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Avgeri K, Mantzarlis K, Gerovasileiou E, Deskata K, Chatzi M, Fotakopoulos G, Sgantzos M, Tsolaki V, Zakynthinos E, Makris D. Quality of Life, Family Support, Spirometry, and 6-Minute Walking Distance Differences between COVID-19 and Non-COVID-19 Intensive Care Unit Patients in One Year Following Hospital Discharge. Healthcare (Basel) 2024; 12:996. [PMID: 38786407 PMCID: PMC11121675 DOI: 10.3390/healthcare12100996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Critically ill patients after Intensive Care Unit (ICU) discharge may present disability in their cognitive and physical functions. OBJECTIVES To investigate the quality of life (QoL) of both COVID-19 and non-COVID-19 patients following ICU discharge, lung function, and physical performance of participants. METHODS This study was prospective and conducted between 2020 and 2021 in the "X" hospital. If patients were Mechanically-Ventilated (MV) > 48 h, they were included. RESULTS Fifty COVID-19 and seventy-two non-COVID-19 participants were included in this study. The mean (SD) of the total SF-36 scores at COVID-19 patients at hospital discharge and 3 and 12 months were 46.5 (14.5), 68.6 (17.8), and 82.3 (8.9) (p < 0.05), while non-COVID-19 participants were 48.5 (12.1), 72.2 (9.9), and 82.7 (5.4) (p < 0.05). The forced expiratory volume in one second (FEV1) and 6-minute walking distance (6MWD) were assessed at 3 and 12 months and significantly improved over 12 months. CONCLUSION The QoL of COVID-19 patients improved significantly over time as FEV1 and 6MWD.
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Affiliation(s)
| | - Konstantinos Mantzarlis
- Medical Deparment, University of Thessaly, 41336 Larissa, Greece; (K.A.); (E.G.); (K.D.); (M.C.); (G.F.); (M.S.); (V.T.); (E.Z.); (D.M.)
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Po HW, Lin FJ, Cheng HJ, Huang ML, Chen CY, Hwang JJ, Chiu YW. Factors Affecting the Effectiveness of Discharge Planning Implementation: A Case-Control Cohort Study. J Nurs Res 2023; 31:e274. [PMID: 37167623 DOI: 10.1097/jnr.0000000000000555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND In many hospitals, a discharge planning team works with the medical team to provide case management to ensure high-quality patient care and improve continuity of care from the hospital to the community. However, a large-scale database analysis of the effectiveness of overall discharge planning efforts is lacking. PURPOSE This study was designed to investigate the clinical factors that impact the efficacy of discharge planning in terms of hospital length of stay, readmission rate, and survival status. METHODS A retrospective study was conducted based on patient medical records and the discharge plans applied to patients hospitalized in a regional medical center between 2017 and 2018. The medical information system database and the care service management information system maintained by the Ministry of Health and Welfare were used to collect data and explore patients' medical care and follow-up status. RESULTS Clinical factors such as activities of daily living ≤ 60, having indwelling catheters, having poor control of chronic diseases, and insufficient caregiver capacity were found to be associated with longer hospitalization stays. In addition, men and those with indwelling catheters were found to have a higher risk of readmission within 30 days of discharge. Moreover, significantly higher mortality was found after discharge in men, those ≥ 75 years old, those with activities of daily living ≤ 60, those with indwelling catheters, those with pressure ulcers or unclean wounds, those with financial problems, those with caregivers with insufficient capacity, and those readmitted 14-30 days after discharge. CONCLUSIONS The findings of this study indicate that implementing case management for discharge planning does not substantially reduce the length of hospital stay nor does it affect patients' readmission status or prognosis after discharge. However, age, underlying comorbidities, and specific disease factors decrease the efficacy of discharge planning. Therefore, active discharge planning interventions should be provided to ensure transitional care for high-risk patients.
