• Title/Summary/Keyword: 급성 뇌졸중

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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.

Endovascular Treatment of Acute Ischemic Stroke (급성 허혈성 뇌졸중의 혈관 내 치료)

  • Jun Hwee Kim;Byung Moon Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.562-576
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    • 2020
  • Acute ischemic stroke is one of the leading causes of disability and death around the world, especially in developed countries. Since the introduction of the 2nd generation devices, endovascular treatment of acute ischemic stroke has rapidly developed and is now considered to be a standard treatment. Here, we summarize the results of recent randomized clinical trials that have compared endovascular thrombectomy with conventional treatment for acute stroke and review the indications, current devices, and endovascular thrombectomy methods used.

Factors Influencing Post Stroke Depression in Acute Stroke Patients (급성기 뇌졸중 환자의 뇌졸중 후 우울에 영향을 미치는 요인)

  • Park, Soonjoo
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.385-394
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    • 2020
  • This study was carried out to investigate the post stroke depression (PSD) occurrence in acute stroke patients and to identify the factors that influence PSD. The study subjects were 104 adults in their 20s or older who were scheduled to be discharged due to inpatient treatment for ischemic stroke in two hospitals. Data were collected using Post Stroke Depression Scale for PSD, Multidimensional Scale of Perceived Social Support for social support, National Institutes of Health Stroke Scale for stroke severity, and Modified Rankin Scale for disability. The average length of stay after stroke onset of the study subjects was 5.9±2.1 days, and 79.8% were within 7 days. Stroke severity score was an average of 2.4±2.5 out of 42 points, and disability score was an average of 1.6±1.1 out of 6 points. Among the subjects, 32.7% had mild or more severe depression after stroke. The subjects with no religion, severe disability, high stroke severity, and less family support had a higher likelihood of experiencing PSD. These results show that depression can appear in the early stages of stroke onset. Therefore, it is necessary to develop nursing guidelines for depression intervention after acute stroke, including continuous early assessment of depression from the acute phase of stroke and religion or family support.

Acute Cerebrovascular Accident in Korea (급성뇌졸중 환자의 발생과 예후)

  • Roh, Sang-Gyun;Kim, Jee-Hee
    • Journal of the Korea Convergence Society
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    • v.3 no.4
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    • pp.23-28
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    • 2012
  • The aim of this study is to reveal the right approach and prognosis of cerebrovascular accident (CVA) by reviewing the various researches on CVAs. The reviews were done by BNBI PubMed, KMBase, RISS, and KoreaMed. Based on the articles, prevalence rate of CVA, prehospital CVA patients assessment and emergency care, and in-hospital care were analyzed. The most important scales are Cincinnati prehospital stroke scale(CPSS) and Los Angeles prehospital stroke screen(LAPSS). These two scales are the basic assessment tools for CVAs and it is necessary to perform the emergency care by way of these scales.

Relations of neurological and social cognitions in patients with acute phase and chronic phase before returning to the community (급성기와 지역사회 복귀 전 만성 뇌졸중 환자의 신경학적 인지기능과 사회인지 기능의 관계)

