• 기본간호학회지
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• 제7권1호
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• pp.122-136
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• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

• Journal of health informatics and statistics
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• 제41권3호
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• pp.318-323
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• 2016

Objectives: Except the known risk factors for stroke, few studies have identified novel metabolic markers that could effectively detect stroke at an early stage. In this study, we explored the dose-response relationship between serum metabolites and the incidence of stroke. Methods: We studied 213 adults in the Korean Cancer Prevention Study-II (KCPS-II) biobank and estimated dose-response relationship between serum metabolites and stroke (42 cases and 171 controls). Three serum metabolites (Acetylcholine, HexadecylAcetylGlycerol, and 1-acetyl-2-formyl-sn-glycero-3-phosphocholine) were used in this study. The analysis included (1) exploratory nonlinear analysis, (2) estimation of flexion points and slopes at below and above the points. In the model to estimate risk of incidence of stroke, we controlled for conventional risk factors such as age, sex, systolic blood pressure, type 2 diabetes, triglyceride, and smoking status. Results: The relationship between incidence of stroke and log-transformed 1-acetyl-2-formyl-sn-glycero-3-phosphocholine was non-linear with flexion point around intensity score of 8.8, whereas other metabolites, log-transformed Acetylcholine and HexadecylAcetylGlycerol, showed negative linear patterns. Conclusions: The study suggests that metabolic markers are associated with incidence of stroke, particularly, at or above the flexion point. The study result may contribute to developing a novel system for precise stroke prediction.

• 보건교육건강증진학회지
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• 제32권1호
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• pp.1-10
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• 2015

Objectives: This study evaluated the effects and relevant factors of community-based education and advocacy intervention on stroke awareness among the general population. Methods: The study enrolled 505 community-dwelling adults aged 19 years or older who completed a survey before and after a community-based intervention held between May 2014 and December 2014. Trained staff collected data about knowledge of five stroke warning signs, emergency response, golden window of time (${\leq}3h$), and demographics. Results: After the intervention, public awareness of all five stroke warning signs increased significantly from 26.5% to 33.9% (p=0.011). Public awareness of the golden window of time also increased significantly from 70.1% in April 2014 to 75.8% in December 2014 (p=0.040). In a multivariate logistic regression analysis, older age, higher education level, and exposure to stroke-related public service announcements or educational materials were significant predictors of knowledge of all five warning signs for stroke. Conclusions: Comprehensive community-based intervention is effective for improving public awareness of the warning signs of stroke and the golden window of time.

• 한국의료질향상학회지
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• 제23권1호
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• pp.43-53
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• 2017

Purpose: This study was to determine the effect of a smartphone video educational program on educational satisfaction of patients in rehabilitation units at a university hospital. Methods: The subjects of this study were 60 stroke patients recruited and divided into two groups; experimental group (n=30) and control group (n=30). Subjects in the experimental group and control group conducted conventional physical and occupational therapy. In addition, only the experimental group provided smartphone video information for a total of 15 sessions. The video consisted of five episodes (10 minutes each) viewed a total of 15 times (for each video three times). The outcome was assessed by educational satisfaction. Result: After inervention, both groups revealed significant increased awareness of prevention of infection educational satisfaction and prevention from falling educational satisfaction and exercise program educational satisfaction. However, the experimental group was more effective than the control group relative to heightened awareness of increasing prevention of infection prevention from falling and exercise program. Conclusion: We suggest that a smartphone video educational program may be effective in improving awareness of the prevention of infection, prevention from falling, and exercise program educational satisfaction. Therefore, video-based information is beneficial for such patients. Further studies are needed for better understanding of the effectiveness of a smartphone video educational program in rehabilitation units at a university hospital.

