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Дисертації з теми "Cerebrovascular disease Patients Australia"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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1

Hoffmann, Tammy Coral. "Development and evaluation of a computer-generated individualised written education package for patients following stroke and their carers /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18924.pdf.

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2

Ellis, Graham. "Stroke liaison workers for patients and carers." Thesis, Connect to e-thesis, 2008. http://theses.gla.ac.uk/288/.

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Анотація:

Thesis (MD.) - University of Glasgow, 2007.
MD. thesis submitted to the Division of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, 2007. Includes bibliographical references. Print version also available.

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3

Kwok, Wing-yee Eunice. "Early supported discharge program for stroke patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720883.

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4

Willats, Lisa. "Improved quantification of perfusion in patients with cerebrovascular disease." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1445148/.

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Анотація:

In recent years measurements of cerebral perfusion using bolus-tracking MRI have become common clinical practice in the diagnosis and management of patients with stroke and cerebrovascular disease. An active area of research is the development of methods to identify brain tissue that is at risk of irreversible damage, but amenable to salvage using reperfusion treatments, such as thrombolysis. However, the specificity and sensitivity of these methods are limited by the inaccuracies in the perfusion data. Accurate measurements of perfusion are difficult to obtain, especially in patients with cerebrovascular diseases. In particular, if the bolus of MR contrast is delayed and/or dispersed due to cerebral arterial abnormalities, perfusion is likely to be underestimated using the standard analysis techniques. The potential for such underestimation is often overlooked when using the perfusion maps to assess stroke patients. Since thrombolysis can increase the risk of haemorrhage, a misidentification of 'at-risk' tissue has potentially dangerous clinical implications. This thesis presents several methodologies which aim to improve the accuracy and interpretation of the analysed bolus-tracking data. Two novel data analysis techniques are proposed, which enable the identification of brain regions where delay and dispersion of the bolus are likely to bias the perfusion measurements. In this way true hypoperfusion can be distinguished from erroneously low perfusion estimates. The size of the perfusion measurement errors are investigated in vivo, and a parameterised characterisation of the bolus delay and dispersion is obtained. Such information is valuable for the interpretation of in vivo data, and for further investigation into the effects of abnormal vasculature on perfusion estimates. Finally, methodology is presented to minimise the perfusion measurement errors prevalent in patients with cerebrovascular diseases. The in vivo application of this method highlights the dangers of interpreting perfusion values independently of the bolus delay and dispersion.

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5

Rau, Marie Therese. "Elderly stroke patients and their partners: a longitudinal study of social support and well-being changes associated with a disabling stroke." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/478.

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This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.

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6

Cotter, Paul Eoin. "Cardiac parameters in young patients with cryptogenic stroke." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648802.

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7

Sit, Bik-yan Sonia. "Cognitive function in Chinese stroke patients /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31595923.

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8

Wan, Wai-kuen Christina, and 尹慧娟. "An exploratory design of an empowerment group for the strokesurvivors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31978228.

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9

郭穎怡 and Wing-yee Eunice Kwok. "Early supported discharge program for stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720883.

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10

Tsang, Sai-ling. "Community readjustment of discharged stroke patients : an exploratory study /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322490.

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11

張晶凝 and Ching-ying Crystal Cheung. "Facial emotion recognition after subcortical cerebrovascular diseases." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31224155.

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12

馮美玲 and Mei-ling Fung. "Stroke rehabilitation: predicting LOS and discharge placement." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970515.

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13

Tam, Lai-yin Ann. "Study of the strain and needs of adult children caregivers of elderly stroke patients /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470265.

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14

Luk, Wai-ha Veronica. "Evidence-based DVT prophylactic guideline for stroke and neurosurgical patients." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251419.

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15

Fung, Shuk-man Wendy. "A study of medical social services and stroke patients : an application of the unitary approach /." [Hong Kong : University of Hong Kong], 1993. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13418014.

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16

Li, Sijian, and 李斯儉. "Evaluating the effectiveness of a stroke education programme in Wuhan City of China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31221397.

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17

Man, Lai-mei, and 文麗媚. "An exploratory study for the health seeking pattern of stroke survivors on alternative medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31978617.

