• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.113-115
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• 2015

Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

• Clinical and Experimental Pediatrics
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• v.50 no.3
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• pp.277-283
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• 2007

Purpose : Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. Methods : A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. Results : Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. Conclusion : Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.

• Therapeutic Science for Rehabilitation
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• v.4 no.2
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• pp.33-50
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• 2015

Objective : This study was conducted to determine various interventions in accordance with the recovery and cognitive processes in order to improve executive function in stroke patients through a systematic review. Methods : The literature search focused on Level I-IV studies published between January 1996 and April 2015 for 20 years in electronic databases(e.g. MEDLINE, SCOPUS, RISS). The keyword search terms were 'Stroke', 'Executive function', 'Executive function deficit', 'Occupational therapy', 'Rehabilitation', 'Remedial', 'Compensatory' and 'Education'. Result : A total of 13 articles were appraised using the hierarchy of levels of evidence-based practice and 6 Level I evidence articles, 1 Level II articles, 2 Level III articles and 4 Level IV articles. Each intervention improved executive function but was different in degree of generalization. Conclusion : Through this systematic review, we found that there are a variety of applied interventions improving executive function in stroke patients and are different in effect depending on methods of interventions. This study provided evidences to occupational therapists for the clinical practice of interventions to improve executive function in stroke patients.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.57-69
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• 2016

Objective: The purpose of this study was to systematically review the articles using accelerometer to measure activity of daily living of patients with stroke. Methods: Depending on selection criteria, 13 studies were searched for PubMed, EMBASE, and Cochrane library database from February 2014 to March 2014. A total of 331 papers were searched, and 13 of these were selected. Results: In studies of 13 selected, acute, subacute, and chronic patients with stroke were enrolled. The kind of accelerometer was uniaxial, biaxial, and triaxial, activity monitor. Measurement activities were mainly arm activity, walking activity, and attachment sites were also various depending on the measurement activities. A measured variable was the total number of activities, the movement speed of the patients, ratio between affected and non-affected, and motion analysis. The result indicated that significant correlation with the other assessment tools in all studies. Conclusions: Accelerometer will be applied with a tool for measuring activity of daily living of patients with stroke, depending on activities characteristics. Further, we need accelerometer studies to apply with a variety of assessment in clinical practice or community settings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.9
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• pp.2509-2515
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• 2009

This study compared the relative effectiveness of trunk stability exercise with general balance exercise on dynamic balance for patients with chronic patients. Thirty eight subjects were recruited and randomly divided into two groups. One group was trained trunk stability exercise and the other group was trained general balance exercise. This process was carried out three times a week for seven weeks. Dynamic balance was measured prior to commencement of the exercise programs, and again after seven weeks, when the programs were completed, in order to establish the effectiveness of both exercise programs. Both the trunk stability exercise and the general balance exercise increased BBS and TUG(p<.001). The trunk stability exercise was more effective at increasing BBS(p<.05). We suggest that trunk stability exercise is effective in the improvement of balance ability in the persons with chronic stroke. Therefore, the trunk stability exercise is considered to important when the stroke patients are trained. Further studies of effectiveness of trunk stability exercise should be carried out to increase our understanding of this area of study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.36-44
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• 2019

Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

• Journal of Korean Academy of Nursing
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• v.44 no.3
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• pp.280-293
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• 2014

Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

• Journal of muscle and joint health
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• v.19 no.2
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• pp.107-119
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• 2012

Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.