• 대한물리의학회지
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• 제6권3호
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• pp.257-266
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• 2011

Purpose : To assess the relationship between post-stroke shoulder pain, motor function, and pain-related quality of life(QOL) Methods : Volunteer sample of 62 chronic stroke survivors with post-stroke shoulder pain and glenohumeral subluxation. The patients answered the question in shoulder pain with the Brief Pain Inventory question 12 (BP1-12), Pain-related Quality of life(BPI-23). Therapists measured the performance of combined upper-limb movement including the hand-behind-neck(HBN), hand-behind-beck(HBB) maneuver, added passive pain-free shoulder external rotation range of motion, and Modified Ashworth Scale(MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activity daily living(Modified Barthel Index-self care, MBI-S/C), motor function of upper limb(Fugl-Meyer Upper/Lower Extremity, FM-U/E). Results : Stepwise regression analyses indicated that post-stroke shoulder pain is associated with the BPI 23, but not with the FM-U/E, MBI-S/C. Thus, the presence of shoulder pain is more important predicting pain-related QOL than its degree in predicting motor function of upper limb and basic activity daily living. Conclusion : Post-stroke shoulder pain was associated with reduced quality of life related to pain. The pain was not associated with the motor function of upper limb and basic activity daily living. The result imply that management of shoulder pain & anatomical position of shoulder joint after stroke should be emphasized. This provides a further incentive to develop effective rehabilitation prevention and treatment strategies for post-stroke shoulder pain.

• Journal of Platform Technology
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• 제9권3호
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• pp.36-43
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• 2021

뇌졸중 질환은 전세계적으로 가장 중요한 사망원인 중 하나이며, 특히 고령자에게 장애의 원인이 되는 가장 중요한 질환이다. 뇌졸중 질환이 발생하면 사망 또는 심각한 장애를 유발하기 때문에, 적극적인 일차 예방과 전조증상의 빠른 발견이 매우 중요하다. 특히, 일상생활에서의 뇌졸중 전조증상 발병을 감지 및 정확히 예측하여 전문가의 신속한 진단을 유도할 수 있어야 한다. 최근까지의 연구에서는 뇌졸중 환자의 전조증상을 예측하는 방법론으로 CT(Computed Tomography)나 MRI(Magnetic Resonance Imaging)와 같은 영상 분석이 대부분이었으나, 이러한 접근에는 오랜 검사 시간과 높은 검사 비용 등에 대한 한계점을 가지고 있다. 본 논문에서는 고령자의 뇌졸중 질환 발병이 보행 시 족압(Foot Pressure)에 어떤 영향을 미치는지 임상 데이터를 이용해 실험하였다. 실험 결과, 보행 중에 뇌졸중 고령자와 일반 고령자 간에 12개의 셀에서 * p < .05 인 유의미한 차가 있음을 분석 및 검증하였다. 결과적으로 고령의 뇌졸중 환자와 일반 고령자의 일상생활의 보행 패턴에 유의미한 차이를 발견했다는 것에 그 의미가 크다고 할 수 있다.

• Journal of Korean Biological Nursing Science
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• 제24권4호
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• pp.262-271
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• 2022

Purpose: The purpose of this study was to identify the factors affecting readmission in stroke patients. Methods: A retrospective study design was used. Participants were 3,675 adult cerebral stroke patients in the inpatient wards of the Department of Neurology and Neurosurgery of G University Hospital located in C city. Data were collected from January 1, 2016 to December 31, 2021 and data were analyzed using χ² test, independent t-test, and multivariate logistic regression with SPSS/WIN 24.0. Results: After discharge for stroke, the readmission rate was 23.7%, and the mortality rate was 0.3%. The variables with significant differences between the readmission group and non-readmission group were age, type of stroke, surgery, ICU treatment, mRS score, blood pressure, diabetes, and heart disease. Factors influencing an readmission in stroke patients were Age 65-74 (OR 1.30, 95% CI=1.03-1.64), ≥ 75 (OR 1.28, 95% CI=1.02-1.62), mRS score 2points (OR 2.50, 95% CI=1.99-3.13), HTN status (OR 1.26, 95% CI=1.07-1.50), CVD status (OR 1.38, 95% CI=1.01-1.90), TC (OR 1.60, 95% CI=1.05-2.44). Conclusion: To lower the readmission rate of stroke patients, it is essential to control lifestyle, including whether or not to take treatment drugs, after diagnosing risk factors such as high blood pressure, diabetes, and heart disease, hyperlipidemia. Nursing interventions that can provide information on risk factor management and coping strategies are urgently needed as symptoms change. In addition, research is needed to develop and implement an intervention strategy that can improve the function of stroke patients as much as possible at home or in society so that they can lead an independent life without the help of others, and verify their effectiveness.

