Purpose The aim of this study was to identify the effects of stigma, social support, and resilience on post-traumatic growth in patients with stroke and to provide foundational data for developing nursing interventions that can effectively promote post-traumatic growth in this population.
Methods This cross-sectional study employed a questionnaire-based survey. The participants were 150 patients who attended the neurology outpatient clinic three months after a stroke diagnosis. Data were collected between February and April 2024 using a structured self-report questionnaire. Analyses included descriptive statistics, reliability analysis, inferential statistics(independent t-test, one-way ANOVA, and Scheffé's test), and hierarchical multiple regression using SPSS/WIN 27.0.
Results The mean post-traumatic growth score was 2.52±1.05 out of 5. Significant factors affecting post-traumatic growth were age, education, religion, the presence of a housemate, income, time since stroke onset, stroke type, and stroke recurrence. Post-traumatic growth was positively correlated with social support (r=.44, p<.001) and resilience (r=.53, p<.001), but not significantly correlated with stigma. Regression analysis identified resilience (β=.37, p<.001), religion (β=.29, p<.001), and stroke type (β=.23, p=.033) as significant predictors, explaining 44.2% of the variance in post-traumatic growth (F=9.45, p<.001).
Conclusion Developing and implementing nursing interventions to increase resilience may be crucial for promoting post-traumatic growth in patients with stroke. Further research is needed to design and evaluate these interventions.
Purpose This systematic review and meta-analysis aimed to investigate the effects of aromatherapy interventions on stroke symptoms in stroke patients. Methods This study adhered to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. Relevant studies published between 2004 and 2022 were searched in the PubMed, CINAHL, Cochrane Library, EMBASE, ERIC, and RISS databases. The review included randomized and non-randomized studies of stroke patients who received aromatherapy interventions targeting stroke symptoms. The extracted literature was evaluated via the ROB 2 and ROBINS-1 quality appraisal checklists and visualized using a risk-of-bias visualization tool. Results The review included five randomized controlled trials and five quasi-experimental studies. The results showed that aromatherapy, administered through massage, inhalation, acupressure, mouth care, and olfactory stimulation, was effective in alleviating pain, constipation, oral health, motor power, muscle strength, balance, fatigue, and sleep quality. Aromatherapy also demonstrated beneficial effects in reducing depression, stress, delirium, blood pressure, pulse rate, respiration rate, serum cortisol, and antioxidants, while enhancing happiness, body temperature, and quality of life. A meta-analysis of mean differences in post-test results revealed that three studies reported a significant effect on pain, with an effect size of 1.85 (95% CI, 0.18~3.51). Conclusion Aromatherapy had positive effects on physical, physiological, psychological, cognitive, and integrative health outcomes. We recommend the use of aromatherapy in stroke patients to improve pain relief and health outcomes.
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Purpose This study investigated how multimodal sensory stimulation affected Glasgow Coma Scale (GCS) scores in stroke patients with decreased consciousness at Dr. Moewardi Hospital in Surakarta, Indonesia. Methods We employed a quasi-experimental approach with a pretest and posttest control group design. The control and intervention groups each contained 22 participants, all of whom were recruited via convenience sampling. The intervention group was given multimodal sensory stimulation (auditory, visual, olfactory, gustatory, and tactile) five times daily for a total of five days, with each session lasting 25 minutes. By contrast, the control group only received routine care from the hospital (i.e., no intervention). For statistical analysis, we used both the Wilcoxon test and Mann-Whitney test. Results We found a significant increase in posttest GCS scores for the intervention group (from 9.63 to 13.18, p=.001), but there was no significant increase for the control group (from 10.09 to 10.54, p=.085). Conclusion In this study, multimodal sensory stimulation effectively increased GCS scores in stroke patients with decreased consciousness. Nurses can use this intervention to improve sensory and GCS scores for such patients while in the intensive care unit.
