PURPOSE: The purpose of this study was to understand the adjustment process of middle-aged people in Korea with hemiplegia after a stroke. METHOD: For this study, the grounded theory method was utilized. RESULTS: After constant comparative analysis, the core category emerged as 'rebuilding the body which was ruined'. In addition, the causal conditions were 'restriction of physical function', and 'loss of roles'. The adjustment process consisted of the 'facing reality phase', 'overcoming depression phase', 'overcoming physical limits phase' and 'reestablishing roles phase'. The main strategies in the facing reality phase were 'holding on to a glimmer of hope', 'getting away from the harsh reality' and 'facing up to the reality'. The main strategies in the overcoming depression phase were 'soothing oneself', 'Self-introspection' and 'restoring self-esteem'. In addition, the main strategies in the self-initiative overcoming physical limits phase was 'discovering personal strategies and striving to recover'. The main strategies in the reestablishing roles phase were 'reestablishing a parents' role', 'reestablishing a spouse's role' and 'reestablishing social roles'. CONCLUSION: In conclusion, even though many middle aged stroke patients remained in the depression phase, most of them who overcame depression strived to conquer physical limits on their own initiative.
*Adaptation, Psychological ; Adult ; *Attitude to Health ; Female ; Hemiplegia/etiology/*psychology ; Humans ; Male ; Middle Aged ; Self Efficacy ; Stroke/complications/*psychology

OBJECTIVETo understand correlative elements of post stroke depression (PSD).

METHODSRecord scores of the Hamilton Rating Scale for Depression (HRSD) for each PSD patient. Assess the degree of neurological deficit by the modified Scandinavian Stroke Scale (MSSS). Then analyze the correlativity of the patient's HRSD with MSSS, and the relation of PSD with the location and course of lesion.

CONCLUSIONThe depression degrees in PSD are positively correlated with the degree of neurological deficit post stroke; PSD is not related with the lesion location; the left-handers who hurt in the right hemisphere of the brain has a higher morbidity than that in the left hemisphere.

Age Factors ; Aged ; Depression ; etiology ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; psychology ; Time Factors

OBJECTIVETo investigate the changes in the population and distribution intestinal microflora and their relationship with depression in post-stroke patients.

METHODSFecal specimens were obtained from 32 patients with post-stroke depression and 30 healthy adults for gene sequencing of 16S RNA V3 region of the intestinal microorganism using Roche/45 high-throughput sequencing platform.

RESULTSThe genus and species of intestinal bacteria showed significant differences between the post-stroke patients and health adults.

CONCLUSIONSignificant changes in the structure of intestinal flora occur in patients with post-stroke depression.

Adult ; Case-Control Studies ; Depression ; complications ; microbiology ; Gastrointestinal Microbiome ; High-Throughput Nucleotide Sequencing ; Humans ; Intestines ; microbiology ; Stroke ; complications ; psychology

Affective Symptoms ; drug therapy ; etiology ; Female ; Fluoxetine ; therapeutic use ; Humans ; MELAS Syndrome ; complications ; psychology ; Middle Aged ; Serotonin Uptake Inhibitors ; therapeutic use ; Stroke ; complications ; psychology

PURPOSE: The aim of this study was to clarify the actual condition of elders with dementia who were registered in the Seoul Dementia Management Project. METHODS: Data were collected from 5,312 elderly patients with dementia. Demographic included characteristics, comorbidity, and healthy lifestyle habits; data from the Seoul Dementia Management Project. RESULTS: First, demographic characteristics were as follows; mean age at the time of definite diagnosis was 78.0 yr. There were slightly more women (69.3%), and 4.55 yr was the average length of education with 41.4% being illiterate or uneducated patients. Second, there were several comorbidities including hypertension (61.7%), diabetes mellitus (31.8%), hypercholesterolemia (10.2%), heart disease (11.1%), obesity (4.2%), and stroke (21.4%). Third, alcoholic history was found in 11.8% of the patients, and smoking in 9.8%. Regular exercise was done by only 29.1% of the patients with dementia. Finally, significant differences between men and women were found for the following; age, education, medical security, hypertension, diabetes mellitus, stroke, alcoholic consumption, smoking, and regular exercise. CONCLUSION: Authors expect that the present data will be used for establishment of dementia associated projects and policies.
Aged ; Aged, 80 and over ; Alcohol Drinking ; Comorbidity ; Dementia/*complications/psychology ; Demography ; Diabetes Mellitus, Type 2/complications ; Exercise ; Female ; *Health Behavior ; Heart Diseases/complications ; Humans ; Hypercholesterolemia/complications ; Hypertension/complications ; Male ; Middle Aged ; Obesity/complications ; Smoking ; Stroke/complications

OBJECTIVETo provide reliable evidence of "J in three-needle therapy" for treatment of stroke.