• 대한물리의학회지
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• 제9권4호
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• pp.475-483
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• 2014

PURPOSE: The purpose of the study was to determine the effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke patients. METHODS: The subjects were 50 patients who were diagnosed with cerebrovascular accident. They were randomly assigned either to a close kinetic chain resistant exercise of lower extremity group (study group)(n=25) or open kinetic chain resistant exercise of lower extremity exercise group (control group)(n=25). Gait abilities were measured by using Timed Up & Go (TUG) test, Functional Gait Assessment (FGA) and spatio-temporal gait variable that were velocity, cadence, stride length, double limb support by 3 axises wireless accelerometer and sway angle of center of mass by same instrument. RESULTS: Study group and control group before and after the intervention there were significantly difference in TUG, FGA, spatio-temporal gait variables and sway angle of center of mass (p<.05). There were significantly different between study group and control group for all variables at post-exercise. CONCLUSION: When all is said and done it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with stroke. In its final analysis when applying resistant exercise of lower extremity to stroke patients' gait, close kinetic chain is more effective than open kinetic chain.

• 대한물리치료과학회지
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• 제27권1호
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• pp.56-65
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• 2020

Purpose: Individuals affected by stroke present with changes in motor function, balance, and cognition. The purpose of this study was to the correlation between motor function, balance, and cognition in patients with stroke. Design: cross-sectional study design. Methods: 67 stroke patients in the experiment were included. For evaluation of motor function which is Manual Muscle Test, Range of Motion, Modified Ashworth Scale for spasticity, grasping power, and balance was measured using the Berg Balance Scale and Functional reach test. For evaluating Cognition which is Korean-Mini Mental State Examination. Results: The results of this study's motor function, balance, and cognition showed a significant positive correlation (p<0.05). Conclusion: The results indicated that motor function, balance, and cognition were significantly correlated with each other. Therefore, it is suggested that to improve the motor function and balance of patients with stoke, it needs to evaluate the cognition and the motor function, balance, and cognitive training should be combined.

• 노인간호학회지
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• 제20권3호
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• pp.167-176
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• 2018

Purpose: Post Stroke Depression (PSD) is one of the most common complications for stroke survivors and is associated with negative health outcomes such as disability, death. The purpose of this study was to investigate the prevalence and predictors of PSD among older Korean adults living in the community. Methods: Data collection was done using the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults. Participants were 706 older adults who had a stroke. Logistic regression analysis was used to determine the predictors of PSD. Results: The prevalence of PSD which was assessed by the short form of the geriatric depression scale was 49.4%. In a logistic regression model, the predictors of PSD were self-rated health (OR=5.90, CI=3.70~9.40), economic state (OR=2.97, CI=2.07~4.24), independent activities of daily living (IADL) (OR=2.17, CI=1.30~3.63), Activities of Daily Living (ADL) (OR=2.02, CI=1.07~3.80), and education (OR=1.53, CI=1.05~2.24). Conclusion: PSD was common among older Korean adults living in the community. Poor self-rated health status, lower economic state, lower levels of Instrumental Activities of Daily Living (IADL) and ADL, lower levels of education should be considered when conducting activities related to prevention and management of PSD in older adults.