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Purpose This study identified relationships among person-centered care environment, patient engagement, and patient outcomes in stroke rehabilitation patients. Methods This descriptive, correlational study was conducted using data from 243 post-stroke patients who were admitted in 6 rehabilitation hospitals. We collected data using self-report, structured questionnaires, which included items about the person-centered care environment, patient engagement, patient outcomes (patient satisfaction with nursing care, activities of daily living, levels of depression), and demographic characteristics. Path analysis and descriptive analyses were performed using SPSS 20.0 and AMOS 20.0. Results The hypothesized path model fit well for data based on goodness-of-fit indices. In the path model, person-centered care environment was significantly related to patient engagement and patient satisfaction with nursing care but not to activities of daily living and levels of depression, controlling for demographic characteristics. Additionally, person-centered care was significantly related to patient satisfaction with nursing care and reduction of depression through patient engagement. Conclusion Findings indicate the importance of developing a person-centered care environment to improve satisfaction with nursing care for stroke rehabilitation patients. A person-centered care environment improves patient engagement, which might be a significant factor in patient outcomes, including reduced depression for stroke rehabilitation patients.
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Purpose This study investigates the mediating effects of self-care competence on the relationship between uncertainty and quality of life in stroke patients.
Methods: This study adopts a descriptive research approach using 158 patients diagnosed with ischemic or hemorrhagic stroke through brain Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The data collection period was from May 20, 2020 to September 29, 2020. The data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and a three-step regression analysis using Baron and Kenny’s method for mediation.
Results: The mean scores for uncertainty, self-care competence, and quality of life were 3.07±0.49, 3.66±1.07, and 3.54±0.93, respectively. Self-care competence was found to completely mediate the relationship between uncertainty and quality of life (z=-5.31, p<.001), and its explanatory power was 77.2%.
Conclusion: To improve the quality of life among stoke patients in uncertain situations, it is necessary to improve their self-care competence and develop step-by-step and differentiated self-care competence enhancement programs through multidisciplinary collaboration.
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Purpose This study aimed to identify how health literacy in patients with stroke and their family caregivers influences their health behavior.
Methods: A total of 95 patient-family caregiver dyads were recruited from March to September 2018. Health literacy was measured using the newest vital sign and the health behavior scale was used to identify the health behavior of patients. Data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, Pearson’s correlation, and multiple regression.
Results: The mean age of patients with stroke and family caregivers was 69.44±8.25 and 54.01±14.42 years, respectively. The proportion of women in the family caregivers was 72.6%. The average health literacy score of patients with stroke and their family caregivers was 2.26±1.75 and 3.03±1.97, respectively. The multiple regression analysis revealed that patients’ interest in health (p<.001), health literacy (p=.037), age (p=.001), and caregivers’ gender (p=.028) were the significant factors influencing health behavior of patients with stroke.
Conclusion: In providing optimal care, nurses must ensure that information is provided to both patients and their family caregivers in a clear and effective manner. To improve health behavior in patients with stroke, various strategies are needed to increase their interest in health while considering their age and health literacy.
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PURPOSE This study explored the level of Post-Traumatic Growth (PTG) in stroke patients receiving rehabilitation treatment and identified the effects of hope, meaning in life, and social support on PTG. METHODS A sample of 165 participants was surveyed in a cross-sectional study. Data were collected from January 17, 2018 to April 9, 2018 using self-report structured questionnaires and analyzed using descriptive statistics and hierarchical regression analysis with SPSS/WIN 24.0 program. RESULTS The mean score for PTG in stroke patients was 2.82±1.14 (range 0~5). Living with family (t=−2.37, p=.019), having a religion (t=2.91 p=.004), higher income (F=8.94, p<.001), shorter period in stroke diagnosis (≤6 month) (F=3.88, p=.010), having no speech defect (t=−2.24, p=.026), and good functional status (F=3.99, p=.020) were associated with higher PTG. The higher levels of hope (r=.73, p<.001), higher meaning in life (r=.64, p<.001), and higher social support (r=.49, p<.001) were related to higher PTG. Hierarchical regression analysis showed that hope (β=.43, p<.001), meaning in life (β=.25, p=.001), and social support (β=.12, p=.044) were effective factors of PTG in stroke patients. These variables accounted for 42%p of the variance in PTG (F=20.52, p<.001). CONCLUSION The study provides insights into how hope, meaning in life, and social support promote PTG in stroke patients. To increase PTG in stroke patients receiving rehabilitation treatment, health care providers should consider developing intervention programs to help increase hope, meaning in life, and social support.
