• Title/Summary/Keyword: Aged stroke patients

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Effects of Fluid Therapy Education Program for Aged Stroke Patients (노인 뇌졸중환자의 수분섭취교육 프로그램의 적용 효과)

  • Lim, Jee Sun;Jo, Hyun Sook
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.277-285
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    • 2015
  • Purpose: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. Methods: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. Results: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum $Na^+$ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. Conclusion: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.

Clinical Analysis of Stroke in Young Adults (청장년층 뇌졸중에 대한 고찰)

  • 정은정;배형섭;문상관;고창남;조기호;김영석;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.1
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    • pp.84-90
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    • 2000
  • Background and Purpose: Stroke in young adults is relatively uncommon. Only 3.7-14.4% of all strokes occur in patients aged 15-45 years. Stroke in young adults has more various and diverse possible causes than stroke in the elderly. We studied to gain further insight into both pathogenic and etiologic determinants in young adults with stroke. Methods : We retrospectively reviewed the medical records of 230 young patients aged 15-45 years who were admitted to the 2nd internal medicine department of Kyung Hee Oriental Medical Center with a diagnosis of stroke between May 1995 and May 1999. We analysed clinical features and diagnostic tests, such as brain imaging, cerebral angiography, echocardiography, 24 hours holter monitoring and other laboratory tests. Results : 1. Of 230 young patients with stroke aged 15-45 years(176 males(76.5%) and 54 females(23.5%)), 140 patients(60.9%) showed ischemic stroke and 90 patients(39.1 %) showed hemorragic stroke. 2. The most prevalent age group was from 40 to 45 years with 142 patients(61.7%) 3. The most frequent site of 140 ischemic stroke was MCA territory in 93 cases(66.4%) and Multiple, VA territory, PCA territory, ACA territory in order of frequency. 4. The most frequent site of 90 hemorrhagic stroke was basal galglia hemorrhage 57 cases(63.3%) and subcortical 13 cases(14.5%), pons, thalmus, subarachnoid, cerebellum in order of frequency. 5. The causes of hemorrhagic stroke were hypertension 49 cases(54.5%), arteriovenous malformation 7 cases(7.8%), ruptured aneurysm 4 cases(4.5%), angioma 3 cases(3.3%). 6. The risk factors of ischemic stroke were smoking, alcohol drinking, hyperlipidemia, hypertension, obesity, heart disease, history of CVA, diabetes mellitus, in order of frequency. 7. The comparison of risk factors between ischemic and hemorrhagic stroke: hypertension was prevalent in hemorrhagic stroke, heart disease and history of CVA were prevalent in ischemic stroke. Conclusions: From the above results, we found that stroke in young adults had various possible causes. Young adults with stroke deserve an extensive but tailored evaluation which include angiography and echocardiography for diagnosis.

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A Study for Distribution of Pattern Identification by Age in Stroke Patients (중풍 환자의 연령에 따른 변증 유형 분포에 대한 연구)

  • Yeo, Hyeon-Su;Hsia, Yu-Chun;Baik, Jong-Woo;Park, Jong-Hyung;Choi, You-Kyung;Ko, Ho-Yeon;Cho, Ki-Ho;Jang, Bo-Hyung;Ko, Seung-Gyu;Han, Chang-Ho;Bang, Ok-Sun;Jun, Chan-Yong
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.145-151
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    • 2009
  • Objectives: The purpose of this study was to investigate distribution of pattern identification by age in stroke patients. Methods: From 1 April, 2007 to 29 September, 2008, 903 patients within a month after onset of stroke were included. Stroke patients were interviewed by oriental medicine doctors who used standard operation procedures for this study. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation of details to patients and patients' agreement given. Results: Distributions of pattern identification in stroke patients differed by age groups. Dampness-Phlegm pattern was more common in the younger group aged under 80 years, while Yin-Deficiency pattern was more common in the older group aged over 80 years. Conclusions: In this study, we found a character of distribution of pattern identification by age in stroke patients within one month after stroke onset. We have concluded that these differences should be considered in the management and treatment of stroke patients.