  • Park, Myoung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.549-556
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    • 2017
  • This study investigated the importance of social cognitive intervention and the cognitive rehabilitation intervention by comparing the difference and examining the relationship between neurological cognitive function and social cognitive function of stroke patients in the acute phase and chronic stroke before returning to the community. LOTCA, cartoon intention inference task, and social behavior sequence task were performed on 30 acute stroke inpatients and 30 chronic stroke patients from May 2015 to June 2016. A two sample t test was conducted to examine the differences between the groups. The Pearson's correlations test was performed to examine the correlation among the variables in each group. As a result, there were statistically significant differences between the neurological cognitive function and social cognitive function of acute stroke patients and chronic stroke patients who were undergoing rehabilitation training before returning to the community (p<0.05). A linear relationship was found between the thinking operation and social behavior sequence task in the acute stroke group (r=0.539, p<0.05). In the chronic stroke group, visual perception (r=0.530, p<0.05), visual motor organization (r=0.655, p<0.05) and thinking operation (r=0.534, p<0.05) were correlated with the cartoon intention inference task. In addition, the social behavior sequence task were correlated with visual organization (r=0.534, p<0.05) and thinking operation (r=0.764, p<0.05). As a result of multiple regression analysis, the neurological cognitive functions influencing the social cognitive function in the cartoon task was found to be the thinking operation (B = 0.431) in acute stroke patients and the thinking operation (B=0.272) and visuomotor organization (B = 0.218) in the case of chronic stroke. In addition, the results of the social behavior sequence task revealed the thinking operation (B=0.417) in the acute stroke patients, and thinking operation (B=0.267), visual motor organization(B=0.274) and visual perception(B=151) in chronic stroke patients to be significant. According to this result, there is a difference in the neurological and social cognitive levels between the two groups. Therefore, the social cognition is strongly related to the high level cognitive function as thinking operation of the neurological cognitive function. Therefore, in further research, it would be necessary to determine if there is a change in higher cognitive function in neurological cognitive function after applying a social cognition intervention program for stroke.

Nursing Quality Improvement for Acute Stroke Patients through the Use of NIHSS (NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략)

  • Park, Kyung-Hyun;Song, Young-Ae;Kong, Hye-Sung;Na, Hwa-Ju;Ryu, Soo-Kyung;Park, So-Young;Kim, Sang-Hee;Choi, Hye-Rim;Bae, Hee-Jun;Han, Moon-Gu;Yang, Mi-Hwa
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.73-81
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    • 2009
  • 문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로 활용하고 있지만 아직 간호현장에서는 보편적으로 사용하지 않고 있다. 이에 뇌졸중 환자 간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중 환자 간호의 질을 보다 향상시키기 위하여 본 활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를 향상시키기 위한 프로그램을 개발 적용한다. 둘째, 간호사가 급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중 악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬 수 있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과 치료를 위한 의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실. 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 "NIHSS 간호사 교육 프로그램"을 마련하였다. 둘째, NIHSS 측정을 통한 뇌졸중 악화 예측율 향상을 위하여 "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"을 개발하고 추적 관찰하였다. 개선효과: NIHSS 측정 신뢰도는 질 향상 활동 전 89%에서 92%로 향상되었다. 그리고 간호사의 뇌졸중 악화 양성 예측율은 58.7%에서 87.1%로 향상되었다(참고 : 간호사의 뇌졸중 악화 음성 예측율 100% 유지). 즉 "NIHSS 간호사 교육 프로그램 활용", "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"의 적용으로 뇌졸중의 조기 발견 및 치료가 가능하였고, 향후 환자 예후에 긍정적인 영향을 줄 수 있을 것이라 기대된다.

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Effects of Occupational Therapeutic Craft Activity on improvement cognitive function and hand function in acute patients with stroke (수공예 작업치료 프로그램 활동이 급성기 뇌졸중 환자의 손 기능에 미치는 효과)

  • Jang, Tae-Yong;Park, Bo-Ra;Yang, Yeong-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.355-365
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    • 2017
  • This study investigatedwhether occupational therapeutic craft activity improves cognitive function and hand function in patients with acute stroke, with the hope of providing clinically useful results for further studies. From March 2016 to November 2016, thirty acute patients with stroke at A general hospital and B rehabilitation hospital in Seoul and Gyeonggi-do, Korea were enrolled and randomly divided into two groups. One group was treated with occupational therapeutic craft activity,and the other general exercise. The subjects performed each activity for 30 minutestwice weekly, for four weeks. To test the effect of intervention, hand function was tested with the Box & Block Test and the Jebsen-Taylor Hand Function Test.Cognitive function measures were the NCSE and Trail-Making Test. Over the four weeks of treatment activities, in the occupational therapeutic craft activity group, hand function measures(p<.05) increased significantly,as did cognitive function measures(p<.05). This study shows that occupational therapeutic craft activity improves hand function and cognitive function effectively in patients with acute stroke. Occupational therapeutic craft activity programscan be based on this study to prepare intervention programs for further studies with acute stroke patients.