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PURPOSE This study aims to identify the effects of health literacy and stroke knowledge on adherence to self-care behavior among the elderly with ischemic stroke. METHODS The participants were 92 outpatients aged 65 or older with ischemic stroke, who were visiting the neurology or neurosurgery departments of two general hospitals in Chungcheongbuk-do between November 20, 2018, and April 9, 2019. The SPSS/WIN 23.0 program was used to analyze descriptive statistics, independent t-tests, and one-way ANOVA, and multiple regression. RESULTS The mean age of participants was 73.25±5.72 and the proportion of men was 71.7%. The average score for health literacy, stroke knowledge, and adherence to self-care behavior were 9.26±2.32, 10.34±2.53, and 81.67±14.72, respectively. There were statistically significant differences in adherence to self-care behavior according to living and time since stroke. Adherence to self-care behavior and health literacy showed a statistically significant positive correlation with stroke knowledge. Stroke knowledge, living alone, and time since stroke(less than one year) were significantly related to the adherence to self-care behavior. This regression model explained 24.0% of the variance in the adherence to self-care behavior. CONCLUSION To improve the adherence to self-care behavior in the elderly with ischemic stroke, it is necessary to develop and implement educational program for those who live alone and who have experienced stroke less than one year previously.
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PURPOSE The purpose of this study was to assess the awareness of warning signs of stroke and identify the risk factors influencing such awareness among diabetics with hypertension who are at a high risk for stroke. METHODS Data from the 2017 Korea Community Health Survey were used. A total of 15,536 adults older than 30 years diagnosed with hypertension and diabetes mellitus were included in the final analysis. Data were analyzed using frequency, percentage, χ2 test, and logistic regression with SPSS/WIN 24.0 program. RESULTS Among the five warning signs of stroke, “sudden trouble in speaking or understanding†(79.0%) was the most commonly identified one and “sudden severe headache with an unknown cause†(65.2%) was the least. Only 48.8% participants identified all five warning signs and 11.8% could not identify any of them. In the logistic regression model, the risk of unawareness of warning signs of stroke was significantly higher among those aged 30~49 years and 70 years or older, with a lower educational level, without a spouse, and with a heavy alcohol consumption and current smoking status. CONCLUSION The level of awareness of warning signs was low in hypertensive diabetic adults. To improve awareness of warning signs of stroke, a customized educational program should be provided to hypertensive diabetic adults considering the risk factors relevant to unawareness of warning signs of stroke. The education on warning signs of stroke can potentially lead to a reduction in morbidity in the survivors.
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PURPOSE The purpose of this study was to identify factors associated with family caregivers' self-management of acute stroke survivors. METHODS The study participants were 130 stroke survivors and their caregivers. Data on participant characteristics, depression, task difficulty, survivor memory and behavioral problem, and self-management were collected from July 1 to September 30, 2017 using a structured questionnaire. Data were analyzed with the SPSS/WIN 23.0 program for descriptive statistics, using independent t-test, one-way analysis of variance, Pearson's correlation coefficient and enter multiple regression analysis. RESULTS Significant factors associated with self-management for family caregivers were survivors' age, the presence of comorbidities, the relationship between caregivers and survivors, and the presence of an alternative caregiver. Self-management has negative correlations with depression, task difficulty, and the occurrence of survivor memory and behavioral problems. The determining factors affecting caregiver self-management were caregiver depression (β=−.46, p < .001) and survivor age (β=.32, p=.004), and their explanation power was about 37%. CONCLUSION The results suggest that caregiver depression and survivor age should be considered in developing the nursing interventions to improve family caregiver self-management. Furthermore, findings underscore the importance of early screening and ongoing psychological assessments for depression in family caregivers of stroke survivors.