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Case-control Study : Cerebral Blood Flow as Measured by TCD in Patients with Risk Factors for Stroke (TCD를 이용한 정상군과 중풍원인질환군의 혈류측정에 관한 비교연구)

  • Heo, Jeong-Eun;Kwon, Jung-Nam;Shin, Won-Tak;Kim, Jong-Deuk;Lee, Sang-Hee;Son, Yeoun-Hui;Kim, Young-Kyun
    • The Journal of Internal Korean Medicine
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    • v.28 no.2
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    • pp.250-261
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    • 2007
  • Objectives : The purpose of this study was to evaluate the blood flow using doppler ultrasound of the MCA, ACA, PCA, BA, ICA in the patients with risk factor for stroke. Methods : 110 patients with risk factor for stroke were selected who had hypertension, diabetes mellitus, hyperlipidemia, or heart disease, as well as 89 healthy adults who did not have any symptoms of those diseases. To evaluate the blood flow, the Vs and Vm of the MCA, ACA, PCA, BA, and ICA in the two groups were measured. Result : In normal healthy adults, subjects showed a decrease in the Vs and Vm: with advancing in age, there was a significant difference in the Vs of MCA, PCA, BA, and ICA. There was a significant difference in the Vm of MCA, PCA, BA, and ICA. In normal healthy adults, females showed high velocities in all examined vessels. There was a significant difference in the Vs of BA. There was a significant difference in the Vm of BA, and ICA. There was a decrease in the Vs, and Vm of all examined vessels of patients with risk factors for stroke in comparison with normal healthy adults. There was no significant difference in the Vs. There was a significant difference in the Vm of MCA, ACA, and PCA. Results were the same between patients aged under 50 and total patients in the Vs and Vm of examined vessels. There were differences between patients aged over 50 and total patients in the Vs of MCA, PCA, BA and for patients aged over 50; patients with risk factor for stroke who had hypertension, diabetes mellitus, hyperlipidemia, or heat disease has higher Vs than healthy adults. Conclusions : There was a significant difference in the blood flow velocity between patients with risk factors for stroke and healthy adults. However, this result was different from results of comparison of TCD findings between patients and healthy individuals by age. Therefore, more detailed studies about aged patients are needed.

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Recent Epidemiological Trends of Stroke

  • Park, Hyun-Seok;Kang, Myong-Jin;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.16-20
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    • 2008
  • Objective : Rapid increase in aged population and westernization of lifestyle have modified epidemiological status of stroke. The purpose of this study is to analyze changing trends of stroke epidemiology in South Korea. Methods : We reviewed retrospectively medical records of 1,124 cases diagnosed as stroke among 54,534 patients who visited the Emergency Medical Center at our hospital from January 1994 to December 1996 (Group A). Also, we evaluated 1,705 cases diagnosed as stroke among 55,381 patients who visited to the same hospital from January 2003 to December 2005 (Group B). The variable features of stroke, such as age, sex, seasonal variation and distribution of stroke subtypes were studied by comparing group A with B. Results : In group A, hemorrhagic stroke (67.9%) was more prevalent than ischemic stroke (32.1%). However, group B showed that the ratio of hemorrhagic stroke (40.3%) to ischemic stroke (59.6%) has been reversed. The highest incidence of stroke was noted in their sixties and seventies of age in group B, which was older than that of group A. In group A, male ischemic stroke (IS) patients outnumbered female patients (1.26:1). Moreover, this gender disproportion became higher in group B (1.53:1). In group A, the number of male intracerebral hermorrhage (ICH) patients were similar to that of female patients (0.97:1). However, male ICH patients outnumbered female patients in group B (1.23:1). As for subarachnoid hemorrhage (SAH), female patients outnumbered male patients more than two-fold in both groups. Both groups showed that the occurrence of ischemic stroke was highest in summer, but that of hemorrhagic stroke was the highest in winter. Conclusion : This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.