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18

Fryer, Bradley James. "The relationship between task complexity and cerebral oxygenation in stroke patients." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/80371.

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Анотація:

Thesis (MSportSc)--Stellenbosch University, 2013.
ENGLISH ABSTRACT: There are a growing number of men and women world-wide who are suffering strokes due to poor lifestyle-related habits. While there is evidence of the differences in cerebral haemodynamics between stroke patients and both elderly and young healthy individuals, limited evidence has examined the effect of rehabilitation on cerebral haemodynamics. Furthermore, most studies have examined changes in cerebral haemodynamics during cognitive and functional tasks in isolation, with no literature published on them simultaneously. The primary aim of this study was to examine whether differences in cerebral haemodynamics exist between stroke patients and healthy elderly individuals while performing a simple and complex cognitive task. Thirty two men and women (age 75 ± 8 years) volunteered to participate in the study and were split into an experimental (n = 14) group consisting of stroke patients and a control (n = 18) group consisting of healthy individuals. Each participant was required to attend one testing session where measurements of oxyhaemoglobin (O2Hb), deoxy-haemoglobin (HHb), tissue oxygenation index (TOI) and total haemoglobin index (THI) were obtained. Measurements were obtained with the participants at rest, while performing the Mini Mental State Exam (MMSE) and the modified Stroop Task as cognitive tests, and the Timed Up-and-Go (TuG) and six minute walk test (6MWT) or Toe Taps (TT) as the functional tests. Furthermore, the outcome scores of the various tests were also recorded. Change in O2Hb levels were lower in the experimental group than in the control group, especially in the left prefrontal cortex (LPFC) while HHb values were higher in the right prefrontal cortex (RPFC) (p > 0.05). There were almost no differences in TOI between the two groups in either the LPFC or RPFC, however, statistically significant differences were seen in THI in the RPFC during the MMSE (p = 0.03), rest period 2 (p = 0.03), the first modified Stroop Task (p = 0.04), as well as the TuG (p = 0.02). Furthermore, significant differences were seen between the two groups with respect to the time taken to complete the TuG, with the experimental group completing it much faster (p = 0.04). The experimental group participants who had received regular rehabilitation performed consistently better across most of the testing phases, with a number of practically significant findings. The results show that definite differences exist between stroke patients and healthy elderly individuals when performing a simple and complex task. The positive effect of low intensity exercise on task performance was clearly seen in both groups, and holds a great deal of practical significance for the development of exercise programmes for healthy individuals, as well as stroke patients. Furthermore, rehabilitation following a stroke has obvious benefits as shown by the positive results of the current study, however, limited research exists to validate these findings, highlighting the need for further research in this area.
AFRIKAANSE OPSOMMING: Daar is ŉ wêreld wye toename in die aantal mans en dames wat beroertes ondervind as gevolg van swak lewenstyl-verwante gewoontes. Alhoewel baie navorsing beskikbaar is oor die verskille in serebrale hemodinamika tussen beroerte pasiënte en bejaardes, asook jong gesonde individue, is daar ŉ beperkte aantal studies oor die effek van rehabilitasie op serebrale hemodinamika. Meeste van hierdie studies het die veranderinge in serebrale hemodinamika tydens kognitiewe of funksionele take in isolasie ondersoek, met geen literatuur waar die effek van albei gesamentlik gemeet word nie. Die hoofdoel van hierdie studie was om die verskille in serebrale hemodinamika tussen beroerte pasiënte en gesonde bejaardes, tydens die uitvoering van ŉ eenvoudige en komplekse kognitiewe taak, te ondersoek. Twee-en-dertig mans en vroue (ouderdom 75 ± 8 jaar) het aan die studie deelgeneem. Die eksperimentele groep (n = 14) het bestaan uit die beroerte pasïente en die kontrole groep (n = 18) was gesonde bejaardes. Elke deelnemer het een toets sessie bygewoon waartydens oksihemoglobien (O2Hb), deoksihemoglobien (HHb), weefsel oksigenasie indeks (TOI) en totale hemoglobien indeks (THI) gemeet is. Metings is tydens rus geneem, asook tydens die kognitiewe toetse, die “Mini Mental State Exam” (MMSE) en die gewysigde Stroop taak gemeet, en die funksionele toetse, naamlik die “Timed Up-and-Go” (TuG) en die ses minute loop toets (6MWT) of “Toe Taps” (TT). Die eksperimentele groep se O2Hb was laer as die kontrole groep, veral in die linker voor frontale korteks (LPFC), en die eksperimentele groep se HHb waardes was hoër in die regter voor frontale korteks (RPFC) (p > 0.05). Daar was geen statisties betekenisvolle verskille in TOI tussen die twee groepe nie, maar wel in die THI in die RPFC tydens die MMSE (p = 0.03), rusperiode twee (p = 0.03), die eerste gewysigde Stroop Taak (p = 0.04) en die TuG toets (p = 0.02). Die kontrole groep was statisties betekenisvol vinniger as die eksperimentele groep in die TuG toets (p = 0.04). Deelnemers in die eksperimentele groep wat gereelde rehabilitasie ontvang het, het konsekwent beter gevaar tydens die toets sessie, en ŉ aantal prakties betekenisvolle verskille is in sekere veranderlikes gevind. Die resultate dui aan dat daar wel ŉ verskil in serebrale hemodinamika bestaan tussen beroerte pasiënte en gesonde bejaardes terwyl hulle eenvoudige en komplekse take verrig. Die positiewe effek van lae intensiteit oefening op prestasie was duidelike sigbaar van beide groepe. Hierdie resultate is prakties betekenisvol as dit kom by die ontwikkeling van oefenprogramme vir gesonde individue asook beroerte pasiënte. Rehabilitasie na ŉ beroerte hou ooglopende voordele in soos aangedui deur die positiewe bevindinge van die huidige studie, hoewel daar beperkte navorsing beskikbaar is om hierdie bevindinge te staaf. Daar is dus ŉ behoefte vir verdere navorsing in hierdie gebied.

