Effectiveness of patient-centered intervention in post-stroke patients in the family and community practice setting: A meta-analysis

Background@#According to the American Heart Association, post- stroke patients often have neurologic deficits which can lead to a variety of complications. Patient-centered approach to care promotes shared decision-making between physicians and patients regarding treatment plan and may lead to better health outcomes for these post-stroke patients@*Objective@#The effectiveness of patient-centered intervention in improving physical functioning among adult post-stroke patients with residual neurologic deficit was determined. Secondary outcomes such as improvement in social functioning, activities of daily living, quality of life and prevention of negative events such as death, re-hospitalization and depression were also evaluated@*Method@#This systematic review included comparative randomized clinical trials involving humans as the clinical subjects, diagnosed to have had a stroke and appropriately evaluated to be in recovery with residual neurologic deficit, with the intervention described labeled as ‘patient-centered care’, and reporting an outcome on the improvement of physical functioning. Online search was done in Pubmed, CENTRAL, NICE, and the grey literature. Three reviewers independently conducted the search, appraisal and data extraction@*Results@#Results varied depending on the outcome measurement tool utilized by the included studies. There was no difference between groups in terms of overall physical functioning and ADL as measured by SIS 16 and SIS 3.0. However, significant improvement was noted in the following subscales of SIS 3.0: hand movement (0.45,3.18, p=0.009, I2=0%), communication (0.86,2.16, p<0.00001, I2= 0%), and memory and thinking (0.13, 1.74, p=.02, I2= 33%). Physical function, ADL and social functioning using RNLI as an outcome (1.44-3.70] p<0.00001, I2= 0%), and physical functioning, social functioning, ADL and QOL as measured by participation (1.48, 3.74, p<0.00001, I2= 0%) and perception of recovery (2.22, 4.00, p<0.00001, I2=0%) also showed significant improvement@*Conclusion@#Patient-centered approaches have potential benefit in improving specific components of physical and social functioning, ADL and quality of life. However, differences in the type of patient-centered intervention and outcome measurement tools warrant further investigation into the specific interventions which will provide the most benefit to post-stroke patients

Abnormal Changes in Some Haemostatic Parameters in First-ever Stroke Patients in Port Harcourt, Nigeria: A Preliminary Findings

Background and Purpose: Cellular component and clotting factors are involved in thrombotic events such as stroke, but the type and nature of alteration of those haemostatic parameters remain unclear. Our objective was to identify possible abnormal changes in some haemostatic parameters in established stroke patients.Materials and Methods: This was a prospective case-control study conducted at Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria. Standard operating procedures were adopted to assayfibrinogen, antithrombin, tissue plasminogen activator, prothrombin time and activated partial thromboplastin time as well as the determination of platelet count and platelet indices.The data were analyzed using Statistical Package for Social Science (SPSS) version 17.0 software Results: A total of 108 individuals comprised of 54 stroke patients aged between 45 and 73 years(mean, 59± 13.04 years), 20 (37.04%) men and 34 (62.96%) women and another 54 age-and sex-matched healthy control subjects were studied. Significantly (p<0.05) higher mean values of mean platelet volume (MPPV), platelet distribution width (PDW), Platelet larger cell ratio (PLCR), antithrombin, tissue plasminogen activator and fibrinogen were observed in the stroke patients when compared to those of the control subjects. Whereas, significantly lower (p<0.05) mean values of platelet count, prothrombin time and activated partial thromboplastin time were observed in the stroke patients than in those of the control subjects. Conclusion: Several haemostatic parameters were found to be altered in stroke patients and have the potential to be risk factors but have not been demonstrated as being causative. Further work is needed to establish where they begin to contribute to stroke prognosis

A study on prevalence of carotid artery stenosis in acute ischaemic stroke patients in Amalapuram, Andhra Pradesh, India