METHODSMulti-central randomized controlled trials were adopted, 180 hemiplegia patients of ischemic stroke were randomly divided into a fin three-needle group (90 cases) and a routine acupuncture group (90 cases). Two groups were both treated with basic neurology therapies, and J in three-needle group was treated with J in three-needle therapy, three acupoints of tempora, hand and foot etc. were selected; the routine acupuncture group was treated with traditional acupuncture, Quchi (LI 11), Huantiao (GB 30), Futu (ST 32) etc. were selected. Both groups were treated with acupuncture for 5 weeks. The cognitive function score of functional comprehensive assessment scale (FCA), the scores of mini-mental state examination scale (MMSE) and modified Barthel index (BI) were compared before and after treatment between two groups. Results After treatment, the scores of FCA, MMSE and BI in both groups were significantly improved compared to those before treatment (P < 0.01, P < 0.05); the improvement of FCA score, MMSE score and BI score in the J in three-needle group were superior to those of the routine acupuncture group after treatment (P < 0.01, P < 0.05). The total effective rate of 85.4% in the J in three-needle group was superior to tohat of 70.0% in the routine acupuncture group (P < 0.05).

CONCLUSIONJ in three-needle acupuncture treatment can obviously improve the cognitive function and activity ability of daily life of hemiplegia patients after stroke, and the therapeutic effect of J in three-needle therapy is superior to that of traditional acupuncture treatment.

Activities of Daily Living ; Acupuncture Therapy ; Adult ; Aged ; Cognition ; Female ; Hemiplegia ; etiology ; psychology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications

OBJECTIVETo explore the curative effect and safety of acupuncture for mild cognitive disorders after stroke.

METHODSRandomized controlled trial was adopted and one hundred cases conforming to criteria were divided into a combined acupuncture and medication group (group A) and a medication group (group B), 50 cases in each group. The basic treatment of cerebrovascular disease was applied in two groups. The group A treated was with acupuncture at Baihui (GV 20), Shenting (GV 24) and Qucha (BL 4) etc. and oral administration of Nimodipine. In group B, Nimodipine was taken orally. The treatment lasted for 3 months, the scores of Mini-Mental State Examination (MMSE), modified Hasegawa Dementia Scale (HDS-R) and Barthel Index (BI) were observed before and after treatment in two groups.

RESULTSThe total effective rate in group A was 66.7% (32/48), which was superior to 30.4% (14/46) in group B (P < 0.05). The scores of MMSE, HDS-R and BI after treatment were apparently improved as compared with those before treatment in two groups (all P < 0.01). The improvements in group A were superior to those in group B (all P < 0.05). There was no adverse event reported during the treatment in two groups.

CONCLUSIONAcupuncture can improve activity of daily living and has significant effect in treating mild cognition disorders after stroke without adverse reactions.

Acupuncture Therapy ; Aged ; Cognition ; Cognition Disorders ; etiology ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

INTRODUCTIONEarly initiation of stroke thrombolysis is associated with improved outcomes. Procurement of consent is a key factor in prolonging the door-to-needle duration. This study aimed to determine the attitudes and preferences of stroke patients and their next of kin (NOK) towards decision-making for stroke thrombolysis in Singapore.

MATERIALS AND METHODSWe surveyed acute ischaemic stroke patients (n = 171) who presented beyond the 4.5-hour therapeutic window and their NOK (n = 140) using a questionnaire with scenarios on obtaining consent for intravenous thrombolysis.

RESULTSIn the patient survey, 83% were agreeable for their NOK to decide on their behalf if mentally incapacitated and 74% were agreeable for the doctor to decide if the NOK was absent. In the NOK survey, the majority (81%) wanted to be consulted before mentally capacitated patients made their decision; 72% and 74%, meanwhile, were willing to decide on behalf of a mentally capacitated and mentally incapacitated patient, respectively. In the scenario where a doctor recommended a mentally incapacitated stroke patient to undergo thrombolysis but the family declined, there was a near equal split in preference to follow the family's or doctor's decision in both the patient and NOK surveys.

CONCLUSIONThe survey found that in the decision-making process for stroke thrombolysis, there was no clear consensus on the preference for the decision maker of the mentally incapacitated patient. In Singapore, there is a strong influence of the NOK in decision-making for thrombolysis.