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19

Chang, Chia-yu Stephanie Celeste. "Does social-demographic information predict residential outcomes in elderly stroke rehabilitation patients in Hong Kong?" Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971520.

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20

Mok, Siu-wai Kanness. "Use of elderly mobility scale as a functional predictor in stroke patients during inpatient rehabilitation." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972056.

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21

Chan, Shuk-ling. "Development, implementation and evaluation of a structural stroke education program for informal caregivers of stroke patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40720251.

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22

Urimubenshi, Gerard. "Profile of and challenges experienced by stroke patients admitted to Ruhengeri Hospital in Rwanda." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3179_1273708790.

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Stroke is the world&rsquo
s third highest cause of death and a major cause of disability. In order to define optimal management for stroke, reliable data are needed. Although Ruhengeri Hospital in Rwanda receives many stroke patients, no in-depth study has been carried out on stroke patients admitted at the hospital. This study, therefore, identified the profile of stroke patients admitted at Ruhengeri Hospital in Rwanda and explored the challenges that they experienced. A concurrent mixed model design was used to collect data. With a data gathering instrument which was developed by the researcher, a quantitative retrospective approach was used to review existing patients&rsquo
records to collect information related to demographic characteristics, documented clinical features and risk factors for stroke, stroke onset-admission interval, length of hospital stay and the process of hysiotherapy for stroke patients. In-depth face-toface interviews were also used to collect data regarding the challenges experienced by stroke patients. The sample for the quantitative phase consisted of medical records of stroke patients admitted at Ruhengeri Hospital from January 1st, 2005 up to December 31st, 2008. In the qualitative phase, a purposive sample of 10 participants was selected.

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23

Tsang, Yuen. "The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B3197224X.

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24

Davison, Andrew Charles. "Development of a smart knee brace for early gait rehabilitation of stroke patients /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 68 p, 2007. http://proquest.umi.com/pqdweb?did=1251900481&sid=2&Fmt=2&clientId=8331&RQT=309&VName=PQD.

