Purpose: The aim of this study was to investigate the prevalence of depressive symptoms in stroke patients and to compare characteristics of different rating scales - Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale-Depression (HAD.D)- with regard to diagnosis and severity assessment for post-stroke depression. Methods: Participants included 44 stroke patients who could communicate. At admission, all study participants received a semi-structured interview using the HDRS and a self-completed questionnaire using the BDI and the HAD-D. Pearson's correlation method was used to examine associations among the three depression scales. The BDI and HAD-D were compared based on HDRS criteria, and the sensitivity and specificity using cut-off values were analyzed. Results: The HDRS showed that 52.30% of stroke patients had depressive symptoms on the BDI and HAD-D it was 59.10%. The HDRS correlated significantly with the BDI (r=0.81, p<0.01) and HAD-D (r=0.55, p<0.01). The BDI correlated significantly with HADS (r=0.50, p<0.01). After calculating the area under the ROC curve to decide on HDRS criteria, the BDI (AUC=0.91, 95% CI: 0.83.0.99) showed a significantly larger area compared to the HAD.D (AUC=0.82, 95% CI: 0.69-0.94). The cut-off value of the BDI was 12.50 points with a sensitivity of 81.00% and a specificity of 76.20%. Conclusion: These findings show that the BDI is a useful screening test for depression that most closely predicts the HRDS score.
Purpose: This study was designed to test structural equation modeling of the quality of life of stroke survivors in order to provide guidelines for development of interventions and strategies to improve their quality of life. Methods: The participants in the study were patients who visited the neurology outpatient department of a tertiary hospital in Seoul between June 25 and October 15, 2009. Data collection was carried out through one-on-one interviews. Demographic factors, functional independence, social support, nutritional status, post-stroke biobehavioral changes and quality of life were investigated. Results: The final analysis included 215 patients. Fitness of the hypothetical model was appropriate (${\chi}^2$=111.5, p=.000, GFI=.926, AGFI=.880, RMSA=.068, NFI=.911, CFI=.953). Functional dependency, social support and post-stroke biobehavioral changes were found to be significant explaining variance in quality of life. Post-stroke biobehavioral changes had the strongest direct influence on quality of life. Nutritional status had an indirect effect on the quality of life. Conclusion: To improve the quality of life of stroke survivors, comprehensive interventions are necessary to manage post-stroke biobehavioral changes, and strengthening social support networks that can contribute to enhancing the quality of life of stroke survivors.
Kim, Keum-Soon;Seo, Hyun-Mi;Kim, Eun-Jeong;Jeong, Ihn-Sook;Choe, Eun-Jeong;Jeong, Sun-I
The Korean Journal of Rehabilitation Nursing
/
v.3
no.2
/
pp.196-211
/
2000
The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.
Purpose: The purpose of this study was to investigate the effects of aquatic exercise on rehabilitation in home stroke patients. Method: A quasi-experimental pretest and posttest design was used to examine the change of balance, ADL, IADL, pain, depression and self-efficacy atthe completion of 6-weeks aquatic exercise program. The subjects consisted of 25 adults who had a stroke. Thirteen experimental and twelve control subjects completed pre and post test measures. Outcome variables were balance, ADL, IADL, pain, depression and self-efficacy. Chi-Square test(Fisher's exact method) was used to examine the equality of the subjects and Wilcoxon Rank Sum Test used to examine the group difference by using SAS. Results: There was no significant difference in balance and depression between the two groups. However, there was a significant difference in ADL, IADL, pain and self-efficacy between the two groups. Conclusion: Aquatic exercise can improve ADL, IADL, self-efficacy and reduce pain. Therefore, further research is recommended by increasing the length of aquatic exercise and number of subjects, so that its effects can be more generalizable.
The purpose of this study was to assess the effect of a group self exercise program in improving the quality of life regarding depression and the activities of daily living (ADL) of chronic stroke survivors, as well as the motor functions such as the 3 meter round walk, upper extremity function, and static balance. The subjects were 12 post-stroke ambulatory community center participants. All subjects participated in one 90 minute session per week for 7 weeks and received a home exercise program in every session. They had to record and submit an exercise check list. Quality of life was measured with the Beck depression inventory and the 8-Item Short-Form (SF-8). Motor functions were measured with the manual function test (MF'T), the kinesthetic ability trainer (KAT 3000), and the modified Barthel index. The level of depression decreased somewhat, but there were no significant differences after intervention. However, quality of life related health (SF-8) improved significant1y. There were significant improvements in the time for the 3 meter round walk, the functions of the affected upper extremities, and static balance and ADL (p<.05). The findings of this study suggest that a group self exercise program can improve quality of life related health and motor functions in stroke survivors.
Purpose: The purpose of this study was to examine the effects of aroma-inhalation on depression, sleep, mood, and smell in stroke patients and their caregivers. Method: This study employed one group pretest-posttest repeated design. Data were collected at three time points: baseline(pre-test), 10 days and 20 days after the intervention(Post-test1 and post-test2, respectively). The sample included a total of 23 subjects. Data were analyzed by SPSS 12.0 program using repeated measure ANOVA. Results: Depression was not statistically significant difference among pre-test, post-test1 and post-test2. Sleep was improved after intervention $37.61{\pm}7.41$(pre-test), $41.22{\pm}8.26$ (post-test1), $44.33{\pm}7.67$(post-test2) (F=8.182. p=.001) Mood was significantly improved after intervention: $16.95{\pm}4.89$(pre-test), $14.89{\pm}6.31$(post-test1), $12.11{\pm}5.04$(post-test2). Smell including smell perception, discomfort due to smell and relation between age and smell was significantly improved after intervention: $2.63{\pm}1.20$ (pre-test). $2.00{\pm}1.16$(post-test1), $1.63{\pm}.96$(post-test2) (F=6.176. p=.006) in smell perception, $2.50{\pm}1.10$ (pre-test). $1.81{\pm}.91$(post-test1), $1.19{\pm}.40$(post-test2) (F=12.26. p=.000) in discomfort due to smell and $3.53{\pm}1.18$(pre-test). $2.59{\pm}1.46$(post-test1), $2.53{\pm}1.33$(post-test2) (F=4.148, p=.025) in relation between age and smell. Conclusion: The results suggest that aroma-inhalation may have an effect on sleep, mood and smell and can be effective nursing intervention to increase the relaxation in stroke patients and their caregivers.
