The Effectiveness of Systematic Stroke Care

系統性的中風醫療照護之有效性評估

屈蓮(Lian Chiu) ； 吳美雲(Mooi-Hun Goh) ； 洪啟宗(Chi-Tzong Hung) ； 徐偉成(Woei-Cherng Shyu) ； 張大邦(Tai-Pang Chang)

《The Kaohsiung Journal of Medical Sciences》 13卷8期 (1997/08) Pp. 496-502

https://doi.org/10.6452/KJMS.199708.0496

摘要

A coordinated, multidisciplinary approach had been applied to enhance the effectiveness of stroke care with varying enthusiasm; however, the effectiveness of this kind of stroke treatment model was noted in many studies. This study was designed to measure the effectiveness of systematic stroke management on the physical-functional outcome in terms of Activities of Daily Living (ADLs) scores. The higher the ADLs score, the higher the degree of physical disability, I.e., the higher the degree of dependence. Eighty-six stroke patients from the Department of Neurology in a medical center, and 88 stroke paients from the Department of Medicine in a local hosptial were followed from the admission day to the discharged date. The effectiveness of stroke care in each hospital was measured by the comparisons between ADLs scores at discharge and ADLs scores at admission. Two-sample tests show that demographic characteristics,length of stay, average time elapsed since the occurrent stroke, number of families in caregiving, and ADL5 scores at admission and at discharge did not differ much between these two groups. The Improved ADLs scores for stroke patients treated in the Department of Neurology of the medical center were changed from the 14.1 ± 4.9 at admission to 12.1 ± 5.2 at discharge, and the changes of ADL5 scores for patients treated in the Department of Medicine of the regional hospital was from 12.8 ± 5.1 to 12.3 ± 5.5 according to the degree of improvement. The significant finding was that the degree of improvement of ADL5 scores for CVA patients from the medical center was significant (Wilcoxon Matched-Pairs Signed-Ranks Test, Z=2.8, p＜O.Oi). Moreover, the degree 01’ improvement of ADLs scores strongly differed between these two groups (Repeated measures of two-way ANOVA, F=6.O, p＜O.05). The information presented here Informs us that degree of physical-functional status of stroke patients should be improved because of the systematic stroke management.

並列摘要

A coordinated, multidisciplinary approach had been applied to enhance the effectiveness of stroke care with varying enthusiasm; however, the effectiveness of this kind of stroke treatment model was noted in many studies. This study was designed to measure the effectiveness of systematic stroke management on the physical-functional outcome in terms of Activities of Daily Living (ADLs) scores. The higher the ADLs score, the higher the degree of physical disability, I.e., the higher the degree of dependence. Eighty-six stroke patients from the Department of Neurology in a medical center, and 88 stroke paients from the Department of Medicine in a local hosptial were followed from the admission day to the discharged date. The effectiveness of stroke care in each hospital was measured by the comparisons between ADLs scores at discharge and ADLs scores at admission. Two-sample tests show that demographic characteristics,length of stay, average time elapsed since the occurrent stroke, number of families in caregiving, and ADL5 scores at admission and at discharge did not differ much between these two groups. The Improved ADLs scores for stroke patients treated in the Department of Neurology of the medical center were changed from the 14.1 ± 4.9 at admission to 12.1 ± 5.2 at discharge, and the changes of ADL5 scores for patients treated in the Department of Medicine of the regional hospital was from 12.8 ± 5.1 to 12.3 ± 5.5 according to the degree of improvement. The significant finding was that the degree of improvement of ADL5 scores for CVA patients from the medical center was significant (Wilcoxon Matched-Pairs Signed-Ranks Test, Z=2.8, p＜O.Oi). Moreover, the degree 01’ improvement of ADLs scores strongly differed between these two groups (Repeated measures of two-way ANOVA, F=6.O, p＜O.05). The information presented here Informs us that degree of physical-functional status of stroke patients should be improved because of the systematic stroke management.

並列關鍵字

stroke ； stroke management ； stroke outcome