Background: Extra cranial carotid disease due to arteriosclerosis is usually associated with hypercholesterolemia and hyperlipidemia. Extra cranial carotid stenosis has been found to be less prevalent in black American and in Egyptians while intracranial disease is far more common Various methods includes transcranial doppler (TCD) ultrasonography, cerebral angiography, computed tomography angiography (CTA) and magnetic resonance angiography (MRA).Methods: All patients with ischaemic stroke of acute onset admitted in the medical wards of Konaseema institute of medical sciences between June 2018 and January 2019 were included in the study. All patients were subjected to CT scan brain study and colour Doppler study of extra cranial carotid arteries and vertebral arteries. Systolic and diastolic velocity of blood flow, carotid intimal medial thickness, presence of athermanous plaque and thrombus was looked for and then the percentage of stenosis of the affected arteries was calculated.Results: In the present study 0ut of 23 patients with carotid stenosis 9 patients had mild carotid stenosis, 8 patients had moderate stenosis and 6 patients had severe stenosis. Out of 23 patients with carotid stenosis the 11 patients have stenosis in the right carotid and 12 patients had stenosis in the left side. The site of stenosis is ICA in 17 patients and CCA in 6 patients.Conclusions: In present study every patient with carotid artery stenosis had one or the other risk factor for carotid atherosclerosis. In other words, there was no patient with carotid artery stenosis, without any risk factor in present study. Hence asymptomatic patients with these risk factors should be screened for carotid stenosis to prevent stroke.

Treatment of Stroke Patients with Shoulder-wrist Syndrome by Acupoint Catgut Embedding and Surface Electromyogram Biofeedback Therapy / 针刺研究

OBJECTIVE: To observe the clinical effectiveness of acupoint catgut embedding and surface electromyogram biofeedback therapy (sEMGBF) in the treatment of stroke patients complicated with shoulder-hand syndrome (SHS). METHODS: A total of 90 stroke patients with SHS were randomly divided into acupoint catgut embedment (ACE), sEMGBF and ACE+sEMGBF (combined treatment) groups (n=30 cases/group). The catgut embedment was performed at Jianliao (LI 14), Jianyu (LI 15), Quchi (LI 11), Waiguan (TE 5) on the affected side, once every 3 weeks, twice altogether. The electromyographic biofeedback therapy (30-50 Hz, pulse duration 200 µs, 6 s-on and 10 s-off, appropriate strength) was applied to the skin area co-vering the deltoid muscle, flexor muscle of wrist and wrist extensor for 20 min, once per day, 5 times/week, for 6 weeks. The total effective rate was assessed by using Liao's and Zhu's methods (1996), the pain severity assessed using visual analogue scale (VAS), and Fugl-Meyer assessment (FMA, 66-points) scale and the patients' activities of daily living function (ADL, 100-points) were also scored. RESULTS: Before treatment, the VAS, FMA and ADL points of the three groups were not significantly different (P>0.05). After the treatment, the total effective rate (93.33%), FMA and ADL scores of the combined treatment group were significantly higher than those of the ACE and sEMGBF groups (P0.05). The VAS score of the ACE group was markedly lower than that of the sEMGBF group (P<0.05). CONCLUSION: The combined administration of ACE and sEMGBF has a better therapeutic effect for stroke patients complicated with SHS relevant to simple ACE and simple sEMGBF therapy in improving the upper limb function, relieving pain, and enhancing the daily life quality.

Effect of Nerve Physicians' Empathy Ability on Depressive Mood of Hospitalized Stroke Patients / 中国医学伦理学

Objective:To explore the effect of nerve physicians ' empathy on depressive mood of hospitalized stroke patients .Methods:Choosing hospitalized stroke patients in a hospital in Guangdong province from January 2017 to May 2017 ,we used the Hospital Anxiety and Depression Scale ( HADS) to measure their depressive mood;the Jefferson Scale of Empathy -Health Professionals ( JSE-HP) to measure their charge doctors ' empathy ability and analyzed the effect of doctors ' empathy on patients ' depressive mood .Results:The score of patients ' depres-sive mood was (7.48 ±4.75).Doctors' empathy ability and patients' family relationship were the influencing fac-tors of depressive mood of hospitalized stroke patients .After equilibrating other factors , when a one -point in-creased on the doctor ' s empathy score , the patient ' s depressive mood score decreased by 0 .135 points ( P <0 .001 ) .Conclusion:Hospitalized stroke patients managed by neurological physicians with high empathy ability are less likely to be depressive .Narrative medicine and empathy should be applied and deepened in the clinical prac -tice.

