Change in Care Dependency of Stroke Patients: A Longitudinal and Multicenter Study

Nursiswati, Nursiswati; Halfens, Ruud J.G.; Lohrmann, Christa

doi:10.1016/j.anr.2017.05.005

Cited by 15 publications

(22 citation statements)

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“…뇌졸중 후 환자의 간호의존도와 영향요인 기 위하여 어느 정도 의존하여야 하는 대상자들에게 자기간호 를 수행하는데 있어 독립성을 복구시키는데 필요한 간호사가 제공하는 도움'으로 정의한다 (Dijkstra, Tiesinga, Plantinga, Veltman, & Dassen, 2005). 따라서 간호의존도는 개인의 신체 적, 정서적, 인지적, 사회적, 환경적 욕구를 충족시키는데 목적 이 있어 (Nursiswati et al, 2017), 뇌졸중 환자의 일상적인 간 호를 변화시키는 구체적인 정보를 제공한다 (Dijkstra et al, 2005). 간호의존도는 (Kang, 2017;Oh, Sung, Park, Lee, & Kim, 2016) 대상 자의 간호의존도 상태에 대한 고려없이 도움이 필요한 영역만을 제시하므로써 간호사가 필요로 하는 구체적인 정보를 제공하는 데 제한점이 있다 (Dijkstra et al, 2005).…”

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Care Dependency of Post-stroke Patients and Its Affecting Factors

Kim¹

2018

kjrehn

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This study was aimed to identify the care dependency and its affecting factors of post-stroke patients. Methods: Cross-sectional and correlational descriptive study design was used. The subjects were 106 post-stroke patients who were in or outpatients in a rehabilitation clinic at D city. Demographic, stroke related and post-stroke status variables (paralysis, arthria, verbal expression, visual disturbance, activity intolerance, nutritional status, depression and cognition) were included as affecting factors. Multiple regression was used to identify the affecting factors. Among demographic and stroke-related variables, significant variables such as age, education level, marital status, financial status, location of treatment, and total admission days were entered with post-stroke status variables. Results: Care dependency was still high regardless of disease duration or type of stroke. Overall, approximately 80.5% of total variances in care dependency was explained with all variables. Among those variables, nutritional status, cognition and activity intolerance were the significant affecting factors. Conclusion: To reduce the care dependency of post-stroke patients, it is recommended to improve nutritional status, cognition and activity intolerance.

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Care Dependency of Post-stroke Patients and Its Affecting Factors

Kim¹

2018

kjrehn

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“…Considering that the acute stroke unit is a markedly different clinical setting than the subacute inpatient rehabilitation unit, the model would need to be adapted. In the acute stroke unit, stroke survivors' dependency levels are reported as high as 92% (Nursiswati et al, 2017), and they frequently require assistance in mobility and daily activities (Nursiswati et al, 2017). In addition, patients require many daily investigations and physical observations, and length of stay is usually shorter in the acute than subacute hospital setting.…”

Section: Declaration By Authormentioning

confidence: 99%

“…work (Galvin et al, 2008). Finally, as patients in the acute phase after stroke are frequently dependent on staff assistance for activities (Nursiswati et al, 2017), understanding how any increase in activity relied on staff assistance is an important consideration for long-term sustainability and future widespread implementation of enrichment.…”

Section: Introductionmentioning

confidence: 99%

“…The acute stroke unit presents a multitude of new challenges that may impede direct clinical translation of the enriched environment model that was successful in the subacute inpatient rehabilitation setting (Janssen et al, 2014b). In the acute stroke unit, patients are often dependent on staff assistance (Nursiswati et al, 2017), and require frequent medical investigations and interventions during the day (Clarke & Forster, 2015). In the sub-acute rehabilitation setting, where patient dependency is lower than in the acute stroke unit (Nursiswati et al, 2017), staff reported that providing assistance to patients was a key limiting factor in patients accessing communal enrichment areas (White et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…In the acute stroke unit, patients are often dependent on staff assistance (Nursiswati et al, 2017), and require frequent medical investigations and interventions during the day (Clarke & Forster, 2015). In the sub-acute rehabilitation setting, where patient dependency is lower than in the acute stroke unit (Nursiswati et al, 2017), staff reported that providing assistance to patients was a key limiting factor in patients accessing communal enrichment areas (White et al, 2014). To address this issue, we included scheduled communal activities with clear responsibilities for nursing and allied health professionals to enable 'mobility assistance' in our enrichment model.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of creating an enriched environment and subsequent impact on activity levels for stroke patients in an acute stroke unit

