• Title/Summary/Keyword: Post Stroke Depression

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The Effects of Self-help Management Program for Post Stroke Patients at Home (재가뇌졸중 환자를 위한 자조관리 프로그램의 효과 연구)

  • Mun, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.15 no.2
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    • pp.218-227
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    • 2004
  • Purpose: The purpose of this study was to determine the effects of 5 weeks self-help management program developed by Kim et al. (2000-b) and reinforced with music therapy for post stroke patients. Method: This was pre-experimental study and the subjects were 14 post stroke hemiplegic patients at home who were registered at the Gunsan Health Center. The program was applied for five weeks and two hours for each session composed of the preparation step, the main step and the finishing step. The contents of the program were ROM exercise, daily activity training, risk factors and aftereffects, nutrition management and stress management. To collect data, all subjects were questioned before and after the application of the program. Collected data were analyzed through frequencies, percentages, Wilcoxen signed rank test and Cronbach's alpha using SPSS-WIN program. Result: After the application of the self-help management program, a statistically significant increase was observed in the subjects' ability to perform activities of daily living (p=.039), ability to perform instrumental activities of daily living (p=.005), self-efficacy (p=.001), self-care behavior (p=.001) and quality of life (p=.001), and a statistically significant decrease was observed in depression (p=.012). Conclusion: The present self-help management program was found to be helpful in improving the subjects' physical and psychological functions after they were attacked by stroke, so to be an effective nursing intervention strategy for post stoke patients. Future researches need to reinforce and materialize music therapy and to develop and apply a self-help management program that includes not only post stroke patients but also their families. In addition, it is necessary to expand the scope of subjects and apply follow-up management in order to continue self-help meetings.

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Effects of Swallowing Training Program for Nursing Home Residents with Stroke (요양시설 거주 뇌졸중 노인을 위한 연하 훈련 프로그램의 효과)

  • Kim, Haesook;Lim, Kyung-Choon
    • Journal of muscle and joint health
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    • v.30 no.3
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    • pp.230-241
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    • 2023
  • Purpose: This study aimed to verify the effects of a swallowing training program on swallowing function and depression for nursing home residents with dysphagia after stroke. Methods: This is a quasi-experimental study with non-equivalent control group pre-post test design. The program (oro-facial muscle strengthening exercises, swallowing exercises, expiratory muscle strengthening exercises, and brain stimulation exercises) applied to the experimental group three times per week for eight weeks, 40-45 minutes for each intervention. The final data from 42 people (21 experimental and 21 control) were analyzed by SPSS/WIN 25.0 using descriptive statistics. 𝜒2 test, t-test, Wilcoxon rank sum test, and Friedman test. Results: The experimental group was significantly improved than control group in oro-facial muscle strength, swallowing symptoms (Z=-2.22, p=.026), and oral intake function level (Z=-2.00, p=.046). However, there was no significant difference between two groups in depression. Conclusion: This study is meaningful in that it reorganized and mediated a swallowing training program as a safe, non-invasive exercise that nurses can implement in a nursing facility with limited medical personnel and it could be easily followed by older adults.

The Preliminary Study on Music?Movement Program developed for Stroke Patients (뇌졸중환자의 음악.동작 프로그램 적용을 위한 예비연구)

  • Suh, Moon-Ja;Jeong, Seong-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.1
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    • pp.79-89
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    • 2003
  • Purpose: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music Movement program developed for the stroke patients. Subjects: 12 stroke survivors at "J" Public Health Center in Seoul. were participated in. The average age was 68 years old, the ratio of sex was almost 5.8:4.2, the duration of was almost over 1 year. Method: Music Movement program was conducted for 2 hours ${\times}$ 1day ${\times}$ 6 weeks. The contents of Music Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs, flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell, 1996), and ADL state(Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p<.05. Results: This program was effective to decrease the depression level of subjects(p<.05). The muscle strength, hand grip power, ROMs, life satisfaction, and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. Conclusion: Considering these results, the practical feasibility of Music Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.