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Affiliation(s)
- Hui-Wen Po
- MSN, RN, Department of Nursing, National Taiwan University Hospital Yunlin Branch, Taiwan
| | - Fang-Ju Lin
- MS, RN, Head Nurse, Department of Nursing, National Taiwan University Hospital Yunlin Branch, Taiwan
| | - Hsing-Jung Cheng
- MS, RN, Supervisor, Department of Nursing, National Taiwan University Hospital Yunlin Branch, Taiwan
| | - Mei-Ling Huang
- MS, RN, Director, Department of Nursing, National Taiwan University Hospital Yunlin Branch, Taiwan
| | - Chung-Yu Chen
- PhD, MD, Assistant Professor, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Juey-Jen Hwang
- PhD, MD, Professor, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Wen Chiu
- PhD, RN, Associate Professor, Department of Nursing, Chung Shan Medical University, and Chung Shan Medical University Hospital, Taiwan
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Avgeri K, Zakynthinos E, Tsolaki V, Sgantzos M, Fotakopoulos G, Makris D. Quality of Life and Family Support in Critically Ill Patients following ICU Discharge. Healthcare (Basel) 2023; 11:healthcare11081106. [PMID: 37107940 PMCID: PMC10138299 DOI: 10.3390/healthcare11081106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/27/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Following discharge from the intensive care unit (ICU), critically ill patients may present cognitive dysfunction and physical disability. OBJECTIVES To investigate the quality of life (QoL) of patients following discharge from ICU, physical performance and lung function and to assess the role of support by family members and friends. METHODS This prospective study was conducted in the University Hospital of Larissa Greece between 2020 and 2021. Patients hospitalized at the ICU for at least 48 h were included and assessed at hospital discharge, at 3 and at 12 months later. The research implements of the study were a dedicated questionnaire and the SF-36 health questionnaire for the appraisal of the QoL. Lung function changes were assessed by spirometry and physical performance by the 6-min walking test (6MWT). RESULTS One hundred and forty-three participants were included in the study. The mean (SD) of the physical and mental health SF-36 scores at hospital discharge, 3 and 12 months were 27.32 (19.59), 40.97 (26.34) and 50.78 (28.26) (p < 0.0001) and 42.93 (17.00), 55.19 (23.04) and 62.24 (23.66), (p < 0.0001), respectively. The forced expiratory volume in one second and 6MWT significantly improved over 12 months. Patients who were supported by two or more family members or patients who were visited by their friends >3 times/week presented better scores in the physical and mental SF36 domains at 12 months. CONCLUSION This study shows that the quality of life of Greek patients who were discharged from the ICU can be positively affected both by the support they receive from their family environment and friends.
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Affiliation(s)
- Konstantina Avgeri
- Department of Medical School, University of Thessaly, 41110 Larissa, Greece
| | | | - Vasiliki Tsolaki
- Department of Medical School, University of Thessaly, 41110 Larissa, Greece
| | - Markos Sgantzos
- Department of Medical School, University of Thessaly, 41110 Larissa, Greece
| | | | - Demosthenes Makris
- Department of Medical School, University of Thessaly, 41110 Larissa, Greece
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Kim KI, Im SC, Kim K. Effects of trunk stabilization exercises using laser pointer visual feedback in patients with chronic stroke: A randomized controlled study. Technol Health Care 2023; 31:471-483. [PMID: 36120797 DOI: 10.3233/thc-220100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P< 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P< 0.025). CONCLUSION Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.
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Dos Santos HM, de Oliveira LC, Bonifácio SR, Brandão TCP, Silva WP, Pereira GS, Silva SM. Use of the International Classification of Functioning, Disability and Health (ICF) to expand and standardize the assessment of quality-of-life following a stroke: proposal for the use of codes and qualifiers. Disabil Rehabil 2022; 44:7449-7454. [PMID: 34752176 DOI: 10.1080/09638288.2021.1995055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Propose a way of coding and qualifying HRQoL following a stroke using the codes and qualifiers of the International Classification of Functioning, Disability and Health (ICF). METHODS An observational, cross-sectional study was conducted involving 51 individuals with hemiparesis resulting from a stroke. ICF codes related to the Stroke Specific Quality of Life (SS-QOL) scale were listed and subsequently classified using the generic ICF qualifiers, which range from .0 - no impairment to .4 - complete impairment. A simple mathematic calculation was proposed to convert the SS-QOL scores into ICF qualifiers. RESULTS The use of the ICF qualifiers revealed that the individuals exhibited a moderate level (.2) of quality of life, with mild impairment (.1) regarding upper limb function, language, self-care, and vision as well as severe impairment (.3) regarding social relations. CONCLUSIONS The proposal presented in this study allowed qualifying 43 ICF codes related to quality of life after a stroke in a simple, standardized manner, enabling the identification of different levels of impairment on each of the domains of the SS-QOL scale. This coding standardizes the evaluation, facilitates communication between healthcare providers, and systematizes the collection of data and information on health.Implications for rehabilitationProposal for qualifying concepts related to body functions, activity & participation, and environmental factors in a simple, standardized manner.The proposed mathematic calculation is simple and easy to understand, which minimizes the occurrence of errors.Possibility to identify different levels of impairment in each of the domains of the Stroke Specific Quality of Life scale, facilitating the establishment of individualized, longitudinal care.The ICF codes standardize the evaluation, facilitate communication between healthcare providers, and systematize the collection of data and information on health and functioning.