At the time of inspection CT cerebral blood flow in patients with acute ischemic stroke, a comparative study of Bolus Tracking Technique and Fixed Time Technique (급성기 허혈성 뇌졸중 환자의 뇌 관류 CT검사 시 고정시간기법과 조영제 추적기법의 비교 연구)

  • Kim, Ki-Jeong;Jeong, Hong-Ryang
    • Proceedings of the Korea Contents Association Conference
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    • 2013.05a
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    • pp.217-218
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    • 2013
  • 급성기 허혈성 뇌졸중 증상이 있는 뇌 관류 CT검사를 시행한 환자를 대상으로 장비사가 제시한 고정 시간 기법(fixed time technique)과 조영제 추적 기법(bolus tracking technique)을 비교하여 환자의 피폭선량을 분석하고자 하였으며 조영제 추적 기법의 유용성과 최적의 조영증강 구간을 구현하는 Time graph를 알아보기 위한 것이다.

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A Preliminary Study of the Effects of Monitor-Based Virtual Reality Games on the Cognition & Activities of Daily Living for Acute Stroke : A Double-blind Randomized Controled Trial (모니터기반 가상현실게임을 이용한 중재가 급성기 뇌졸중 환자의 인지 기능과 일상생활활동에 미치는 영향에 대한 사전연구: 이중 맹검 무작위 대조 시험 연구)

  • Choi, Bong-Geun;Kwon, Jae-Sung
    • The Journal of the Korea Contents Association
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    • v.20 no.9
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    • pp.531-540
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    • 2020
  • Objectives: This study aimed to investigate the effects of a 4-weeks intervention using a monitor-based virtual reality game intervention(VRI) on the cognitive function and activities of daily living of individuals with acute stroke. Methods: For this study, 19 individuals with acute stroke were recruited. To compare the effectiveness of the VRI and the computer based cognitive intervention(CBCI), Each of the two groups were provided different interventions a 30 minutes a day, 5 times per week for 4 weeks, and to measure the effects of the intervention, the TMT A&B, DST, RKMT and K-MBI were performed before and after interventions. Results: Both the VRI and the CBCI were found to have significantly improved the cognitive function and activities of daily living, and the difference in change compared between groups showed that the effectiveness of the VRI was significantly higher. Conclusion: Based on the findings of this study, the monitor-based VRI is anticipated to prove useful as an effective intervention for the cognitive function and activities of daily living of stroke patients. Furthermore, the utility of monitor-based VRI is likely to be high in clinical occupational therapy.

A Rationale for Instrumental Music Playing for Upper Extremity Rehabilitation in Subacute Stroke (아급성 뇌졸중 환자의 상지재활을 위한 악기 연주의 임상적 활용 근거 연구)

  • Jeong, Eunju
    • Journal of Music and Human Behavior
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    • v.10 no.1
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    • pp.1-23
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    • 2013
  • Upper extremity dysfunction is a common consequence following stroke. Spontaneous recovery during the first six months post-stroke is rigorous and considered as a significant indicator of potential long-term progress. Various approaches have been utilized to regain functional upper limb movement necessary for independent living; however, conventional therapy approaches have failed to prove consistency, especially for subacute stroke patients. There is, thus, a need for innovative therapeutic strategies that motivate stroke survivors to facilitate neural and functional recovery during the critical window immediately following stroke. The effect of music on physical enhancement has been frequently reported in the field of medicine as well as neurorehabilitation. The efficacy of rhythm on lower extremity deficits has been well established. Yet, the rationale for using instrumental music making enhancing subacute upper extremities rehabilitation is not clearly described to date. Based on the key mechanism of music as sensori-motor movement facilitator, this paper reviews previous empirical research that utilized music-based interventions for upper extremity rehabilitation for stroke patients, either in the form of receptive or expressive activity. This paper, further, focuses on the current research trends in subacute stroke upper limb rehabilitation and provides applicable rationale of using instrumental music playing.