PURPOSE: The aim of this study was to develop and measure the effect of a movie-based-nursing intervention program designed to enhance motivation for rehabilitation and reduce depression levels in stroke patients. METHODS: The study used a quasi-experimental, nonequivalent control group and a pretest-posttest design. The 60 research subjects were assigned to the experimental (n=30) or control group (n=30). The movie-based nursing intervention program was provided for the experimental group during 60-minute sessions held once per week for 10 weeks. The program consisted of patient education to strengthen motivation for rehabilitation and reduce depression, watching movies to identify role models, and group discussion to facilitate therapeutic interaction. RESULTS: After 10 weeks of participation in the movie-based nursing intervention program, the experimental group's rehabilitation motivation score was significantly higher, F=1161.54 (within groups df=49, between groups df=1), p<.001, relative to that observed in the control group. In addition, the experimental group's depression score was significantly lower relative to that observed in the control group, F=258.97 (within groups df=49, between groups df=1), p<.001. CONCLUSION: The movie-based nursing intervention program could be used for stroke patients experiencing psychological difficulties including reduced motivation for rehabilitation and increased depression during the rehabilitation process.
Depression* ; Humans ; Motion Pictures as Topic ; Motivation* ; Nursing* ; Patient Education as Topic ; Program Development ; Rehabilitation* ; Research Subjects ; Stroke*

PURPOSE: This study was to examine the effects of a footbath program on heart rate variability, blood pressure, body temperature and fatigue of stroke patients with stroke-induced hemiparesis. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 40 stroke patients, twenty for the footbath program and twenty for the control group, who were hospitalized in a long-term rehabilitation hospital in G city of Korea, from February to April 2014. The twenty participants in the experimental group received the intervention of footbaths and an educational program focused on the prevention of stroke complications; Collected data were analyzed by the IBM SPSS WIN 20.0 program using a t-test, chi2 test, Mann-Whitney U test and repeated measures ANOVA. RESULTS: Significant differences were found in heart rate variability, systolic blood pressure, hand and foot temperatures and fatigue between the two groups. But no significant differences were found in diastolic blood pressure, core temperatures, forehead temperatures, and hand temperatures between the two groups. CONCLUSION: The footbath program was an effective intervention for skin temperature change and fatigue reduction for stroke patients. Therefore, it is recommended that the footbath program can be utilized as an effective nursing intervention for stroke patients in long-term rehabilitation care hospitals.
Blood Pressure* ; Body Temperature* ; Fatigue* ; Foot ; Forehead ; Hand ; Heart Rate* ; Heart* ; Humans ; Korea ; Nursing ; Paresis ; Rehabilitation ; Skin Temperature ; Stroke*

PURPOSE: This study compared the importance and performance of rehabilitation nursing needs perceived by stroke patients and nurses. METHODS: A total of 275 subjects were divided into two groups. One group was 136 stroke patients and the other was 139 nurses. Data were collected with the Rehabilitation Nursing Service Inventory. The data were analyzed by t-test and ANOVA using the SPSS/WIN 21.0 program. RESULTS: The degree of importance and performance in rehabilitation nursing needs perceived by the stroke patients were 3.69±0.47 and 3.48±0.50, respectively, showing a significant difference (t=21.04, p<.001). The degree of importance and performance perceived by nurses were 3.84±0.42 and 3.60±0.45, respectively, showing a significant difference (t=26.53, p<.001). A significant difference in the degree of importance and performance in rehabilitation nursing needs was also observed between stroke patients and nurses (t=-2.78, p=.006; t=-2.12, p=.035). CONCLUSION: These findings showed that there was a perception gap between stroke patients and nurses. Therefore, it will necessary to identify methods for reducing this perception gap and developing rehabilitation nursing intervention considering the rehabilitation nursing needs of stroke patients.
Health Services Needs and Demand ; Humans ; Rehabilitation Nursing* ; Rehabilitation* ; Stroke*