PURPOSE The purpose of this study was to identify the factors influencing resilience of patients with stroke. METHODS A cross-sectional descriptive research design was used. The subjects of this study were 136 hospitalized patients with stroke in Dankook university hospital in Cheonan, Korea. Data were collected from August 2016 to March 2017 using a structured questionnaire including patient's characteristics, depression, uncertainty, social support, self-efficacy, and resilience. Data were analyzed using the SPSS/WIN 21.0 program for descriptive statistics, using independent t-test, one way analysis of variance, Pearson's correlation coefficient, and multiple regression. RESULTS Resilience had a statistically significant relationship with education (t=−2.17, p=.032), duration of diagnosis (F=4.09, p=.019), and mobility (F=4.44, p=.014). Further, depression (r=−.30, p < .001), self-efficacy (r=.44, p < .001), and social support (r=.37, p < .001) were significantly correlated with resilience. In the multiple regression analysis, self-efficacy and social support were statistically significant factors that explained 30.3% of variance of resilience in hospitalized patients with stroke. Depression and uncertainty were not found to be significant. CONCLUSION The results of the study indicate that factors influencing resilience are self-efficacy and social support. Therefore, nursing intervention programs for increasing the resilience should include strategies for improving self-efficacy and social support for hospitalized patients with stroke.
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PURPOSE Although post-stroke sensory disorder is different from post-stroke pain, it is often considered as central pain or overlooked in the clinical field. The purposes of this study were to develop the nursing algorithm for stroke patients with sensory disorder and examine its effect. METHODS The study used a methodological design to develop the nursing algorithm and a pretest-posttest design to examine its effect in stroke patients. The algorithm was developed through the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) using systematic review, expert panel interview, and patient interview. The algorithm was applied to 51 ischemic stroke patients experiencing sensory disorder at subacute stage by 10 nurses in a university hospital in Seoul city, Korea. RESULTS The contents of the algorithm included inclusion and exclusion criteria for relevant patients, assessment tool developed in this study, and the intervention (non-pharmacological and pharmacological) process based on the assessment results. The assessment tool and the intervention process had acceptable inter-rater reliability with Cohen's Kappa .82 and .94, respectively. The scores of sensory disorder decreased from 2.71 to 0.51 with the algorithm application in 51 patients. CONCLUSION The nursing algorithm for sensory disorder in stroke patients improved the symptoms and can be used conveniently by clinical nurses. Using this algorithm, nurses can provide relevant care for stroke patients with stiff, cool, obtuse, or vibrating sensors that cause insomnia, anorexia, and physical functional decline.
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PURPOSE This study aimed to develop a navigation program for family caregivers of stroke patients admitted to a rehabilitation hospital and evaluate differences in caregiver outcomes before and after the intervention. METHODS The navigation program consists of education, demonstration and return demonstration. To evaluate the program, we conducted a quasi-experimental study in 44 caregivers (22 experimental group received the navigation program vs. 22 controls group did not received). Caregivers completed the burden, anxiety, depression, self efficacy, caregiving mastery, quality of life, and patient's Activities of Daily Living (ADL). Data were collected using self-report structured questionnaires. The data were analyzed using the SPSS/WIN 21.0 with the χ2-test, and independent t-test. RESULTS Compared with the control group, caregivers who received the navigation program reported significant decrease in caregiver burden, depressive symptoms and anxiety and significant improvement in their mastery, self-efficacy, quality of life and patient's ADL. CONCLUSION Delivering the navigation program to family caregivers of stroke patients in a rehabilitation hospital setting was feasible. Our results provide preliminary support for the navigation program to reduce negative outcomes (e.g., burden, anxiety, depression) and improve positive outcomes (e.g., mastery, self efficacy, quality of life, patient's activities of daily living) in family caregivers who experience first stroke diagnosis of their loved one.