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Анотація:

Thesis (M.S.M.E.)--University of Delaware, 2006
Principal faculty advisors: Sun, Jian-Qiao, Dept. of Mechanical Engineering; Katherine Rudolph, Dept. of Physical Therapy. Includes bibliographical references.

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25

Wang, Li, and 王立. "Agreement between stroke patients' and proxy assessments of health-related quality of life." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48426003.

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Background: Stroke has become the second most cause of death and leading cause of disability worldwide. Patients-reported health related quality of life measures are often used in evaluating stroke outcomes. However, many stroke patients can not participate in the outcome assessments due to severe disability or aphasia or cognitive impairment. In this case, proxy respondents can be used as secondary information sources. The principle thing needs to be paid attention to in using proxy’s assessments is the reliability or agreement between patient and proxy. Western studies have shown that the agreement between patient and proxy was moderate to substantial. However, such studies are limited in China. Simply applying overseas research outcomes on local population is not appropriate. Therefore, we conducted this study to find out the agreement between stroke patients and proxy assessments about quality of life in China. Methods: 100 patient-proxy pairs were enrolled in our study. Our study was a hospital-based study. The included patients were 3 months after stroke, and patients with more than moderate aphasia or cognitive impairment were excluded. Proxies were people who knew the patients > 1 year, contacted with the patients ≥ 3 days per week, were responsible for ≥ 2 caregiving tasks, and ≥ 18 years. The Chinese version of Stroke-specific quality of life scale (SS-QoL) was used to assess the stroke patients’ QoL, and proxy version of SS-QoL was used in proxies’ evaluation. The evaluation process of patient and proxy was separately and concurrently. Method of self-reported combined with interview-administered was adopted. Paired t tests or Wilcoxon signed ranks tests were performed to test the systematic differences between patient and proxy. The agreement level between patient and proxy assessments on stroke QoL was estimated by Intraclass correlation coefficient (ICC). Multiple linear regression was performed to find out factors affecting the patient-proxy agreement. Results: Patients were older (61 versus 48 years) and more often male (63% versus 44%). Mean systematic differences ranged from 0.03 to 0.44. Only 3 domains of differences were statistical significant (Language, Personality, and Work/productivity). The strength of agreement between patient and proxy reporting ranged from fair to perfect (ICC: 0.31 to 0.87). Better agreement was observed in more objective domains while worse agreement was reported in more subjective domains. Proxy education was tested to be a significant predictor of the overall patient-proxy score difference, which indicated that higher proxy education level was associated with greater agreement. It was shown that higher overall patient-reported or proxy-reported SS-QoL score was associated with less stroke impairments. Factors of stroke impairments, patient/proxy education level, patient/proxy gender, and stroke type separately have significant impacts on the agreement between patient and proxy in different domains of QoL. Conclusion: Our findings indicate that proxies may provide reliable information for assessments about stroke patients’ quality of life in China. And the outcomes are more appropriate for mind to moderate stroke patients. For further studies, the reliability of proxy information about severe stroke patients should be paid attention to. Research about changes of agreement between patient and proxy along with the disease development process would be focused on.
published_or_final_version
Public Health
Master
Master of Public Health

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26

Cooper, Natalie R., and University of Lethbridge Faculty of Arts and Science. "Reduced peri-infarct dysfunction with pre-stroke exercise : molecular and physiological correlates." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2003, 2003. http://hdl.handle.net/10133/215.

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The effects of pre-stroke exercise and levesl of brain-derived neurotrophic factor (BDNF) on behavioural and functional recovery were examined following focal cortical ischemic infarct. Intracortical microstimulation (ICMS) was used to derive topographical maps of forelimb representations within the motor cortex and ischemia was induced via bipolar coagulation of surface vasculature. One month of excerise prior to ischemia significantly increased the amount of peri-infarct movement represnetations and initiates vascular changes within motor cortex. Further, this exercise-induced preservation of peri-infarct movement representations is associated with behavioural recovery and is dependent on BDNF levels in the motor cortex. These results provide further support for the idea that endurance exercise prior to stroke may enhance functional and behavioural recovery.
140 leaves : ill. (some col.) ; 29 cm.