PURPOSE: The purpose of this study was to compare motivation for rehabilitation, family support and adherence to rehabilitation and identify factors predicting adherence to rehabilitation between depressive and non-depressive stroke patients. METHODS: Stroke patients admitted to rehabilitation hospitals (n=159) participated in the study. Data were collected through self-reported questionnaires including general characteristics, depression, motivation for rehabilitation, family support and adherence to rehabilitation. The data were analyzed by descriptive statistics, t-test, χ² test, Pearson correlation coefficients and logistic regression using the SPSS/WIN 21.0 program. RESULTS: 62.9% of the subjects were identified as depressive patients. Motivation for rehabilitation (F=48.18, p=.020) and adherence to rehabilitation (F=9.68, p=.002) in depressive stroke patients were significantly lower than non-depressive stroke patients. Family support also in depressive group was lower than non-depressive group but there was no statistical significance (F=2.35, p=.127). Motivation for rehabilitation (OR=11.46), family support (OR=1.05) and onset period (less than 2 year)(OR=3.61) predicted the good adherence to rehabilitation in depressive stroke patients. CONCLUSION: The results of this study indicate that health professionals need to identify factors affecting adherence to rehabilitation and provide a nursing intervention considering the depression especially when caring for stroke patients.
Depression ; Health Occupations ; Humans ; Logistic Models ; Motivation* ; Nursing ; Rehabilitation* ; Stroke*

OBJECTIVE: To investigate how much formal caregivers know about caring for stroke patients, and whether they adequately provide it. METHODS: Formal caregivers, who worked for stroke patients at 8 hospitals (including 4 university hospitals, 2 rehabilitation hospitals, and 2 convalescent hospitals) participated in this study. The survey was based on a self-report questionnaire, with 6 categories containing a total of 48 questions about the specific care of stroke patients: the demographic characteristics of the caregivers, bed positioning, the provision of meals, position changes and transfers, the range of motion exercises, and caregiver training. RESULTS: A total of 217 caregivers were surveyed, and they were distributed as follows: 41% came from the university hospitals, 35% came from the rehabilitation hospitals, and 24% came from the convalescent hospitals. The percentages of correct answers were distributed as follows: 64.3% for bed positioning, 74.3% for providing meals, and 62.4% for position change and transfer. The total and subscale scores of the caregivers working at convalescent hospitals were significantly lower than those of the caregivers working at the other types of hospitals (p<0.05). Only 7.8% of the total participants received training on a regular basis. The caregivers obtained most of the information from caregiver associations (58.1%), and the majority of the caregivers (65.4%) were willing to receive training. CONCLUSION: About one third (33.8%) of caregivers did not have adequate knowledge of how to properly care for stroke patients; in fact, a significant number of caregivers demonstrated inappropriate and insufficient knowledge in several areas. It is assumed that the provision of regular training, by rehabilitation experts, will improve the professionalism and knowledge of the caregivers, and positively affect patient outcomes.
Caregivers ; Education ; Exercise ; Hospitals, Convalescent ; Hospitals, University ; Humans ; Meals ; Nursing Care ; Range of Motion, Articular ; Rehabilitation ; Stroke*