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Affiliation(s)
| | - Leia Cordeiro de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Sandra Regina Bonifácio
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | | | - Wallace Pereira Silva
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
| | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE), São Paulo, SP, Brazil
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Wang C, Yu T, Luo X, Zhou C, You C, Duan L, Liu S, Chen Y, Jiang Y, Zhu H. Protocol for the development of a clinical practice guideline for discharge planning of stroke patients. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:937. [PMID: 36172097 PMCID: PMC9511188 DOI: 10.21037/atm-22-3151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/02/2022] [Indexed: 11/06/2022]
Abstract
Background A standardized discharge plan is important to continuous medical care and discharge management of stroke patients. Currently, there is a lack of high-quality, evidence-based discharge planning guidelines for stroke patients. Most existing discharge planning guidelines have been developed for other diseases and stroke-related guidelines focus more on prevention, treatment, and rehabilitation and less on discharge planning. Therefore, they do not provide a systematic and comprehensive answer to the key issues of discharge planning for stroke patients. To improve the level of recovery and quality of life of stroke patients, to better guide clinical caregivers in developing and implementing discharge plans, the Evidence-based Nursing Center of West China Hospital, Sichuan University and the World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation have jointly initiated the development of the clinical practice guideline for discharge planning of patients with stroke. Methods The guideline development process is designed to follow the WHO handbook for guideline development and Guidelines 2.0. Evidence grading and guideline recommendations are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The key steps in developing the guideline include: (I) establishing the guideline working groups; (II) selecting the priority clinical questions; (III) evidence retrieval and evaluation; (IV) grading the quality of evidence; (V) forming recommendations; and (VI) external review. Discussion This guideline will follow the clinical characteristics and management priorities of stroke and will be developed by a multidisciplinary guideline development team, in strict accordance with the core principles and methods of guideline development. This guideline will provide an evidence-based reference for standardized discharge screening, assessment, discharge procedures, and outpatient follow up, so as to improve the quality of discharge services and standardize the discharge management of stroke patients, and ultimately improve their post-discharge rehabilitation and quality of life. Trial Registration The guideline was registered at the Practice guidelines REgistration for transPAREncy. The registration No. is IPGRP-2022CN331.
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Affiliation(s)
- Cong Wang
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.,Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Ting Yu
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.,Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou, China.,Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Chunfen Zhou
- Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Chao You
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lijuan Duan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Shanshan Liu
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.,Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Institute of Health Data Science, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Yan Jiang
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, China.,Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong Zhu
- Nursing Department, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing, Sichuan University, Chengdu, China
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Song Y, Cui C, Jia Y, Zhang W, Meng L, Sznajder KK, Xu Y, Yang X. Family Functioning and Optimism as Protective Factors of Life Satisfaction Among Stroke Patients During the COVID-19 Epidemic in Shenyang, China. Front Public Health 2022; 10:738634. [PMID: 35558534 PMCID: PMC9087178 DOI: 10.3389/fpubh.2022.738634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/24/2022] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease-19 (COVID-19) pandemic may result in detrimental consequences for stroke patient's wellbeing. Family functioning and optimism could help stroke patients cope with crises leading to possible improvements in life satisfaction. This study aims to explore the protective effects of family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic in China. This study was designed as a cross-sectional survey. A total of 207 stroke inpatients who were receiving pharmacotherapy and rehabilitation in general public hospital of Liaoning province during the COVID-19 pandemic in China were consecutive selected and interviewed by online questionnaires via the WeChat platform effectively from April 8 to 30, 2020. The scales included: Satisfaction with Life Scale (SWLS), Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Scale and Revised Life Orientation Test (LOT-R). Hierarchical multiple regression (HMR) analysis was conducted to test the associated factors of life satisfaction. Stroke patient's life satisfaction was at a high level (Mean = 26.46, SD = 6.23) during the pandemic. Stroke patient's residence, duration of stroke, stroke type, and community shut down measures were the strong predictors of life satisfaction. Family functioning and optimism increased life satisfaction among stroke patients. This study contributes to the research on the association between family functioning and optimism on life satisfaction among stroke patients during the COVID-19 pandemic. Interventions that improve family functioning and enhance optimism should be provided in order to elevate life satisfaction for stroke patients.
