• 성인간호학회지
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• 제25권2호
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• pp.113-124
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• 2013

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.

• 대한한방내과학회지
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• 제21권1호
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• pp.146-155
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• 2000

Objectives : This study was to investigate using FIM(functional independence measure) in 70patients with stroke and to evaluate prognosis. Methods : The subjects of this study were 70 patients who were admitted to the Dong-Eui oriental hospital within 7days after stroke. Improving rate were measured by using the FIM(at admission, after 2week and 4week). Each patients was diagnosed with sasang constitutional analysis(QSCC ll), Brain-CT, MRI scan and clinical observation. Results : There were significant results statistically between FIM(degree of improvement) and sex, age, side of hemiparesis, and hypertension. While diabetes mellitus, heart disease, hypercholesterolemia, and severity of early state were not significant meaning statistically. Conclusions : Sex, age, side of hemiparesis, and hypertension were relevant factors in predicting the functional outcome in the patients with stroke. I thought that the meaning of man-left and woman-right(男左女右) is not severity of early state but degree of improvement.

• 재활간호학회지
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• 제18권2호
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• pp.107-117
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• 2015

Purpose: This study was conducted to identify the effects of a self-monitoring rehabilitation program based on the Bandura's self-efficacy theory on the activities of daily living (ADL), 6-minute walking distances, self-efficacy and quality of life (QoL) among stroke patients after three to six months. Methods: The participants consisted of 29 patients in the experiment group and 28 patients in the control group who admitted at rehabilitation specific hospital. Self-monitoring program developed by the researcher lasted twice a week for 8 weeks from August to September, 2013. Results: ANCOVA showed that all of dependent variables of this study, ADL and 6-minute walking distances as a physical function, self-efficacy and QoL for intervention group were higher than those for control group(p<.001). Conclusion: The self-monitoring rehabilitation program based on the self-efficacy theory was found to be effective in improving physical function, self-efficacy and QoL for early post-stroke patients. Early rehabilitation program for stroke patients was recommended to consider the self-monitoring of current physical and psychosocial status as a strategy of self-management.

• 한국콘텐츠학회논문지
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• 제20권10호
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• pp.385-394
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• 2020

본 연구는 급성기 뇌졸중 환자의 뇌졸중 후 우울 발생 현황을 파악하고 뇌졸중 후 우울에 영향을 미치는 요인을 규명하기 위해 수행되었다. 연구대상자는 2개 지역병원에서 허혈성 뇌졸중으로 입원 치료 후 상태가 안정되어 퇴원 예정인 20대 이상의 성인 104명을 편의추출 하였다. 뇌졸중 후 우울 측정은 뇌졸중 후 우울척도, 사회적지지는 사회적지지 척도, 뇌졸중 심각도는 미국 국립보건원 뇌졸중 척도, 장애정도는 수정 랜킨 척도를 이용하였다. 연구결과 대상자의 뇌졸중 발병 후 입원기간은 평균 5.9±2.1일이었고 79.8%가 7일 이내였다. 뇌졸중 심각도는 평균 2.4±2.5점이었으며 69.2%가 경증 뇌졸중이었고, 장애정도는 평균 1.6±1.1점이었고 46.2%가 발병 전의 모든 업무와 일상활동 실행이 가능했다. 대상자의 32.7%가 경증 이상의 우울상태였으며, 종교가 없고(p<.004), 장애정도가 심하고(p<.031), 뇌졸중 심각도가 높으며(p<.034), 가족지지가 적을수록(p<.009) 뇌졸중 후 우울을 경험할 가능성이 높은 것으로 나타났다. 이러한 결과를 통해 뇌졸중 환자들에게 발병 초기 단계부터 우울이 나타날 수 있음을 알 수 있다. 따라서 뇌졸중 급성기 단계부터 우울에 대한 지속적인 조기 사정과 종교나 가족지지 등을 포함한 급성기 뇌졸중 후 우울 중재에 대한 간호지침 개발이 필요하다.

• 한국전문물리치료학회지
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• 제12권2호
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• pp.98-104
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• 2005

This study was done to research the general information, causes of stroke, risk factors, complications during admission of geriatric CVA inpatients. We retrospectively studied 208 above 65 years old geriatric CVA inpatients treated in Ajou university hospital from 1994 to 2003 by medical record. These were divided into two groups by following years. We were gathered information about sex, onset age, cause of stroke, number of stroke, complications, housing, family, insurance, smoking, alcohol. Most of incidence of the stroke was noted in the group of young old age (65~74 years old) and old age (75~84 years old). The occurrence rate of male stroke (38.5%) was less than of female stroke (61.5%) and the ratio of male to female was 1:1.6. The occurrence rate of ischemic stroke (72.6%) was higher than of hemorrhagic stroke. The occurrence rate of ischemic stroke increased more and more at the late stage. The most common risk factors for stroke was hypertension and complications during hospitalization were neurogenic bowl and bladder. These results of epidemiologic study may help above 65 years old geriatric CVA early treatment and prevention, rehabilitation and use basic data for multiple prospective study using stroke registry.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.130-136
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• 2007

Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

• 대한한의학회지
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• 제31권5호
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• pp.82-89
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• 2010

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

• Journal of Korean Neurosurgical Society
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• 제57권6호
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• pp.401-407
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• 2015

The nonprogressive unilateral intracranial arteriopathy known as transient (focal) cerebral arteriopathy is not a well-recognized arteriopathy among practitioners of Korea and Japan, although it cannot be easily differentiated from early moyamoya disease. This review summarizes the nomenclature, pathophysiology, diagnostic evaluation, clinico-radiological features, and management of nonprogressive (reversible or stable) unilateral arteriopathy based on the relevant literature and our own experiences. Nonprogressive unilateral arteriopathy should be strongly suspected in children presenting with basal ganglia infarction and arterial beading. The early identification of patients likely to have nonprogressive or progressive arteriopathy would ensure proper management and guide further research for secondary stroke prevention.

• 대한한의학회지
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• 제21권3호
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• pp.113-118
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• 2000

Objectives : Stroke patients have continuously increased and many studies have been performed to predict their prognosis. Tongue Inspection is a diagnostic method that has been widely used in oriental medicine. The aim of this study was to examine if stroke patients' motor recovery might be related to tongue inspection. Methods : MBI(Modified Barthel Index) and tongue inspection of stroke patients within 3 days of onset were assessed on admission and at 10 days following admission. Results : Functional recovery was significantly better in those who showed favorable changes of tongue, especially in tongue coat color(P=0.030) and thick and thin tongue coat(P=0.092). Conclusions : The results suggest that tongue inspection can be used to predict a prognosis of early stage stroke patients.

• 감성과학
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• 제22권3호
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• pp.55-64
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• 2019

Stroke is a health problem experienced by many elderly people around the world. Stroke has a devastating effect on quality of life, causing death or disability. Hemiplegia is clearly an early sign of a stroke and can be detected through patterns of body balance and gait. The goal of this study was to determine various feature vectors of foot pressure and gait parameters of patients with stroke through the use of a wearable sensor and to compare the gait parameters with those of healthy elderly people. To monitor the participants at all times, we used a simple measuring device rather than a medical device. We measured gait data of 220 healthy people older than 65 years of age and of 63 elderly patients who had experienced stroke less than 6 months earlier. The center of pressure and the acceleration during standing and gait-related tasks were recorded by a wearable insole sensor worn by the participants. Both the average acceleration and the maximum acceleration were significantly higher in the healthy participants (p < .01) than in the patients with stroke. Thus gait parameters are helpful for determining whether they are patients with stroke or normal elderly people.