PURPOSE The purpose of this study was to examine whether the uncertainty mediates relationship between rehabilitation motivation and social support. METHODS Participants were 123 adults patients diagnosed as stroke in a hospital located in a Metropolitan City. Data were collected by self-administered questionnaires measuring uncertainty, family support and medical team support as social support, rehabilitation motivation. Data were analyzed using t-test, one-way ANOVA, Pearson's correlation, and multiple regression analyses. The significance of mediating effect was analyzed by Sobel test. RESULTS Family support and uncertainty, respectively, were influential on rehabilitation motivation (β=.39, p < .001, β=-.18, p=.011). Uncertainty showed partial mediating effect on relationship between family support and rehabilitation motivation, however, the effect was not significant (Z=1.63, p=.103). CONCLUSION Interventions improving family support and decreasing uncertainty may be helpful in enhancing rehabilitation motivation.
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PURPOSE The purpose of this study was to identify the following: knowledge of stroke, fear of recurrence and health behaviors among patients with ischemic stroke. Further, factors influencing health behavior will be described. METHODS Data were collected from 180 patients with ischemic stroke at a general hospital. The study instruments included items about general and health related characteristics, a Stroke Knowledge Scale, a Stroke Fear of Recurrence Scale, and a Health Behavior Scale. Hierarchical regression method was conducted to examine predictors of health behavior. RESULTS The mean age of the participants was 63.62±11.10 years, and 57.8% of the sample was men. The mean score for stroke knowledge (possible range=0~17) was 14.99±1.76, the mean score for fear of recurrence (possible range=0~32) was 23.16±3.75, and the mean score for health behavior (possible range=20~80) was 54.69±6.46. Stroke knowledge and fear of recurrence were associated with health behavior in patients with ischemic stroke (F=9.98, p < .001, Adjusted R²=.43). CONCLUSION The results demonstrated that stroke knowledge and fear of recurrence impacts the health behavior among patients with ischemic stroke. Thus, nursing interventions which focused on fear of recurrence as well as enhancing stroke knowledge could help health behavior in patients with ischemic stroke.
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PURPOSE This study was to test a structural model of spirituality and the quality of life of stroke survivors' caregivers in order to provide guidelines for the development of intervention and strategies to improve their quality of life. METHODS Data were collected from 133 family caregivers of stroke patients who were hospitalized in C university hospital located in Seoul. Data collection using survey questionnaires was done from May, 2013 to February, 2014. RESULTS Fitness of the hypothetical model was appropriate. Physical component of quality of life of family caregivers is directly affected by two variables (51.5%), burden and depression. Mental component of quality of life of family caregivers is directly affected by three variables (77.6%), depression, burden, and functional dependence of patients. Depression as well as burden were directly affected by spirituality and functional dependence of patients respectively. Thus, spirituality directly affected depression and burden and indirectly affected the quality of life of family caregivers. CONCLUSION Therefore, spiritual intervention to improve the stroke caregivers' quality of life might be necessary to support and strengthen their spirituality as a mediating variable that can contribute to decreasing their depression and burden.