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Affiliation(s)
- Yuequn Song
- Department of Neurosurgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Can Cui
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Yajing Jia
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Weiyu Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Lifang Meng
- Department of Scientific Research Management, China Medical University, Shenyang, China
| | - Kristin K Sznajder
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Yuanyuan Xu
- Group of Chronic Disease and Environmental Genomics, China Medical University School of Public Health, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
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Tiwari S, Joshi A, Rai N, Satpathy P. Impact of Stroke on Quality of Life of Stroke Survivors and Their Caregivers: A Qualitative Study from India. J Neurosci Rural Pract 2021; 12:680-688. [PMID: 34737502 PMCID: PMC8559087 DOI: 10.1055/s-0041-1735323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objectives Stroke is a significant global public health challenge attributable to an array of disabilities it causes alongside an impairment in cognition. The monetary impact of stroke care includes acute treatment expenses as well as outrageous expenses of postdischarge chronic hospital care and rehabilitation services. The current study aimed to study the perceptions along with experiences of stroke survivors and caregivers. Materials and Methods In-depth interviews (IDIs) of stroke survivors and their primary caregivers were conducted at their home 2 months after their discharge from the hospital in Bhopal, India. These IDIs were later analyzed. Results The following eight themes emerged: pervasive and irreversible, multifunction loss and dependency, holistic impact on the health of person and family, money and matter, nonaccommodative cost and baffled belief, professional paralysis, social crisis, and slow and obscured progress. The added obligation of taking care of a disabled stroke survivor along with adjusting their own lifestyle with financial apprehensions, worry about future, prolonged hours of care, and stress are major factors that increase the burden of the caregivers. Conclusion Caregivers should be sensitized with proper counseling and training through health care institutions to ensure appropriate care and management of stroke survivors at home, as it will also help in addressing their psychosocial needs, and minimizing the knowledge gap, doubts and uncertainties about the disease and its aftereffects.
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Affiliation(s)
- Sharad Tiwari
- National Mental Health Program, National Health Mission, Madhya Pradesh, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Nirendra Rai
- Department of Neurology, All India Institute of Medical Sciences, Bhopal, India
| | - Parmeshwar Satpathy
- Department of Community Medicine, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, India
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Kalav S, Bektas H, Ünal A. Effects of Chronic Care Model-based interventions on self-management, quality of life and patient satisfaction in patients with ischemic stroke: A single-blinded randomized controlled trial. Jpn J Nurs Sci 2021; 19:e12441. [PMID: 34264000 DOI: 10.1111/jjns.12441] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/23/2021] [Accepted: 06/06/2021] [Indexed: 11/30/2022]
Abstract
AIM This study was designed to evaluate the effect of Chronic Care Model (CCM)-based interventions on primary outcomes (self-efficacy, quality of life/QoL, patient satisfaction) and secondary outcomes (activities of daily living/ADL, metabolic control variables, stroke knowledge level, healthy eating habits, physical activity, taking regular medication, measuring blood pressure regularly, living in harmony with the disease, outcomes regarding telephone interviews) in patients with ischemic stroke. METHOD The intervention group (IG) received a 12-week StrokeCARE intervention protocol based on the four components of the CCM. The control group (CG) received only routine patient care. Changes between scores at two time points regarding self-efficacy, QoL, ADL, and metabolic control variables were calculated for each group, and then the mean changes were compared between the two groups. RESULTS The mean ages of the patients were 55.9 ± 11.44 and 58.9 ± 13.82 years (respectively IG; CG), and 64.7% of the patients were male in both groups. Most patients had other chronic diseases accompanying ischemic stroke. No significant differences were found between the two groups with respect to self-efficacy and QoL. Patient satisfaction was significantly higher in the IG. Positive feedback percentages of the patients in the IG regarding stroke knowledge level and consuming whole-grain food at the end of the 12 weeks increased significantly. This protocol had no significant effects on the secondary outcomes. CONCLUSION The CCM-based interventions may increase the satisfaction level of the patients and help to raise awareness of the risk of a secondary stroke. More studies are needed to examine the effects of these interventions (ClinicalTrials.gov-Identifier Number:NCT04161820).
