Medical Data Acquisition and Internet of Things Technology-Based Cerebral Stroke Disease Prevention and Rehabilitation Nursing Mobile Medical Management System.

This research was aimed at exploring the application value of a mobile medical management system based on Internet of Things technology and medical data collection in stroke disease prevention and rehabilitation nursing. In this study, on the basis of radio frequency identification (RFID) technology, the signals collected by the sensor were filtered by the optimized median filtering algorithm, and a rehabilitation nursing evaluation model was established based on the backpropagation (BP) neural network. The performance of the medical management system was verified in 32 rehabilitation patients with hemiplegia after stroke and 6 healthy medical staff in the rehabilitation medical center of the hospital. The results showed that the mean square error (MSE) and peak signal-to-noise ratio (PSNR) of the median filtering algorithm after optimization were significantly higher than those before optimization (P < 0.05). When the number of neurons was 23, the prediction accuracy of the test set reached a maximum of 89.83%. Using traingda as the training function, the model had the lowest training time and root mean squared error (RMSE) value of 2.5 s and 0.29, respectively, which were significantly lower than the traingd and traingdm functions (P < 0.01). The error percentage and RMSE of the model reached a minimum of 7.56% and 0.25, respectively, when the transfer functions of both the hidden and input layers were tansig. The prediction accuracy in stages III~VI was 90.63%. It indicated that the mobile medical management system established based on Internet of Things technology and medical data collection has certain application value for the prevention and rehabilitation nursing of stroke patients, which provides a new idea for the diagnosis, treatment, and rehabilitation of stroke patients.

The Core Knowledge and Skills of Nursing Competency Regarding Mealtime Assistance for Hemiplegic Patients in China.

PURPOSE: Hemiplegic patients often experience malnutrition and feeding risks due to disabilities and inadequate nursing support; nursing roles regarding mealtime assistance remain unclear in China. Therefore, this study aimed to clarify the core knowledge and skills of nursing competency regarding mealtime assistance for hemiplegic patients in China. METHODS: A cross-sectional survey of self-administered questionnaire to 640 nurses (response rate: 57.7%) from two tertiary teaching hospitals and two sanatoriums was conducted. Survey content included 25 items regarding the mealtime assistance competency plus 6 items on demographic characteristics. The factor structure of the 25 items was explored and verified by exploratory and confirmatory factor analysis. Its reliability was confirmed by Cronbach's alpha. RESULTS: Three factors including 22 items with a cumulative rate of 60.9% were identified: "Assistance knowledge and skills for acute period", "Knowledge about assistance and guidance for recovery period," and "Professional basic knowledge regarding hemiplegia." Its reliability was ensured with Cronbach's alpha ranging from .86 to .96. In addition, evidence for its construct validity was obtained, as structural equation modeling revealed a good fit to the data within the allowable range based on various fit indices. CONCLUSION: This study clarified the core knowledge and skills regarding mealtime assistance competency for hemiplegic patients, with "Assistance for acute period" most concerned, followed by "assistance and guidance for recovery period," and "Professional basic knowledge," and the latter two need more attention. Obtained results can provide useful evidence for competent nursing practice to improve the quality of mealtime assistance for hemiplegic patients in China.

Psychological health of caregivers and association with functional status of stroke patients.

OBJECTIVE: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients. METHODS: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls. The functional state of patients was assessed by the Barthel Index (BI). Furthermore, emotional state of the caregivers was assessed by the Hospital Anxiety and Depression Scale (HADS) and their life quality was assessed by the SF36 Health Survey. RESULTS: The mean anxiety (9.73 ± 4.88) and depression rates (9.81 ± 5.05) in the caregivers were significantly higher than those in controls (p<0.001, respectively). Significant impairments were observed in both their mental and physical health. Regression analysis also showed a significant negative correlation between the BI scores and the HADS scores. CONCLUSION: Caregivers had an impaired emotional state and the level of their anxiety was associated with the severity of functional disability of the patients. Therefore, the support provided to the caregiver might be influential on the functional recovery of the patients.

Current evidence in the management of poststroke hemiplegic shoulder pain: a review.

Hemiplegic shoulder pain is a common, complex, and distressing complication, which is related to stroke and occurs in the paralytic side of the patient. It not only presents in the early stage but also can persist into the chronic stage of stroke. The incidence of this complication varies from 12% to 58%, and the most common period of occurrence is at 8-10 weeks poststroke. The multifactorial etiology and underlying mechanisms make it intractable. It is difficult to get a clear description of the percentage of patients receiving adequate pain relief because of a large number of treatments and different results found in interventional studies performed in subjects in different stages of stroke. This review summarizes the incidence, temporal presentation, and etiology of hemiplegic shoulder pain and the current advances in its management and analyzes the reliability and validity of the studies. It suggests careful and regular assessment, and an integrated care model is necessary in practice.

Emergency department nurses' perceived barriers and facilitators to caring for stroke patients.

Stroke is currently the 3rd leading cause of death in the United States and is the leading cause of severe, long-term disability. With the advent of recombinant tissue plasminogen activator/alteplase, there is a treatment option for ischemic stroke. Unfortunately, only a small number of eligible patients receive this treatment. Whereas much research has been performed on barriers to treatment related to prehospital delays, less research has been performed on in-hospital delays related to hospital staff's perceptions of stroke patients. In this qualitative exploratory study, focus group interviews were conducted to examine emergency nurses' experiences in caring for stroke patients. A convenience sample was recruited using flyers distributed in the emergency department. Three groups of emergency nurses were interviewed in a private location within the facility. The 30-minute, semistructured interviews included 2 to 4 emergency nurses and were moderated by the investigator. Individual transcripts were analyzed for trends, patterns, and recurring themes. Three major themes regarding barriers to and facilitators of stroke care emerged: (a) nurses' comfort with assessment of stroke patients, (b) feedback regarding nurse performance and patient outcomes; and (c) environmental issues such as staffing, competing priorities, and patient and family needs. Despite the various challenges facing emergency nurses, all groups verbalized a desire to provide excellent care to these patients. Further research is recommended to address these challenges and to explore potential solutions identified in this study to improve the care of stroke patients.

Clinical case study: a 4-year-old boy with posterior fossa syndrome after resection of a medulloblastoma.

Posterior fossa syndrome can occur after neurosurgical resections of childhood posterior fossa tumors, such as medulloblastomas. Posterior fossa syndrome is characterized by transient mutism, emotional lability, cognitive deficits, weakness, ataxia, and cranial nerve dysfunction. Symptoms generally appear 1 to 3 days after surgery and persist for months to years. Neuroscience nurses play an integral role in helping affected children and their families through the diagnosis, treatment, and sequelae of this frightening syndrome.

[An explanatory model for health-promoting behaviors in patients living at home who have post stroke hemiplegia].

PURPOSE: A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia. METHOD: Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires. RESULT: Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way. CONCLUSION: It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.