 29.9% working hours, p=0.017) than working hours. However, off-hour hospital presentation was not related to poor short-term outcome in subjects with ICH and SAH. Conclusion : This study indicates that off-hour hospital presentation may lead to poor short-term morbidity and mortality in patients with IS, but not in patients with ICH and SAH in Korea. Excessive death seems to be ascribed to old age or the higher severity of medical conditions apart from that of stroke during off hours.