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Affiliation(s)
- Simge Kalav
- Faculty of Nursing, Department of Internal Medicine Nursing, Aydin Adnan Menderes University, Aydin, Turkey
| | - Hicran Bektas
- Faculty of Nursing, Department of Internal Medicine Nursing, Akdeniz University, Antalya, Turkey
| | - Ali Ünal
- Neurology Department, Akdeniz University School of Medicine, Antalya, Turkey
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The Efficiency of Spa Rehabilitation in Chronic Ischemic Stroke Patients-Preliminary Reports. Brain Sci 2021; 11:brainsci11040501. [PMID: 33921075 PMCID: PMC8071377 DOI: 10.3390/brainsci11040501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/02/2021] [Accepted: 04/13/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Rehabilitation-oriented therapy after a stroke must continue in various forms as a life-long effort. Aim: The study investigated the impact of spa rehabilitation on the quality of life and functional efficiency in patients after an ischemic stroke at a chronic stage of recovery. Methods: The assessment was carried out in a spa resort in southeastern Poland. It involved 32 patients with strokes who participated in a three-week rehabilitation program. Three examinations were performed: upon admission, on the day of discharge and at a two-month follow-up. The quality of life and functional efficiency were assessed with the WHOQOL-BREF and Barthel Index. Results: The quality of life was significantly higher in Exam II compared with Exam I (p < 0.001), and improvement was retained at the follow-up. The Barthel scores were higher in Exam II compared with Exam I (79.84 vs. 68.59), while the differences between the scores in Exams II and III were small (p = 0.039). Conclusions: Three-week spa rehabilitation seems to favorably affect the functional efficiency and quality of life after a stroke. The effects appear to be long-term. The gender, age and time from stroke onset do not seem to impact short-term effects. However, long-term effects are related to the time from stroke onset.
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Zhang B, Li D, Liu Y, Wang J, Xiao Q. Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta-analysis. J Adv Nurs 2021; 77:3255-3273. [PMID: 33675076 DOI: 10.1111/jan.14800] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/22/2020] [Accepted: 01/20/2021] [Indexed: 01/17/2023]
Abstract
AIMS To explore the beneficial effects of virtual reality (VR) interventions on upper- and lower-limb motor function, balance, gait, cognition and daily function outcomes in stroke patients. DESIGN A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES English databases (PubMed, EMBASE, the Cochrane Library, CINAHL, Web of Science, Physiotherapy Evidence Database, ProQuest Dissertations and Theses) and Chinese databases (Chinese BioMedical Literature Service System, WANFANG, CNKI) and the Clinical Trial Registry Platform were systematically searched from inception until December 2019. Additionally, reference lists of the included studies were manually searched. REVIEW METHODS The methodological quality of studies was scored with the Cochrane 'risk-of-bias tool' and PEDro scale from the Physiotherapy Evidence Database by two independent evaluators. RESULTS In total, 87 studies with 3540 participants were included. Stroke patients receiving VR interventions showed significant improvements in Fugl-Meyer assessment of Upper Extremity, Action Research Arm Test, Wolf Motor Function Test, Fugl-Meyer Assessment of Lower Extremity, Functional Ambulation Classification, Berg Balance Scale, Time Up and Go, Velocity, Cadence, Modified Barthel Index and Functional Independence Measure. However, differences between VR intervention and traditional rehabilitation groups were not significant for Box-Block Test, 10 m Walk Test, Auditory Continuous Performance Test, Mini-Mental State Examination and Visual Continuous Performance Test. CONCLUSION This review suggests that VR interventions effectively improve upper- and lower-limb motor function, balance, gait and daily function of stroke patients, but have no benefits on cognition. IMPACT This review identified the positive effects of VR-assisted rehabilitation on upper- and lower-limb motor function, balance, gait and daily function of stroke patients. And, we verified the duration of VR intervention affects some health benefits. The benefit of VR on cognitive function requires further investigation through large-scale multicentre RCTs.