Effects of Individualized Enteral Nutritional Support on Nutritional Status and Complications in Severe Stroke Patients / 中国药师

Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

Effect of Chinese nursing management model on stroke patients in community family beds / 中国实用护理杂志

Objective To investigate the effect of Chinese nursing management model on stroke patients in community family beds. Methods Using the method of convenient sampling, from January 2016 to December 2016, 60 patients with stroke were randomly divided into experimental group and control group, each with 30 cases. The intervention group was given a family-based TCM nursing management model on the basis of routine nursing care. The intervention time was 6 months, and the control group was given community routine nursing.Barthel and Stroke-Specific Quality of Life Scale(SS. QOL)scores were used to compare the daily life ability and quality of life. Results Barthel scores were (41.21 ± 5.47),(50.38 ± 4.33)points,the scores of SS.QOL were(45.64 ± 4.34)and(53.22 ± 5.85)points, the difference between the two groups was statistically significant(t=7.023, 6.968,P<0.05). The knowledge demand rate of prevention of recurrence and complication in stroke patients was 88.3%(53/60). Conclusions The management pattern of Chinese nursing management model nursing care in community family beds has significantly improved the quality of life and quality of life of stroke.

Effect of Nerve Physicians' Empathy Ability on Depressive Mood of Hospitalized Stroke Patients / 中国医学伦理学

Objective:To explore the effect of nerve physicians ' empathy on depressive mood of hospitalized stroke patients .Methods:Choosing hospitalized stroke patients in a hospital in Guangdong province from January 2017 to May 2017 ,we used the Hospital Anxiety and Depression Scale ( HADS) to measure their depressive mood;the Jefferson Scale of Empathy -Health Professionals ( JSE-HP) to measure their charge doctors ' empathy ability and analyzed the effect of doctors ' empathy on patients ' depressive mood .Results:The score of patients ' depres-sive mood was (7.48 ±4.75).Doctors' empathy ability and patients' family relationship were the influencing fac-tors of depressive mood of hospitalized stroke patients .After equilibrating other factors , when a one -point in-creased on the doctor ' s empathy score , the patient ' s depressive mood score decreased by 0 .135 points ( P <0 .001 ) .Conclusion:Hospitalized stroke patients managed by neurological physicians with high empathy ability are less likely to be depressive .Narrative medicine and empathy should be applied and deepened in the clinical prac -tice.

Effect of Two Acupuncture Methods on Three-dimensional Gait Time-space Parameters and Surface Electromyography of Post-stroke Patients with Flaccid Paralysis / 广州中医药大学学报

Objective To compare the effect of electro-acupuncture(EA) and warm-needle moxibustion(WNM) on the foot three-dimensional gait time-space parameters and surface electromyography of post-stroke patients with flaccid paralysis. Methods A total of 61 patients were randomly divided into EA group (N=30) and WNM group(N=31). Both groups were given post-stroke conventional treatment, and additionally EA group received EA while WNM group was given WNM. Before treatment and after 2 treatment courses, we detected the foot three-dimensional gait time-space parameters of pace race, stance phase, swing phase, bilateral stance phase, and step length, and surface electromyography parameters of root mean square(RMS), integrated electromyogram (iEMG) and co-contraction ratio(CR) of tibialis anterior muscle and gastrocnemius at the state of maximal isometric voluntary contraction(MIVC). Results(1) After treatment, the foot three-dimensional gait time-space parameters of the two groups were improved in various degrees (P<0.05 or P<0.01 compared with those before treatment) , and the improvement of EA group was superior to that of WNM group (P < 0.05). (2) After treatment, the RMS and iEMG of the gastrocnemius and tibialis anterior muscle as well as CR of dorsal extensor at MIVC state were improved in various degrees (P < 0.05 or P < 0.01 compared with those before treatment) , and the improvement of EA group was superior to that of WNM group(P < 0.05 or P < 0.01). Conclusion WNM exerts better effect on improving the parameters of three-dimensional gait time-space parameters and surface electromyography of post-stroke patients with flaccid paralysis than EA.

Effect of Aerobic Exercise Training on Physiological Parameters of Rehabilitative Stroke Patients.