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The Effects of Circuit Obstacle Group Gait Training on Gait and Emotion in Stroke Patients (순환식 장애물 집단 보행 훈련이 뇌졸중 환자의 보행 능력과 정서에 미치는 효과)

  • Kim, Chul-Min;Lee, Ho-Jung;Choi, Myeong-Su;Song, Ju-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.1
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    • pp.125-135
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    • 2012
  • Purpose : This study is designed to demonstrate the effects of circuit obstacle group gait training on walking ability and emotion in stroke patients. Methods : Twenty one patients with stroke were participated in this study. The subjects were divided into control group(n=10) and experimental group(n=11). Circuit obstacle group gait training consisted of walking around obstacles, walking over obstacles, walking up and down slopes and walking up and down stairs. Circuit obstacle group gait training was conducted five times per week, 1 hour per session, for 6 consecutive weeks. At pre-test and post-test, subjects were tested with 10 m walking test, timed up and go test, up and down 4 stairs test, depression and self esteem. Results : After 6 weeks of research, the experimental group showed statistically significant difference in all items when comparing prior to training and after training (p<.05), but the control group showed statistically significant difference in items other than depression and self esteem(p<.05). In the comparison between the two groups, the experimental group showed higher improvement than the control group in the 10 m walking test, timed up and go test, and up and down 4 stairs test, and there was statistically significant difference in decrease of degree in depression between the experimental group and control group(p<.05). Conclusion : This study have shown that circuit obstacle group gait training improves walking ability and emotion in stroke patients.

A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

The Effect of Emotional and Informational Support Intervention on Role Stress and Depression of Primary Family Caregivers Caring Stroke Patients (정서$\cdot$정보적 지지중재가 뇌졸중환자 가족원의 역할스트레스와 우울에 미치는 영향)

  • Park Young Sook;Park Hye Yeon
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.96-110
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    • 2001
  • The purpose of this study was to examine the effect of emotional and informational support intervention on role stress and depression of primary family caregivers caring stroke patients and to develop an effective nursing intervention method for them. This study selected the quasi-experiment, based on pre-test and post-test design of non-equivalent control group as a method of study. This study was conducted with 69 primary family caregivers caring stroke patients hospitalized in K and D hospitals in Daegu from August 20 to October 25, 2000. Out of them, 34 were placed in the experimental group, and 35 in the control group. The emotional and informational intervention program was divided into two aspects-emotional support and informational support- and executed three times, using prepared instruments and a guidebook. The intervention program consisted of the 1st intervention for one or one-half hour, the 2nd intervention for 30 minutes in two or three days after the 1st intervention. and the 3rd intervention for 30minutes in another two or three days after the 2nd intervention. Pre-test was carried out just before the 1st intervention, and the post-test was carried out right after the 3rd intervention, in order to collect data. The measuring instrument of role stress used was one that was modified to the role stress instrument of Yang Young-hee(1992) and the stress instrument of Choi Eun-sook (1992). The reliability was Cronbach's $\alpha=.8271$. The measuring instrument of depression used was one that was developed by Beck(1967) and standardized by Han Heung-moo et al(1986). The reliability was Cronbach's $\alpha=.8693$. Data were analyzed with percentage, mean, standard deviation, $x^2-test$, t-test and Paired t-test by using SPSS 9.0 program. The results of this study are summarized as follows: 1. Role stress score of the experimental group was revealed to be significantly lower than that of the control group 2. Depression score of the experimental group was revealed to be significantly lower than that of the control group Accordingly, the emotional and informational support intervention can be a way to reduce role stress and depression of primary family caregivers caring stroke patients.

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A Scoping Review of Acupuncture Points for Post-Stroke Sequelae: Focusing on the Electroacupuncture (뇌졸중 증상별 경혈 활용에 대한 주제범위 문헌고찰: 전침을 중심으로)