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Affiliation(s)
- Bohan Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Dan Li
- School of Nursing, University of Pittsburgh, Pittsburgh, USA
| | - Yue Liu
- School of Nursing, Capital Medical University, Beijing, China
| | - Jiani Wang
- Fuwai Hospital, CAMS &PUMC, Beijing, China
| | - Qian Xiao
- School of Nursing, Capital Medical University, Beijing, China
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Szőcs I, Dobi B, Lám J, Orbán-Kis K, Häkkinen U, Belicza É, Bereczki D, Vastagh I. Health related quality of life and satisfaction with care of stroke patients in Budapest: A substudy of the EuroHOPE project. PLoS One 2020; 15:e0241059. [PMID: 33091092 PMCID: PMC7580926 DOI: 10.1371/journal.pone.0241059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Disadvantaged socioeconomic status is associated with higher stroke incidence and mortality, and higher readmission rate. We aimed to assess the effect of socioeconomic factors on case fatality, health related quality of life (HRQoL), and satisfaction with care of stroke survivors in the framework of the European Health Care Outcomes, Performance and Efficiency (EuroHOPE) study in Hungary, one of the leading countries regarding stroke mortality. METHODS We evaluated 200 consecutive patients admitted for first-ever ischemic stroke in a single center and performed a follow-up at 3 months after stroke. We recorded pre- and post-stroke socioeconomic factors, and assessed case fatality, HRQoL and patient satisfaction with the care received. Stroke severity at onset was scored by the National Institutes of Health Stroke scale (NIHSS), disability at discharge from acute care was evaluated by the modified Rankin Score (mRS). To evaluate HRQoL and patient satisfaction with care we used the EQ-5D-5L, 15D and EORTC IN PATSAT 32 questionnaires. RESULTS At 3 months after stroke the odds of death was significantly increased by stroke severity (NIHSS, OR = 1.209, 95%CI: 1.125-1.299, p<0.001) and age (OR = 1.045, 95%CI: 1.003-1.089, p = 0.038). In a multiple linear regression model, independent predictors of HRQoL were age, disability at discharge, satisfaction with care, type of social dwelling after stroke, length of acute hospital stay and rehospitalization. Satisfaction with care was influenced negatively by stroke severity (Coef. = -1.111, 95%C.I.: -2.159- -0.062, p = 0.040), and positively by having had thrombolysis (Coef. = 25.635, 95%C.I.: 5.212-46.058, p = 0.016) and better HRQoL (Coef. = 22.858, 95%C.I.: 6.007-39.708, p = 0.009). CONCLUSION In addition to age, disability, and satisfaction with care, length of hospital stay and type of social dwelling after stroke also predicted HRQoL. Long-term outcome after stroke could be improved by reducing time spent in hospital, i.e. by developing home care rehabilitation facilities thus reducing the need for readmission to inpatient care.
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Affiliation(s)
- Ildikó Szőcs
- Department of Neurology, Semmelweis University, Budapest, Hungary
- MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
| | - Balázs Dobi
- MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
- Department of Probability Theory and Statistics, Eötvös Loránd University, Budapest, Hungary
| | - Judit Lám
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Károly Orbán-Kis
- Department of Physiology, University of Medicine and Pharmacy of Tirgu-Mures, Targu-Mures, Romania
| | - Unto Häkkinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Éva Belicza
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Dániel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
- MTA-SE Neuroepidemiological Research Group, Budapest, Hungary
| | - Ildikó Vastagh
- Department of Neurology, Semmelweis University, Budapest, Hungary
- Department of Neurology, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
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