Rosbergen-Wildemors¹

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Individuals with stroke in an acute stroke unit spend the majority of their day inactive and alone.There is strong evidence that greater physical activity, and emerging evidence that greater social and cognitive activity after stroke promotes functional recovery. One approach found to increase activity levels in all these activity domains following stroke is an enriched environment, which is an intervention designed to stimulate physical, social and cognitive activity. The enriched environment is well investigated in animal models post stroke and refers to housing conditions that are designed to stimulate motor and sensory functions, as well as social and cognitive activity. Evidence has shown that rodents recovering within an enriched environment starting 24-hours post stroke showed greater functional recovery than recovery in standard housing conditions. The first clinical translation of an enriched environment was undertaken in the subacute inpatient rehabilitation setting, which showed that individuals with stroke (n=14) undergoing enriched rehabilitation were 1.2 times more engaged in 'any activity' as compared to no enrichment. However, the enriched environment has not yet been explored in an acute stroke unit. Thus, the primary aim of this thesis was to investigate whether an enriched environment embedded in an acute stroke unit could increase activity levels in physical, social, cognitive and combined activity domains across individuals with acute stroke.Study 1 examined the effect of embedding an enriched environment in an acute stroke unit on activity levels using a controlled before-after observational design. Activity levels were observed in a control group receiving usual care, and subsequently in a group who recovered in an enriched acute stroke unit. The enriched environment focused on three key areas: 1) creating a stimulating environment including communal areas for eating, socialising and group activities, and provision of resources throughout the ward and at the patient bedside; 2) involvement of patients and families to increase activity outside therapy hours, and 3) using change management strategies to support staff to implement the enriched environment within existing staffing levels. Behavioural mapping was used to determine the primary outcome measure 'any', physical, social and cognitive activity.Participants were observed every 10-minutes from 7.30am till 7.30pm on weekday and weekends.We found that the enriched group (n=30) spent a significantly greater proportion of their day engaged in 'any activity' (p=0.005), physical (p<0.001), social (p=0.007) and cognitive activity (p=0.002) as compared to the control group (n=30). Furthermore, the enriched group spent a lower proportion in a supine position, in their room and being alone. The secondary aims were to explore the impact of an enriched environment on functional outcomes, adverse events and length of stay.No differences between groups were found for functional outcomes at discharge from the acute Publications during candidature Peer...

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Psychometric properties of the Care Dependency Scale in stroke survivors in Indonesian hospitals

Nursiswati

Halfens

Lohrmann

2020

International Journal of Nursing Sciences

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Purpose This study aimed to evaluate the psychometric properties of the Indonesian version of the Care Dependency Scale (CDS) among stroke survivors. Methods The study was undertaken in four hospitals. We analysed datasets obtained from 109 stroke survivors on inpatient wards and in outpatient clinics, who were rated by nurses to determine the CDS reliability coefficients. The Cronbach’s α and Cohen’s kappa coefficients were applied. Concurrent validity was conducted for the data on care dependency, which werecollected from 49 of these 109 participants on inpatient wards by nurses using the CDS and the Barthel Index. A Spearman’s rank correlation analysis was conducted to measure the association between the CDS and the Barthel Index results. Results An analysis of the results of the CDS tested on the inpatient ward and in the outpatient clinic revealed a high level of internal consistency. The reliability analysis yielded the same Cronbach’s α coefficient of 0.98 for both the inpatient and outpatient data. A significant, moderate correlation was observed between the CDS and Barthel Index results. Conclusion The CDS can be recommended for use as a tool for the assessment and evaluation of stroke survivors who are receiving acute or long-term care.

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Change in Care Dependency of Stroke Patients: A Longitudinal and Multicenter Study

Cited by 15 publications

References 20 publications

Care Dependency of Post-stroke Patients and Its Affecting Factors

Care Dependency of Post-stroke Patients and Its Affecting Factors

Feasibility of creating an enriched environment and subsequent impact on activity levels for stroke patients in an acute stroke unit

Psychometric properties of the Care Dependency Scale in stroke survivors in Indonesian hospitals

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