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Factors Influencing the Quality of Life of Family Caregivers of Stroke Patients: A Cross-Sectional Survey Ji-Hye Lee, Mi Sook Jung Journal of Korean Academy of Fundamentals of Nursing.2023; 30(4): 479. CrossRef
Factors Influencing Family Caregivers' Self-management of Acute Stroke Survivors Ji Yeon Lee, Hee Kyung Chang Korean Journal of Adult Nursing.2018; 30(6): 669. CrossRef
PURPOSE Aspiration pneumonia (AP) is the major complication of dysphagia in patients with acute stroke. Nursing management for dysphagia influences on patients' health outcomes. The purpose of this study was to develop and evaluate the effects of Dysphagia Nursing Protocol (DNP) for patients with acute stroke. We aimed to examine the incidence of AP and the dependency rate at the discharge. METHODS We used a non-equivalent control group posttest only design in this study. DNP was developed with content validity index > 0.75 in all items. This protocol was composed of the evaluation, education, complication prevention, and checking phases. After training the staff nurses, we applied DNP protocol to the experimental group. The control group was enrolled from June to August 2013 (n=80), and the experimental group was June to August 2014 (n=64). RESULTS The incidence of AP was 16.3% in control group while 4.7% in experimental group (p=.028), and the Odds Ratio (OR) was 0.26 (p=.045). The dependency ratio was 66.3% in control group while 43.8% in experimental group (p=.011), and the OR was 0.33 (p=.011). CONCLUSION DNP was beneficial for the reducing the risk of AP and the improved the functional status.
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Dysphagia and daily oral fluids among cerebrovascular stroke patients: an theory-based nursing intervention protocol Zeinab Hussein Ali, Marwa Abd-Elaziz, Amany Abdrbo Frontiers of Nursing.2023; 10(2): 213. CrossRef
PURPOSE This study was to provide understanding about the meaning of nasogastric tube feeding experiences by the cerebral stoke patients with dysphagia. METHODS Data were collected through a face to face interview from five cerebral stroke patients who had dysphagia along with a nasogastric tube insertion. The contents of the interviews were analyzed using the hermeneutics phenomenological method developed by van Manen. RESULTS The experience of having a nasogastric tube was not only limited to physical problems but also was linked to other psychological problems. Many patients reported that they tolerated the nasogastric tube in order to overcome the stroke along with the desire to eventually take food orally. The essential themes associated with the experience of nasogastric tube insertion were: "The loss of pleasure from food", "The loss of human relationship from surrounding table", "Cower and shrink from the different appearance to others" and "Acceptance for life in painful experiences". CONCLUSION This study would highlights the importance of not only physical focused care but also psychological and social aspects. Therefore, nurses should consider all factors when providing nursing care to stroke patient with nasogastric tube feeding.
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Dysphagia and quality of life: a narrative review Jung Mi Song Annals of Clinical Nutrition and Metabolism.2024; 16(2): 43. CrossRef
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Dietary Habits, Food Product Selection Attributes, Nutritional Status, and Depression in Middle-Aged and Older Adults with Dysphagia Dahyeon Ko, Jieun Oh, Soyoung Joo, Ju Yeon Park, Mi Sook Cho Nutrients.2022; 14(19): 4045. CrossRef
Combined Effects of NMES and Mendelsohn Maneuver on the Swallowing Function and Swallowing–Quality of Life of Patients with Stroke-Induced Sub-Acute Swallowing Disorders Haewon Byeon Biomedicines.2020; 8(1): 12. CrossRef
The mediating and moderating effects of meaning in life on the relationship between depression and quality of life in patients with dysphagia Ju‐Yeun Kim, Young Whee Lee, Hwa‐Soon Kim, Eun‐Hyun Lee Journal of Clinical Nursing.2019; 28(15-16): 2782. CrossRef
PURPOSE The study was designed to identify influencing and mediating factors of health behaviors of stroke patients based on the hypothetical model constructed in this study. METHODS Non-experimental correlational research design was used. One hundred and five stroke patients were conveniently selected from one university hospital located in Incheon. Data were collected with survey and analyzed by path analysis to examine the significant influencing and mediating factors of health behaviors in stroke patients. RESULTS Age, diagnosis, disability in ADL, knowledge related to health behavior, and self-efficacy had significant direct causal influences on health behavior. And it was shown that knowledge and self-efficacy mediated influence of cohabitation status with family (whether or not living together with family) on health behavior. Self-efficacy also mediated influence of knowledge on health behavior. CONCLUSION From the results, it was proposed that providing knowledge related to health behavior and enhancing self-efficacy by educating skill necessary for health behaviors and promoting health related beliefs might increase health behavior particularly for stroke patients living together with family.