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27

Mo, Wing-yan Anita, and 巫詠欣. "Acute stroke patients age 65 years and older: outcome and predictors." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010298.

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28

Li, Mei-ling, and 李美玲. "Impact of stroke on quality of life and cost." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B46939283.

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29

Vlasic, John P. II. "A research study on emotional adjustment of a spouse following stroke." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1169.

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This research project focuses on age as a predictor in the emotional adjustment of a spouse following his/her partner's stroke. The medical records of 80 stroke cases were reviewed at Kaiser Permanente Medical Center, Fontana, California. Patients and spouses were examined in two age groupings, age 55 and below, and ages 56 and above. Study of these two age groups afforded the most meaningful division to study spouse adjustment.

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30

Biggs, Debbie Lynn. "Health promotion needs of stroke patients accessing community health centres in the metropole region of the Western Cape." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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Анотація:

Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs&rsquo
assessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel ®
. Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants&rsquo
suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants&rsquo
health status and ultimate quality of life.

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31

Sit, Bik-yan Sonia, and 薛碧茵. "Cognitive function in Chinese stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45010390.

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32

陸慧霞 and Wai-ha Veronica Luk. "Evidence-based DVT prophylactic guideline for stroke and neurosurgicalpatients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251419.

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33

Rhoda, Anthea. "The rehabilitation of stroke patients at community health centres in the Western Cape." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_5654_1318838292.

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The rehabilitation of stroke patients can occur at different settings. These include in-patient settings, such as stroke units or general rehabilitation wards and out-patient settings, such as out-patient departments attached to hospitals, day hospital departments and the patientsâ home. In South-Africa, day hospitals have been upgraded and are now referred to as Community Health Centres which provide comprehensive health services to the population. In the Western Cape these centres are faced with the rehabilitation of stroke patients who have been discharged early from hospital during the acute stage or who have never been admitted to hospitals. To date there is a lack of best practice guidelines and formal evaluations in terms of efficacy and effectiveness of rehabilitation at these centres. The aim of the study was therefore to investigate the rehabilitation of stroke patients at Community Health Centres in the Metropole Region of the Western Cape. The structure, process and outcomes (SPO) model was used as a conceptual framework in this study.

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Lam, Lok-tao Otto, and 林樂濤. "A randomized clinical trial of oral health promotion interventions among patients following stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hdl.handle.net/10722/207561.

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OBJECTIVES: The primary objective of this study was to evaluate the effectiveness of of oral health promotion interventions on both clinical oral health, and oral opportunistic pathogens in hospitalized patients following acute stroke. Secondary objectives were to investigate the development of infectious complications, as well as health-related quality of life during the hospitalization period, and to monitor clinical oral health, oral opportunistic pathogens, and health-related quality of life following hospital discharge. METHODS: A total of 102 patients were recruited into a clinical trial conducted among stroke patients in a rehabilitation ward. Patients were randomly assigned either: 1) oral hygiene instruction 2) oral hygiene instruction and chlorhexidine mouthrinse or 3) oral hygiene instruction, chlorhexidine mouthrinse, and assisted brushing. Dental plaque, gingival bleeding, oral opportunistic pathogens, health-related quality of life, oral health-related quality of life, and functional status were assessed at baseline and review. The development of infectious complications was also monitored during the clinical trial. Patients completing the clinical trial were assessed at six months following hospital discharge. RESULTS: Eighty-one patients were available for review at the end of the clinical trial. Reductions in dental plaque (PI) scores were significantly greater in the two groups receiving chlorhexidine compared to the group receiving oral hygiene instruction alone (p<0.001). Reductions in gingival bleeding (GBI) scores were three to four-fold greater in groups receiving chlorhexidine. Almost three quarters (72.8%) of patients harbored oral aerobic and facultatively anaerobic Gram-negative bacilli (AGNB) at baseline. Over half of the patients had detectable Staphylococcus aureus (56.8%) and yeasts (59.3%). Percentage frequencies and viable counts of pathogens remained relatively stable during the course of the clinical trial, and no significant differences were observed between groups (p>0.05). No cases of pneumonia were observed during the course of the clinical trial. Health-related quality of life (p<0.001), oral-health related quality of life (p=0.014), general functional disability (p<0.001), and toothbrushing ability (p=0.001) improved significantly during hospitalization. A total of 52 patients were reviewed six months following hospital discharge. PI scores were significantly higher than those observed at the end of the clinical trial (p<0.001), but were still significantly lower than those documented at baseline (p<0.001). Changes in GBI scores did not reach statistical significance (p>0.05). Percentage frequencies of AGNB (p=0.001), and viable counts of both AGNB (p<0.001) and yeasts (p=0.028) were significantly reduced at six months. No significant gains in life quality or oral functional disability were observed following hospital discharge (p>0.05). CONCLUSIONS: The clinical oral health condition of stroke patients may be safeguarded following acute stroke with the use of chlorhexidine mouthrinse in conjunction with a standard mechanical plaque removal regimen. These interventions are acceptable to the majority of patients, and their administration poses a minimal burden to rehabilitation ward staff. There was, however, no significant difference in the effectiveness of the three different oral health promotion interventions in combating oral opportunistic pathogens. Gains in quality of life and oral functional disability were largely limited to the in-hospital rehabilitation period.
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Dentistry
Doctoral
Doctor of Philosophy