Aim: Stroke constitutes a considerable cause of morbidity and mortality in any society. Despite the increasing effect of stroke, information about the prophylactic effect of aerobics exercise on the health disorder in Ghana is rare. The objective of the study is to investigate the effect of aerobic exercise (AE) training on rehabilitative stroke patients considering their body mass index (BMI), resting systolic blood pressure (RSBP), resting diastolic blood pressure (RDBP), resting heart rate (RHR) and resting blood oxygen saturation (RSp02). Study Design: Quasi-experimental research design with pre-post test was employed. Place and Duration of Study: The study was conducted at physiotherapy clinic of Komfo Anokye Teaching Hospital, Kumasi, Ghana. The AE training and measurement were conducted from November, 2013 to April, 2014 in the gymnasium of the physiotherapy clinic. Methodology: The study comprised of fifty rehabilitative stroke [partial (36, 72.0%) and permanent (14, 28.0%)] patients with mean age of 54.04±13.07 years attending physiotherapy clinic. Age ranged from 26 to 80 years. The patients [male (27, 54.0%) and female (23, 46.0%)] went through moderate intensity, two sections a week of AE training for two months. Forty (80.0%) of the participants has experience in exercise programme while ten (20.0%) has none prior to the AE training programme. Physiological parameters of BMI, RSBP, RDBP, RHR and RSp02 were measured two days before and after the AE training period, and analysed. Results: The BMI (24.89±3.56 vs 23.11±2.89; t=9.237, p<0.05), RSBP (131.48±23.43 vs 120.94±7.42; t = 3.468, p<0.05), RDBP (87.70±16.03 vs 79.50±6.26, t = 3.577, p<0.05), RHR (84.22±8.47 vs 74. 22±3.80; t = 8.879, p<0.05) and RSp02 (93.44± 5.14 vs 96.56±1.98; t =-4.905, p<0.05) significantly changed after two months of AE training. There is significant difference in gender-based analysis on the effect of AE training on BMI (22.36 ±2.70 vs23.99±3.00; t=-2.058, p<0.05) and RDBP (81.63±5.83 vs 77.00± 5.92; t=2.779, p<0.05). There was no significant differences in the effect of AE training on physiological parameters analysed based on degree of stroke and exercise experience. Conclusion: AE training was effective on the BMI, RSBP, RDBP, RHR and RSp02 of rehabilitative stroke patients irrespective of gender and degree of stroke. Significance attention should be given to aerobic exercise in the rehabilitating process of stroke patients to minimize adverse affects of some drugs on their blood pressure, heart rate and oxygen saturation.

Effects of Fluid Therapy Education Program for Aged Stroke Patients

PURPOSE: This study was to verify the effects of a fluid therapy education program for aged stroke patients for preventing dehydration, pyuria and bacteriuria. METHODS: The study employed a non-equivalent control group pretest-posttest design in quasi experimental basis. Subjects were 38 stroke patients (20 in the experimental group and 18 in the control group) older than 65, hospitalized in a senior care center in S city, Korea. RESULTS: The amount of daily average fluid intake, normal ratio of blood urea nitrogen-creatinine ratio, serum Na+ and urine white blood cells were increased significantly in the experimental group. Normal ratio of bacteriuria increased in the experimental group, but not significantly. CONCLUSION: The education program is considered to be an effective nursing intervention tool for preventing dehydration and urinary tract infections which related to the secondary wellness of aged stroke patients. However, longer term study is necessary for better quality of nursing and developing more specific education programs for aged stroke patients usually hospitalized for a long period of time.

Workplace postgraduate education and changes in rehabilitation therapists’autonomy during the medical examination of stroke patients / 医学教育

Introduction: In the rehabilitation period following a stroke, rehabilitation therapists must thoroughly evaluate the condition of patients for the purposes of goal-setting and effective training. Postgraduate education in the medical examination of patients after stroke was provided for rehabilitation therapists, and changes in their autonomy during medical examinations were subsequently assessed.<br>Method: The education consisted mainly of reading case reports about patients who had strokes and learning neurological examination techniques. A total of 35 once-weekly education sessions were provided to rehabilitation therapists working in a convalescent rehabilitation ward. The rehabilitation therapists evaluated their independence with respect to obtaining patient backgrounds, vital signs, physical findings, neurological findings, laboratory results, and basic knowledge of illness at the beginning and end of the education sessions and 6 months after the sessions ended. Each evaluation item was compared according to the time of evaluation.<br>Results: Rehabilitation therapists’ autonomy over obtaining patient backgrounds, neurological findings, laboratory results, and basic knowledge of illness was greater at the end of the education sessions than at the start of the sessions. Their autonomy over obtaining information in these 4 areas and obtaining physical findings was greater 6 months after the end of the education sessions than at the start of the sessions.<br>Discussion: We conclude that workplace postgraduate training in the medical examination of patients who have had strokes improves rehabilitation therapists’ autonomy during medical assessments.