Purpose: This study was to evaluate the effects of a rehabilitation exercise program on physical function and mental health status in chronic stroke Patients with hemiparesis Method: This study used a single group experimental design with repeated measures. Data collection and intervention were done from August, 2004 to November. 2004 at a community. Participants were fifteen patients (mean age: 68.6), and a 100 meter walking time and box and block tests were conducted at baseline, 4weeks, and post-intervention (8weeks) Activities of daily living and the levels of depression and anxiety were measured by using SCL-90-R at pre and post Intervention. This program consisted of 1 hour individual exercise 3 times a week for 8 weeks, and it focused on stretching, walking, arm and hand exercise, and hand massage. Result: 1. ADL, IADL, and the 100m walking time in the patients were improved compared with baseline. However. box and block tests was not shown significant improvement compared with baseline. 2. Depression and anxiety scores were improved more than that of baseline. Conclusion: The rehabilitation exercise program can be effective in improving physical function and mental health status, and it has a potential for improving Physical health status in Patients with chronic stroke hemiparesis.
Purpose: The purpose of this study was to examine the effects of taping therapy on the range of motion and pain of shoulders, physical functions and depression among hospitalized patients with stroke a geriatric hospital. Methods: The study design was a none equivalent control group pre-post test quasi-experimental design. The participants were 25 patients for experimental group and 25 patients for the control group. The period of this study was from March to July 2010. The twenty minute taping therapy was performed for twice a week for eight weeks. Results: The results showed that taping therapy was effective in range of motion shoulders (flexion: t=-5.81, p =.001, abduction: t=-3.69, p =.001) and pain of shoulders (rest: t=3.18, p = .003, movement: t=2.97, p =.005), grip (t=-3.22, p =.002) and balance (t=3.20, p =.002), and depression (t=3.24, p =.002). The variable of ADL (t=-1.99, p =.052) was not significant. Conclusion: The results of the taping therapy increased range of motion shoulders and grip and balance of physical functions, and decreased pain in shoulders and depression. The findings support that taping therapy can be used as a nursing intervention for stroke patients in practical nursing and communities.
The purposes of this study was to determine the effect of exercise in stroke patients and to define to strategy to promote their activity of daily living, decrease to their depression. The experiemental design was designed nonequivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionaire on 60 patients who had been in patient department in D University hospital and K University hospital in Busan from November 5th, 2000 to the end of February 28th, 2001. Exercise was conducted by the researcher and was carried out experimental group once per day for 20 minutes for daily fourteen days. ADL check List tool by Kang and Center of Epideilogic Studies-Depression (CES-D) were used for measurement in this study. The data was analyzed by means of freqency, percentage, $mean{\pm}SD$, t-test, chi-square test and ANOVA with SPSS/PC. The results were summarized as follow; 1. The experimental group which received exercise should be higher in activity of daily living than the control group was supported (t=2.70, P=.009). 2. The experimental group which received exercise should be lower in depression than the control group was not support(t=-1.120, P=.267) but experimental group post-pre depression score support(t=7.247, P=.000). 3. Factors influencing the activity of daily living measured are payer of medical expenses (F=3.98, P=.018) and complications(t=3.97, P=.056). 4. Factors influencing the depression measured are economic status(F=5.71, P=.009) and caregivers (F=3.09, P=.045). In conclusion, the exercise incresed the activity of daily living and effect on depression of stroke patiens. Based upon these results, it is recommended that the nurses who take care of stroke patients such as exercise.
Objective: This study was conducted to verify the effectiveness of a cognitive rehabilitation program consisting of physical exercises and mental activities for patients with chronic stroke with mild cognitive impairment (MCI). We aimed to investigate how this cognitive rehabilitation program affects patients' cognitive ability, depression, and sleep quality. Design: One group pretest-posttest design Methods: The study was conductedon 12 patients who participated in thecognitive rehabilitation complex exercise program for 16 weeks. The Korean version of the Montreal Cognitive Assessment (MoCA-K), Hamilton Depression Rating Scale (K-HDRS), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the measured variables before and after study participation. The cognitive rehabilitation complex exercise program included 30 minutes of cognitive exercise and 30 minutes of Brill Exercise. The Wilcoxon signed-rank test was used to compare the variables before and after program participation. Cronbach's ɑ was used to assess the reliability of the test variables. Results: The post-program assessment showed a statistically significant increase in the MoCA-K score, which measures cognitive function (Z=-2.628, P=0.009). For depression ratings, there was a statistically significant decrease in the K-HDRS score (Z=-2.041, P=0.041). For sleep quality, although there was a numerical increase in the PSQI score, the difference was not statistically significant (Z=-0.702, P=0.483). The reliability test confirmed that all the individual test variables exhibited high reliability (cognitive function, 0.859; depression, 0.872; sleep, 0.822). Conclusions: We found that cognitive rehabilitation program used in this study had a positive effect on the cognitive function and depression in patients with chronic stroke with MCI.
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