Attitude to Health ; Brain Ischemia ; complications ; psychology ; therapy ; Decision Making ; Dissent and Disputes ; Humans ; Informed Consent ; Mental Competency ; Proxy ; Singapore ; Stroke ; etiology ; psychology ; therapy ; Surveys and Questionnaires ; Thrombolytic Therapy ; Time-to-Treatment

OBJECTIVETo assess the clinical efficacy on post-stroke speech disorder treated with acupuncture and psychological intervention combined with rehabilitation training.

METHODSThe multi-central randomized controlled study was adopted. One hundred and twenty cases of brain stroke were divided into a speech rehabilitation group (control group), a speech rehabilitation plus acupuncture group (observation group 1) and a speech rehabilitation plus acupuncture combined with psychotherapy group (observation group 2), 40 cases in each one. The rehabilitation training was conducted by a professional speech trainer. In acupuncture treatment, speech function area in scalp acupuncture, Jinjin (EX-HN 12) and Yuye (EX-HN 13) in tongue acupuncture and Lianquan (CV 23) were the basic points. The supplementary points were selected according to syndrome differentiation. Bloodletting method was used in combination with acupuncture. Psychotherapy was applied by the physician in psychiatric department of the hospital. The corresponding programs were used in each group. Examination of Aphasia of Chinese of Beijing Hospital was adopted to observe the oral speech expression, listening comprehension and reading and writing ability.

RESULTSAfter 21-day treatment, the total effective rate was 92.5% (37/40) in observation group 1, 97.5% (39/40) in observation group 2 and 87.5% (35/40) in control group. The efficacies were similar in comparison among 3 groups. The remarkable effective rate was 15.0% (6/40) in observation group 1, 50.0% (20/40) in observation group 2 and 2.5% (1/40) in control group. The result in observation group 2 was superior to the other two groups (P<0.01, P<0.001). In comparison of the improvements of oral expression, listening comprehension, reading and writing ability, all of the 3 groups had achieved the improvements to different extents after treatment (P<0.01, P<0.001). The results in observation group 2 were better than those in observation group 1 and control group.

CONCLUSIONAcupuncture and psychological intervention combined with rehabilitation training is obviously advantageous in the treatment of post-stroke speech disorder.

Acupuncture Therapy ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Speech Disorders ; etiology ; psychology ; rehabilitation ; therapy ; Speech Therapy ; Stroke ; complications

OBJECTIVETo probe into effects of Linggui Bafa (method for picking eight points linked with extraordinary meridians according to time) on the therapeutic effect and quality of life in patients of post stroke depression.

METHODSOne hundred and twenty cases were randomly divided into 3 groups, an observation group 1, an observation group 2 and a control group, 40 cases in each group. All patients were given routine clinical treatments and second level medical prevention. Patients in the observation group 1 received Linggui Bafa acupuncture treatment 2 weeks after stroke; at the same time the observation group 2 was treated with oral administration of Sertraline. The control group did not receive any form of either acupuncture or oral medication, but early rehabilitative intervention and psychological treatment were initiated. Curative effects were evaluated with Hamilton Depression Scale (HAMD), Function Independent Measure (FIM), National Institutes of Health Stroke Scale (NIHSS) and SF-36 after the treatment and 6 months later, respectively.

RESULTSThe scores of HAMD, FIM (cognition function) and general health, role-physical, role-emotional, social function, vitality, mental health in SF-36 in the observation group 1 were significantly higher than those in the control group after treatment and 6 months later (P<0.01, P<0.05). The scores of physical function in SF-36 after treatment and NIHSS 6 months later in the observation group 1 were significantly improved than those in the control group (P<0.01, P<0.05). The scores of FIM (cognition function) and role-physical, social function, mental health in SF-36 after treatment and HAMD and general health, social function, mental health in SF-36 6 months later in the observation group 2 were significantly better than those in the control group (P<0.01, P<0.05). The scores of HAMD, FIM (cognition function) and general health, role-emotional, social function, vitality, mental health in SF-36 in the observation group 1 were significantly improved than those in the observation group 2 after treatment and 6 months later (P<0.01, P<0.05). The scores of NIHSS and role-physical in SF-36 in the observation group 1 were significantly higher than those in the observation group 2 6 months later (P<0.05).

CONCLUSIONAcupuncture can improve depression symptoms and quality of life of patients with post stroke depression and the effects were better than Sertraline.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Depression ; etiology ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Stroke ; complications ; Treatment Outcome