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Chow, Esther Oi-wah, and 周愛華. "Resilience among stroke survivors: the experience of Hong Kong women." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B4501534X.

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Jones, Craig L. "Neuropsychological symptomatology associated with right and left hemisphere cerebral vascular accidents within an acute care rehabilitation setting." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/862284.

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The present study investigated the extent to which right and left hemisphere stroke patients, within an acute care rehabilitation unit, differ in neuropsychological symptomatology as reported on a self-report instrument.The subjects were 90 patients admitted to an acute care rehabilitation unit within a midwestern hospital. Two groups of 30 were obtained on the basis of stroke location, either right or left hemisphere. In addition, a group of 30 orthopedic patients were selected to serve as a comparison group.Data was collected using the Neuropsychological Symptom Inventory (Rattan, Dean & Rattan, 1989). A discriminant analysis revealed two discriminant functions which were used to classify group membership. Slightly more than 86% of both left hemisphere stroke patients and orthopedic patients were correctly classified. However, only 46% of right hemisphere stroke patients were accurately predicted. The results clearly support the ability to differentiate the groups and suggest a homogeneous character of the left hemisphere stroke and orthopedic groups. The right hemisphere group appears heterogeneous in make-up. Further statistical analysis revealed no significant difference (a<.05) between stroke groups when examining a factor related to emotional/depression symptoms. However, when stroke patients were compared to orthopedic patients on this factor, a high degree of significance was revealed (p<.001).These results suggest that right hemisphere patients cannot be treated as if they make up a single disorder group within the rehabilitation setting. The use of a self-report measure may prove beneficial with this group is assessing the level of neuropsychological impairment and to make modifications in treatment planning. Additionally, the existence of depression within the stroke group suggest that rehabilitation should focus more on these reactions within the first few weeks post-stroke.
Department of Educational Psychology

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Ozimek, Elicia N. "The effect of body weight support treadmill training on paretic leg contribution in hemiparetic walking in persons with chronic stroke." Muncie, Ind. : Ball State University, 2009. http://cardinalscholar.bsu.edu/435.

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Wong, Oi-chi, and 王藹慈. "Evidence-based bedside swallowing assessment by nurses for the patients with stroke." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48339301.

