To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea.
A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage. Stroke severity as assessed with the National Institutes of Health Stroke Scale (NIHSS), functional outcomes using the Korean version of the Modified Barthel index (K-MBI), Functional Independence Measurement (FIM), and cognitive function using the Korean version of Mini-Mental State Examination (K-MMSE) were assessed at admission and discharge.
Subjects with a family history of stroke were more likely to have an ischemic stroke (90.7%) than were those without a family history (70.9%). The K-MBI, FIM, NIHSS, and K-MMSE scores did not show significant differences between patients with or without family history.
Family history of stroke was significantly associated with ischemic stroke, but not with functional outcomes. Other prognostic factors of stroke were not distributed differently between patients included in this study with or without a family history of stroke.
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To evaluate the effect of post-stroke depression (PSD) on rehabilitation outcome and to investigate the risk factors of PSD, especially, the role of caregivers type (family or professional) in subacute stroke patients.
Two hundred twenty-six stroke patients were enrolled retrospectively. All the subjects' basic characteristics, Korean version of the Beck Depression Inventory (K-BDI), Korean version of the Modified Barthel Index (K-MBI), and the modified Rankin Scale (mRS) were recorded when the patient was transferred into the Department of Rehabilitation Medicine and at the time of discharge. The results were statistically analyzed by using SPSS ver. 20.0.
The patients' K-BDI score showed a significantly negative association with K-MBI at discharge (β=-0.473, p<0.001) and a significantly positive association with the mRS score at discharge (β=0.316, p<0.001). Patients with lesions on the left hemisphere (odds ratio [OR], 3.882; 95% confidence interval [CI], 1.726-8.733) and professional caregiver support (OR, 0.028; 95% CI, 0.012-0.065) had a higher rate of depression.
Depression was prevalent in stroke patients, and it had a negative effect on patients' functional outcome. Patients who had a lesion on the right hemisphere had less depression. The type of caregiver was related to the incidence of subacute PSD, and family caregivers were found to lower the frequency of stroke patients' depression.
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To investigate employment status after spinal cord injury (SCI) and identify personal, family, and injury characteristics those affect their employment in South Korea.
Participants were 334 community-dwelling persons 20-64 years of age who had sustained SCI for more than one year. Investigators visited each participant's home to carry out the survey. Bivariate and binary logistic regression analyses were performed to identify personal, family, and injury characteristics that influenced employment after SCI.
Employment rate decreased significantly from 82.5% to 27.5% after SCI. Logistic regression showed that the probability of employment was higher in men than women, and in individuals older than 45 years at the time of injury than those aged 31-45 years of age. Moreover, employment was higher in individuals injured for longer than 20 years than those injured for 1-5 years and in individuals with incomplete tetraplegia than those with complete paraplegia. Employment was lower in individuals with SCI caused by industrial accidents than those injured in non-industrial accidents.
Injury characteristics are the most important predictors of employment in persons with SCI. For persons with lower employment rate, individualized vocational rehabilitation and employment-support systems are required.
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Method: The subjects of this study were 28 family members of stroke patients who had participated in group education program. The program was composed of eight sessions. The aim of this study was to increase understanding of the nature of stroke and treatment procedures, and to enhance family caregivers' ability to take care of patients, and to reduce family caregivers' burden. The program team members included social workers, medical doctors, and nutritionists. The data was analyzed using Wilcoxon Signed Rank Test.
Results: There were significant differences in all three areas between pre and post groups (p＜0.001). It means the program will help the participants improve mental health state, enhance stress coping skills and improve the perception of social support.
Conclusion: A formalized group education program is an important resource in helping family members understand the stroke and their ability to cope with the rehabilitation process. Since family members provide a critical role in the long-term rehabilitation, family group education should be an essential part in the rehabilitation program.
Objective: To analyze the factors affecting on the level of the quality of life of stroke patients and their family caregivers.
Method: Among the stroke patients receiving rehabilitation treatment at forty three out patient clinic in university hospitals, 289 stroke patients who scored over 24 out of 30 points in MMSE-K and their family caregivers were interviewed using questionnaires.
Results: The main contributory variable on the quality of life (QOL) of caregivers was the socio-demographic factor and QOL of caregivers was improved with decreasing age, the higher level of education, the less burden of care and the better condition of patient. High correlation coefficients were showed between QOL of stroke patients and ADL, QOL of caregivers and burden of care, and the burden of care and the neurological impairment. The main contributory variable on the QOL of stroke patients was clinical characteristics factor and QOL of stroke patients was improved with increasing the levels of cognitive function and ADL performance, decreasing the level of neurological impairment, the more social support from friends and the less burden of caregivers.
Conclusion: In order to improve the QOL of stroke patients, not only patients' physical factors, but psychological factors, socio-demographic factors and QOL of caregivers should also be considered.
Objective: The main purposes of this study were to understand the correlations among Modified Barthel Index (MBI), Functional Independence Measure (FIM), and ESCROW (Environment, Social support, Cluster of family members, Resources, Outlook, Work or School status) Profile, and to establish the more appropriate assessment standards to check patient's conditions in the hospital and in their homes and society.
Method: Thirty-four patients, who received the rehabilitation treatment and home visiting at the Presbyterian Medical Center, were evaluated for their functions by MBI, FIM, and ESCROW Profile.
Results: The mean scores of assessment measures by home visiting were all higher than in the hospital showing an improvement of the patients' functions after discharge from the hospital. The results of MBI and FIM in the hospital and home visiting showed a significant correlation, while the results of MBI and Cognitive FIM measure indicated a relatively low correlation coefficient. Although each result of MBI, FIM, and ESCROW provided a low correlation when the patients were in the hospital, the result for home visiting revealed very significant correlations. Especially, the items of environment, social support, outlook, and work status of ESCROW showed very significant correlations with MBI and FIM.
Conclusion: The results showed that MBI and FIM measurements were very useful in observing and following up the functional conditions of the patients, while ESCROW profile was more appropriate to evaluate the familial and social rehabilitation status.
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