A pilot study of the effect of aerobic training with bicycle ergometer on hemiplegic stroke patients without ambulation ability / 中华物理医学与康复杂志

Objective To study the effectiveness and feasibility of low intensity of aerobic bicycle ergometer training on hemiplegic stroke patients unable to perform assistive or independent ambulation.Methods Thirty stroke patients unable of assistive or independent ambulation were randomly divided into a control group and a aerobic training group.Patients in the aerobic training group performed low intensity of aerobic bicycle ergometer training for 30 min,3 times a week for 6 weeks in addition to a routine rehabilitation regime.The training duration and course of routine rehabilitation training were the same in both groups.The related cardiovascular response in aerobic training and changes in motor performance as well as the risk factors for stroke were observed in both groups.Results Twenty-four patients(12 patients in each group)completed the experiment.Patients in aerobic training group performed all training regime safely without any adverse response.Their motor function(including FMA score,Rivermead index,BI ADL ability),exercise endurance duration in exercise test,glucose level at 2 h in oral glucose tolerance test,fasting insulin level and HOMA-IR index all improved greatly as compared to the control group(P ＜ 0.05).Conclusion Low intensity of aerobic bicycle ergometer training can be safely and effectively administered in hemiplegic stroke patients unable of assistive ambulation or independent ambulation.

Study of Recognition and Necessity of Oriental Medicinal Menu, and Development of Oriental Therapeutic Menu for Stroke Patients

The purpose of this study was to develop the oriental therapeutic menu(Yak-sun) through the recognition and necessity of oriental medicine diet in stroke patients admitted to K Oriental Medical Hospital. From May to July 2007, the 73 stroke patients were surveyed for the recognition and necessity of oriental therapeutic menu. The oriental therapeutic menu was developed on the basis of literature of oriental medicine books and research papers. The developed two week cycle of menus were then reviewed by the experts and specialists. The sensory evaluation and nutritional analysis of the menu were followed. The stroke patients who participated in the survey did not know about the oriental medical diet, however, 61.6% of the patients had interest. Most of the patients expected the efficacy of oriental therapeutic diets. Total of forty three medical herbs and ten herb-combined prescriptions were used in the menu. The daily average calorie of developed menu was 2,031 +/- 57.6 kcal and the most of nutrients met Dietary Reference Intakes for Korean(KDRIs). The caloric ratios of carbohydrates, protein, and lipid were 61.3%, 18.7%, 20.0%, respectively. The average values of cholesterol(194 +/- 57.5 mg/day), sodium(3,078 +/- 678.5 mg/day), calcium(1,099 +/- 140.1 mg/day), and dietary fiber(33 +/- 7.0 g/day) were met Korean dietary guide line for stroke patients. Oriental therapeutic diet might be unfamiliar to the hospital patients even though they had interest in and favorable thought about it. Implements of oriental therapeutic diet to the hospital patients might be useful to improve the quality of service in the hospitals.

The Effects of Exercise on Functional Status, Activity of Daily Living and Social Re-adjustment in Stroke Patients / 재활간호학회지

PURPOSE: The purpose of this study was to evaluate the effects of exercise on functional status, activity of daily living and social re-adjustment(social function, depression) in stroke patients. METHOD: A quasi-experimental pretest and posttest study was used. The subjects consisted of 33 adults who were stroke in the G hospital, and the period of data collection was from February 8, 2006 to August 30, 2006. Seventeen patients were assigned to experimental group and sixteen to the control group. The subjects of the experimental group performed an exercise for 15-20 minutes twice a day, 3-5 times per week, during six weeks. Outcome variables were functional status, activity of daily living and social re-adjustment. Chi-Square test and T-test were used to examine the equality of the subjects and ANCOVA used to examine the group difference using SAS. RESULTS: There ware significant differences in functional status, activity of daily living, and social re-adjustment(social function, depression) between the two groups. CONCLUSION: The above results state the exercise can be an effective intervention to improve the functional status, activity of daily living, and social re-adjustment(social function, depression) of stroke patients.