PURPOSE Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. METHODS The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. RESULTS A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. CONCLUSION We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.
PURPOSE The purpose of this study was to investigate the balance confidence and balance ability among community-residing stroke patients. METHODS: The sample for this study was a convenience sample obtained from patients who visited welfare centers for the disabled in three cities from October to December in 2009. The Activities-specific Balance Confidence Scale and Berg Balance Scale were used to measure confidence in task performance and balance ability. RESULTS: The level of balance confidence and balance ability were low in these subjects. There was a significant relationship between balance confidence and balance ability (r=.424, p=.000). Subjects with less balance ability felt less balance confidence. CONCLUSION: Among community-residing stroke patients, falls are common. Falls prevention which may contribute to the incidence of fall and fall related injury should be part of stroke rehabilitation plan. Also, it is necessary that an intervention for falls prevention after stroke should take into account factors such as the balance confidence and balance ability.
PURPOSE The purpose of this study was to determine an increase in the number of younger and middle-aged people who have a stroke and the differences in their recovery experience compared with older people. METHODS The research question for this study was "What is the recovery experience of young adults and middle-aged people who suffer a stroke?". In order to answer the question, the grounded theory method was utilized. The data was collected through individual in-depth interviews of six participants, their age ranged from 36 to 45 years old. RESULTS After comparative analysis, the core category was "standing up for oneself with limit". The experience process were categorized into four stages: 'Facing Reality stage', 'Motivation stage', 'Desire Recovery stage', 'Self-Overcoming stage'. CONCLUSION Most of the research for the recovery process was prognostic in nature and the results. This study was demonstrated certain indicators which can be useful in further research.
PURPOSE The purpose of this study was to evaluate the effects of the meridian massage on the hand edema, activities of daily living (ADL), and depression in hemiplegic stroke patients. METHODS The research was a quasi-experimental design using a non-equivalent control group pre-post test. The subjects were 40 stroke patients who admitted to rehabilitation department in a hospital. The data was collected from January to March, 2009 used the millimeter measurement for checking hand edema and the structured questionnaires. The meridian massage on affected hand was carried out for 10 minutes per day during 2 weeks to the experimental group. Descriptive statistics, -test, Fisher's exact test, and t-test with SPSS/WIN 12.0 program were used to analyze the data. RESULTS After the intervention, there were statistically significant differences in the changes of hand edema, ADL, and depression in the experimental group compared with the control group. CONCLUSION The meridian massage was effective in improving hand edema, the level of ADL, and depression for the hemiplegic stroke patients. Therefore the meridian massage can be utilized as an effective adjuvant therapy for stroke patients suffering from hand edema in clinical practice.
PURPOSE This study was to examine the reliability and validity of Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional measurement for stroke patients. METHODS This was a methodological study performed from May 6 to June 10, 2009 at a tertiary university hospital in Seoul. For reliability of PG-SGA, inter-rater reliability was used for statistics. For concurrent validity, BMI and biomarkers were compared between PG-SGA 0 ~ 8 and > or = 9. In addition, sensitivity, specificity, and predictive value of PG-SGA compared with SGA were calculated using a contingency table. For predictive validity, hospital day, complications, and readmission within 1-month after discharge were compared between PG-SGA 0 ~ 8 and > or = 9. RESULTS Correlation of PG-SGA score between two observers was 0.83, and kappa value for the agreement of severe malnutrition was 0.78(all p(s) < .001). The scored PG-SGA showed high sensitivity and specificity (100% and 96.7%, respectively). Severe undernourished patients (PG-SGA > or = 9) had significantly low TLC, protein, albumin, and prealbumin (all p(s) < .01) compared with non-undernourished patients (PG-SGA 0 ~ 8). Also, in severe undernourished patients, complications and readmission (all p(s) = 0.01) were more often represented, and hospital days (p = .013) were significantly delayed. CONCLUSION PG-SGA is a reliable and valid measurement to assess nutritional status for stroke patients.