Adjustment of Middle-aged People with Hemiplegia after a Stroke (뇌졸중 후 편마비를 가진 중년기 환자의 적응과정)

  • Lee Hwa-Jin;Yi Myung-Sun
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.792-802
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    • 2006
  • Purpose: The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke. Method: For this study, the grounded theory method was utilized. Results: After constant comparative analysis, the core category emerged as 'rebuilding the body which was ruined'. In addition, the causal conditions were 'restriction of physical function', and 'loss of roles'. The adjustment process consisted of the 'facing reality phase', 'overcoming depression phase', 'overcoming physical limits phase' and 'reestablishing roles phase' The main strategies in the facing reality phase were 'holding on to a glimmer of hope', 'getting away from the harsh reality' and 'facing up to the reality'. The main strategies in the overcoming depression phase were 'soothing oneself', 'Self-introspection' and 'restoring self-esteem'. In addition, the main strategies in the self-initiative overcoming physical limits phase was 'discovering personal strategies and striving to recover'. The main strategies in the reestablishing roles phase were 'reestablishing a parents' role', 'reestablishing a spouse's role' and 'reestablishing social roles'. Conclusion: In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.

Effects of Depression on the Rehabilitation Motivation of Middle-Aged Stroke Patients - Focused on the Mediating Effects of Resilience (뇌졸중 중년 환자의 우울이 재활동기에 미치는 영향 - 극복력의 매개효과 중심으로)

  • Oh, Soo-Yong;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.58-66
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    • 2017
  • This study was a descriptive correlational study investigating the mediating effects of resilience in the relationship between depression and rehabilitation motivation in middle-aged stroke patients. There was a total of 185 middle-aged patients aged 40 to 64 years, who were diagnosed with stroke at a university hospital and rehabilitated at three local hospitals located in S city and four hospitals in U city. The data were collected using a self-reported questionnaire between the 1st and 31st of December in 2016. The data were analyzed using t-test, ANOVA, Pearson's correlation coefficient, and step-wise causal method using SPSS/WIN 22.0 statistical program. To test the statistical significance of the mediation effect, PROCESS and bootstrapping were used. The mean age of the subjects were $56.26{\pm}6.37$ years. There were 70.3% male subjects, an average depression level was $21.21{\pm}7.09$, an average resilience was $25.52{\pm}9.63$, and rehabilitation motivation was $47.44{\pm}5.87$. Depression was negatively related to resilience and rehabilitation motivation. However, resilience and rehabilitation motivation have a static correlation. These results confirmed that resilience appears to be a complete mediating effect in the relationship between depression and rehabilitation motivation. Therefore, it is important to develop a resilience enhancement program to improve the motivation of rehabilitation for stroke patients.

A Systematic Review on Driving Rehabilitation of After Stroke (뇌졸중 환자의 운전재활에 관한 체계적 고찰)

  • Park, Bo-Ra
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.37-46
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    • 2018
  • Objective : The aims of this study is to investigate the research trends of driver rehabilitation in stroke patients through systematic consideration and suggests future research directions. Method : This study was conducted on a total of 6 subjects selected from 2008 to 2017. The analysis criteria were classified into qualitative level, published journal, evaluation tool, and keyword. Result : The study on the driving rehabilitation of stroke patients was the highest in IV and V levels at 33.32% each, and the most studies were published in 2014. The keywords of the study were 33.32% each related to driving and stroke. Conclusion : This study investigated the driving rehabilitation of stroke patients. Based on the results, it is necessary to continuously study the effects of various programs for driving rehabilitation in the future.

Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.102-109
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    • 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.

Prevalence and associated factors of dysphagia in patients hospitalized with acute stroke (급성 뇌졸중 입원 환자의 연하장애 유병률과 관련요인)

  • Chang, Hee-Kyung;Yun, Suk-Kyung;Gil, Cho-Rong
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.417-428
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    • 2019
  • The aims of this study were to evaluate the prevalence of dysphagia in patients hospitalized with acute stroke and to identify factors associated with dysphagia. The study was conducted in a tertiary hospital and a total of 131 patients hospitalized with acute stroke (aged 34-92 years old, 58.0% male) were enrolled. The prevalence of dysphagia was 24.4% out of 131 participants and risk factors associated with dysphagia were age, neurological severity, oral health status, and dependence in activity of daily living of participants. Considering the long-term rehabilitation trajectory, it is necessary to apply the early screening and preventive nursing intervention for dysphagia during acute stage of stroke patient.