  • Lee, Hwa Yeon;Kim, Song-Yi;Choi, Su-Hyeon;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.4
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    • pp.197-208
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    • 2021
  • Objectives : The aim of this study was to conduct a scoping review focusing on acupuncture points information applied in experimental studies using electroacupuncture for stroke. Methods : First, we set the research question of this study to identify which acupuncture points were studied for various symptoms of post-stroke sequelae in clinical and animal experiments. For this purpose, among the records searched through EMBASE, experimental studies including acupuncture points used in electroacupuncture treatment for stroke were selected as inclusion criteria for this study. The acupoints information used in each experiment was extracted from the included studies according to the type of study design and symptoms of stroke sequelae, and quantitative analysis was performed. Results : A total of 973 studies using acupuncture treatment, of which 429 papers including electroacupuncture were analyzed. Most of the animal experiments were conducted on general conditions instead of specific symptoms of stroke, and in clinical studies, electroacupuncture studies were conducted on symptoms such as hemiplegia and spasticity, cognitive and mental problems, dysphagia, shoulder problems, and depression that occur after stroke. Acupuncture points such as GV20, ST36, LI11, and LI4 were mainly used regardless of stroke symptoms. Except for these acupuncture points, GV26, GV14, GV16, and GV24 were frequently used in animal experiments, and TE5, LI15, LI10, and LR3 were widely used in clinical studies. Conclusions : Although this study extracted and analyzed only the frequent acupuncture points in the electroacupuncture study for stroke. However, in the future, it is necessary to be able to secure the evidence for acupuncture treatment elements through comparative studies between different acupuncture points or other elements constituting electroacupuncture.

Effects of Purposeful Activities Combined with Music on Upper Extremity Function, Therapeutic Motivation, and Mood in Acute Stroke Patients (음악을 병행한 목적있는 활동이 급성기 뇌졸중 환자의 상지기능, 치료동기와 기분에 미치는 효과)

  • Moon, Jong-Hoon;Kim, Kye-Ho;Lee, Soon-Hyun;Won, Young-Sik
    • PNF and Movement
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    • v.15 no.3
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    • pp.267-279
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    • 2017
  • Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.

Descriptive Study of Relationships between Depression, Family Support, and Rehabilitation-motivation in Patients with Cerebrovascular Accident (통원 뇌졸중 환자의 우울 및 가족 지지가 재활 동기에 미치는 영향)

  • Lee, Hwa-Jin;Yi, Myung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.2
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    • pp.188-196
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    • 2004
  • Purpose: This study was conducted to identify relationships between depression, family support, and rehabilitation-motivation in patients with cerebrovascular accident. Method: The data were collected from 'S' hospital in Seoul from Feb. 1, 2004 to Apr. 30, 2004. The data were analyzed using a SPSS 10.0 program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Result: The results were as follows: The mean rehabilitation-motivation was 119.89, which was slightly high. The rehabilitation-motivation was influenced by religion, education level, occupation, economic status, treatment fee, duration of hospitalization, level of language ability and ADL. Rehabilitation-motivation has showed correlation with family support (r=.538, p=.000) and depression (r=-.417, p=.000). The variables related to rehabilitation-motivation were identified as family support, level of ADL, occupation, depression, and education level, using stepwise multiple regression. They were accounted for 57% of predictability of the rehabilitation-motivation, with the family support the highest at 29.3%. Conclusion: With increasing post stroke patients in Korea, we need to pay more attention to the rehabilitation of them. This study indicates that health professionals need to focus on the intervention especially in increasing family support and in decreasing depression of the patients with cerebrovascular accident.

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"Brain Stunning" Atypical Feature of tPA Thrombolysis Following Aneurysm Embolization

  • Park, Min-Woo;Yi, Hyeong-Joong;Gupta, Rishi;Horowitz, Michael B.
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.300-302
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    • 2006
  • "Stunning" represents prolonged contractile depression of any muscular component after alleviation of severe ischemia, as shown in reperfusion following acute myocardial ischemia or ischemic stroke. Clinically, it presents with no or delayed recovery past to thrombolytic therapy but its pathogenic mechanism is not fully uncovered yet. We describe a unique case of a 63-year-old woman, who was undertaken endovascular coiling for the aneurysms, deteriorated several hours later without known cause, and showed delayed clinical improvement over the next 3 days following thrombolysis. Immediate post-thrombolysis magnetic resonance imaging scan showed no apparent abnormality except for high signal intensity within the corresponding hemisphere. Reversible but delayed nature of " brain stunning" can be explained by these images and it seems to be caused by a certain type of reperfusion injury.