Factors Affecting the Quality of Life in Stroke Patient at Home / 재활간호학회지

PURPOSE: The purpose of this study was to identify factors affecting the Quality of Life of the Stroke Patients. METHOD: The subjects were 249 Stroke Patients who had visiting at the hospital and health care center. The research tools were FIM, CES-D, ATD PA, Quality of life Scale. Data were analyzed with SPSS WIN program in which frequency, percentage, Pearson's correlation and stepwise regression were used examination the factors affecting the quality of life. RESULT: There were positive correlation between patient's FIM and Quality of life, depression and physical disability, and negative correlation between FIM and depression and physical disability. Depression was the most important factor with influence on quality of life. CONCLUSION: Based on the results, Active nursing intervention to decreased depression and to improve patients physical functional status in needed.

The Effects of Foot Reflexology on ADL and Fatigue in Stroke Patients / 재활간호학회지

PURPOSE: This study was to examine the effects of foot reflexology on ADL and fatigue in stroke patients. METHOD: The subjects were 31 stroke patients hospitalized in the Oriental Medicine Hospital of D University from June to November, 2002. Foot reflexology was applied to the experimental group twice a week for 6 weeks, 40 minutes each. For the data analysis, chi2-test was conducted to verify the homogeneity of general characteristics and clinical characteristics, and t-test was done to verify the homogeneity of ADL and fatigue. To examine the relative efficacy of the intervention, ANOVA and ANCOVA were conducted. RESULTS: After foot reflexology, the subjects in the experimental group showed significant improvement in ADL. They also had less physical, psychological, and neurosensory fatigue, which are three areas of fatigue. CONCLUSION: The results suggest that foot reflexology is an effective intervention that helps the body work efficiently, eases stress and strain, and enhances the homeostasis of the body through stimulating the reflex zone of internal organs in the body. Therefore, it is necessary to develop foot reflexology as an unique nursing intervention.

The Positive Experiences in Caregiving of Stroke Patients: A Study of Caregiving Satisfaction

BACKGROUND: Although research on caregiving for individuals with chronic illness indicates that the outcomes of caregiving may have both positive and negative experiences, little is known about the positive experiences of caregiving among those who are taking care of stroke patients. Positive experiences are likely to buffer the effects of stress and burden caused by caregiving activities, and may promote caregivers' positive attitudes beneficial to the recovery of stroke patients. METHODS: 78 caregivers for stroke patients participated in this questionnaire study. Content analysis was conducted to explore positive experiences, and hierarchical multiple regression analyses were employed to investigate predictors for caregiving satisfaction. RESULTS: Half of the respondents were at least somewhat satisfied with their caregiving activities. Care givers' positive experience can be classified by 7 categories. Of these, improving of patients' condition, cognitive change in health, and cognitive changes in disease were relatively accounted for majority. The quality of the past relationship between patients and care givers was related on the care satisfaction. CONCLUSIONS: Although caregiving for stroke patients entails stress and burden, about half of the respondents in this study showed that caregiving activities may involve some positive experiences. The better relationship caregivers had with the patients before the onset of illness, the more caregiving satisfaction was reported. Health care professionals need to recognize the positive aspects of caregiving for stroke patients, and pay attention to the quality of prior relationship between stroke patients and their caregivers that can promote caregiving satisfaction.

Influence of rehabilitation training on heart rate of stroke patients in the early stage / 中国康复理论与实践

@#ObjectiveTo observe the influence of rehabilitation training on heart rate of stroke patients in the early stage.MethodsThe heart rate (HR) of 30 patients within one week after the onset of stroke was evaluated by FUKUDA DS 880A teleelectrocardiograph and the rating of perceived exertion (RPE) was collected during practicing bridging, rolling and moving the arms.ResultsThe HR of 30 patients was only increased 7.57, 6.23 and 6.57 beats per minute during practicing bridging, rolling and moving the arms. RPE of all patients was less than 11.ConclusionAppropriate rehabilitation training is safety and unable to increase the loading of heart in the early stage after the onset of stroke.

A Development of Nursing Outcome Indicators for Stroke Patients / 성인간호학회지

PUPPOSE: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients. METHOD: focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed. RESULT: 12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested. CONCLUSION: This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.