PURPOSE This study was conducted to study the acceptance of disability and influential factors between hemiplegic elderly and non-elderly after stroke. METHODS Data were collected with questionnaires from 104 elderly and 134 non-elderly with hemiplegia. Data were analyzed by chi-square-test, t-test, ANOVA, ANCOVA, Pearson correlation coefficient, and multiple regression. RESULTS Significant predictors of acceptance of disability were family support, activities of daily living, and age, and these factors accounted for 24.2% of variance in acceptance of disability in the hemiplegic elderly. On the other hand, the significant predictors were family support and employment, and these factors accounted for 32.3% of variance in acceptance of disability in the non-elderly. Family support was the most influential variable in both the elderly and the non-elderly. CONCLUSION An acceptance of disability program for the hemiplegic elderly should be designed differently from that for the non-elderly.
PURPOSE This descriptive study was conducted to identify the level of knowledge of stroke symptoms and risk factors among older adults. METHODS A total of 200 older adults over 65 years of age were conveniently recruited from out patient departments of two hospitals and a health care center from October to November 2008. The level of knowledge was assessed using both open-ended questions and a structured questionnaire based on semi-structured interviews. Data were analyzed by t-tests and ANOVA using the SPSS program. RESULTS 52.5% of the sample had hypertension and 30% had diabetes. The mean knowledge scores for symptoms and risk factors were 8.4 +/- 3.1(out of 15) and 9.5 +/- 3.9 (out of 16), respectively. The older adults who had lower education, lower family income, and who lived in rural areas were more likely to have less knowledge of stroke symptom and risk factors(p < .05). There was no significant knowledge difference between the older adults who had at least one risk factor and those who had no risk factor for stroke. CONCLUSIONS Educational intervention should be focused on informing older adults who are at risk for stroke about the early symptoms and management of risk factors, especially those who have low education and low social status.
PURPOSE The purpose of this study was to identify the effect of meridian acupressure on constipation in bed-ridden aged inpatients. METHODS: The research design was a non-synchronized non-equivalent control group pretestposttest design. The subjects consisted of 28 bed-ridden aged inpatients. Meridian acupressure was administered to the experimental group at 30 minutes before breakfast every morning for two weeks. Each meridian was pressured for 10 seconds, 10 times. The frequency of defecation and stool form were examined every day. The data was analyzed by the chi-square-test, Fisher's exact test, t-test and repeated measures ANOVA. RESULTS: The experimental group given Meridian Acupressure had a higher frequency of defecation(F = 59.372, p = .000) and normal stool(F = 46.046, p = .000) than the control group. CONCLUSION: The results suggest that Meridian Acupressure was an effective method for the relief of constipation for bed-ridden aged inpatients. A follow -up research is needed to validate that other patients with constipation can use the Meridian Acupressure as a non-invasive nursing intervention instead of a laxative or enema.
PURPOSE This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. METHODS: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. RESULTS: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. CONCLUSION: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.
PURPOSE This study examined the effect of a self-help management program which strengthens self-efficacy on the self-efficacy and the activities of daily living(ADL) in stroke patients. METHODS: A quasi-experimental nonequivalent control group, pre and post design was used. The subjects consisted of 47 stroke patients. Twenty-six patients were assigned to the experimental group and 21 patients were assigned to the control group. The self-help management program by strengthen self-efficacy and general hospital care were carried out on the experimental group. General hospital care was performed on the control group. The data was collected before and 5 weeks after the program. All subjects were questioned about the self-efficacy and ADL before and after the program. RESULTS: The scores of the self-efficacy and ADL in the experimental group were higher than those in the control group. CONCLUSION: The self-help management program by strengthen self-efficacy is effective in increasing the self-efficacy and ADL. Therefore this program may be a useful intervention to increase the ADL in stroke patients.
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