Stroke is a major cause of death and disability in Singapore and many parts of the world. Chronic disease management programmes allow seamless care provision across a spectrum of healthcare facilities and allow appropriate services to be brought to the stroke patient and the family. Randomised controlled trials have provided evidence for efficacious interventions. After the management of acute stroke in a stroke unit, most stable stroke patients can be sent to their family physician for continued treatment and rehabilitation supervision. Disabled stroke survivors may need added home-based services. Suitable community resources will need to be harnessed. Clinic-based stroke nurses may enhance service provision and coordination. Close collaboration between the specialist and family physician would be needed to right-site patients and also allow referrals in either direction where necessary. Barriers to integration can be surmounted by trust and improved communication. Audits would allow monitoring of care provision and quality care enhancement. The Wagner model of chronic care delivery involves self-management support, shared clinical information systems, delivery system redesign, decision support, healthcare organisation and community resources. The key and critical feature is the need for an informed, activated (or motivated) patient, working in collaboration with the specialist and family physician, and a team of nursing and allied healthcare professionals across the continuum of care. The 3-year Integrating Services and Interventions for Stroke (ISIS) project funded by the Ministry of Health will test such an integrative system.
Delivery of Health Care, Integrated ; organization & administration ; Evidence-Based Medicine ; Humans ; Ischemic Attack, Transient ; Medicine ; Middle Aged ; Models, Organizational ; Neurology ; Primary Health Care ; Rehabilitation Nursing ; Singapore ; Specialization ; Stroke ; nursing ; Stroke Rehabilitation

BACKGROUND: The purpose of this study is to investigate discharge destinations and outcomes of geriatric stroke patients in university hospitals, and to examine their correlates and variables. METHODS: A total of 24 subjects, who were admitted between January and June 2006 in two university hospitals in Daegu, were enrolled in this prospective study. Data on demographic factors, socioeconomic factors, clinical, functional status and discharge destinations of patients were documented. Pearson's chi square test and t-test were used for statistic analysis. RESULTS: Ten patients were discharged to the community(their own home: 7, offspring's home: 3) and 14 patients were discharged to other hospitals(rehabilitation hospitals or nursing home:12, oriental medicine hospitals: 2) Analysis revealed that discharge destinations had significant correlations with severity of cognitive function, severity of speech disturbance, admission FIM scores and discharge FIM scores(p<0.05). CONCLUSIONS: Large part(75%) of geriatric stroke patients could not return to pre-stroke living situations. Their discharge destinations were associated with cognitive function, speech disturbance, admission and discharge FIM scores. Recognizing these correlations could be helpful for appropriate intervention to geriatric stroke patients during admission for more comprehensive rehabilitational management.
Daegu ; Demography ; Geriatrics ; Hospitals, University* ; Humans ; Medicine, East Asian Traditional ; Nursing ; Prospective Studies ; Rehabilitation ; Socioeconomic Factors ; Stroke*

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.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Female ; *Health Behavior ; *Health Promotion ; Hemiplegia/etiology/*nursing/rehabilitation ; *Home Nursing ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Questionnaires ; Self Efficacy ; Stroke/complications/*nursing/psychology

PURPOSE: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. METHOD: The subjects were 60 stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, x2-test, and t-test using the SPSS/Win 10.0 computerized program. RESULT: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. CONCLUSION: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.
Adult ; Aged ; Aged, 80 and over ; Depression ; Female ; Humans ; Lower Extremity/physiopathology ; Male ; Middle Aged ; *Musculoskeletal Manipulations ; *Self Efficacy ; Self-Help Groups ; Stroke/nursing/*rehabilitation ; Walking

PURPOSE: This study was to examine the effect of morning stretching on depression and motivation of rehabilitation for stroke patients. METHOD: Design of this study was noneqivalent control pre-test post-test design. Subjects were total 62 patients (Experimental: 30 subjects, Control: 32 subjects) being hospitalized for stroke in a national medical center. Measures were CES-D for depression and PAREMO for motivation of rehabilitation. Data were collected from 1st March to 30th July, 2004. Data have been processed using SPSS/WIN 11.0. RESULTS: The results of this study were as followings: 1) Experimental group was showed lower level of depression than that of control group (t=8.934, P=.000). 2) Experimental group was showed higher motivation of rehabilitation than control group (t=-12.43, P=.000). CONCLUSION: As a result, it was confirmed that morning stretching which was intervened in this study was one of the nursing intervention that lowers the level of depression and promotes motivation of rehabilitation for stroke patients, that helps to improve their psychological and mental problems.
Depression* ; Humans ; Motivation* ; Nursing ; Rehabilitation* ; Stroke*