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Background and Purpose Stroke is the loss of brain’s function caused by hypoxia of brain cells depending on the severity and the location of the stroke. In Hong Kong, strokes are the 4th leading cause of death and morbidity in the year of 2010. Dysphagia is a common morbidity related to stroke. Approximately, 50% of stroke patients with dysphagia are suffered with aspiration and aspiration pneumonia which may lead to increased length of stay in hospitals, mortality rate and medical costs. An early nursing dysphagic screening and assessment protocol can help in early detect of dysphagia and therefore help to reduce incidence of aspiration and pneumonia. In order to understand the effectiveness of the nursing dysphagic screening and assessment protocol for the acute stroke patients, a number of studies have been reviewed to gather evidences for the translational research. A bedside nursing swallowing screening and assessment for patients with stroke is developed by incorporating findings from the literature review. Review Question In comparison to the routine care, is the nursing dysphagia assessment intended for the acute stroke patients more effective in reducing (1) the waiting time for having swallow assessment and the (2) the incidence of aspiration and pneumonia? Methods A systematic review of literatures from Ovid Medline (from 1946 to 2012), Pubmed (all dates), CINAHL Plus (from 1971 to 2012) and China Journal Net (from 1912 to 2012) was conducted. Five studies of bedside swallow screening and assessment that can be performed by nurses were selected and critically appraised using the recognized assessment criteria. Results The key components identified from the reviewed studies including swallowing assessment should be performed by trained nurses and acute stroke patients should be alert and able and can keep the sit up position during the swallowing assessment. Moreover, water swallowing test must be included as a part of the swallow assessment and assessment should best be performed in daily basic. Patients should be keeping nil of mouth when they failed the screening and referred for further assessment and management. Implementation potential in terms of transferability, feasibility and the cost benefit ratio of the proposed innovation were assessed. A communication plan was developed for the integration of the proposed innovation into the clinical setting. Outcome measures such as positive predictive value of detecting dysphagia, mean waiting time of waiting the initial swallow screening, occurrence of pneumonia, staff knowledge and compliance were identified to evaluate the effectiveness of the proposed innovation and guideline. Conclusion The findings of this systematic review showed that the nursing dysphagic swallow screening and assessment is effective in detecting the dysphagia of the acute stroke patients. Further development of the proposed innovation will be conducted in the clinical setting in order to satisfy the needs of the acute stroke patients.
published_or_final_version
Nursing Studies
Master
Master of Nursing

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De, la Cornillere Wendy-Lynne. "Participants’ experience of the Bishop Lavis Rehabilitation Centre stroke group." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1695.

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Thesis (MPhil (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy. Centre for Rehabilitation Studies))--University of Stellenbosch, 2007.
Current emphasis for rehabilitation in South Africa remains on individual intervention within the move towards primary health care. Primary health care is the strategy that has been adopted by the South African department of health to bring access and equity in health care services. Even so, the burden of providing effective rehabilitative services with limited resources requires innovative strategies, such as the use of therapeutic groups, to address certain aspects of rehabilitation. These strategies must be proven effective. There is a paucity of literature detailing the uses of group therapy in physical rehabilitation, and particularly the use of interdisciplinary group work in stroke rehabilitation. Furthermore, evidence shows that stroke survivors feel ill equipped to return to their communities despite rehabilitation. Stroke is a major cause of death and disability in South Africa, and is a condition shown to benefit from rehabilitation. These factors led to the selection of the Bishop Lavis Rehabilitation Centre stroke group as the setting for this study, which aims to describe the range of experiences relating to attendance or non-attendance of those referred to this programme. This descriptive study, employing quantitative means (to describe the demographic details of the participants) and qualitative means (to describe the experiences of participants), was conducted with twenty participants. Data was collected by means of an administered questionnaire. Following that, a focus group discussion involving six participants was used to gather in-depth information. Quantitative data was analysed with the assistance of a statistician, utilising the computer program, Statistica. The Chi-Squared, Kruskal-Wallis and ANOVA tests were used, with p>0.05 showing statistical significance. Qualitative data was thematically analysed, whereby data was categorised by means of an inductive approach. The study population consisted of 20 participants, with an average age of 59 years, of whom 15 were female and five male. The stroke group provided meaning to participants on two levels. On a psychosocial level, the phenomena of universality (identifying with others in a similar position), development of socialising techniques, imparting information and cohesiveness emerged strongly. On the level of meaning related to stroke recovery, improvement in ability to execute activities of daily living, mobility and strength were most frequently mentioned. Transportation issues were most commonly mentioned as factors negatively influencing attendance. Staff attitude and activities of the programme were most often cited as positive factors. Given the positive response of study participants, and the programme’s ability to sustain intervention with limited resources, it was concluded that this programme has a valid place within stroke rehabilitation in Bishop Lavis. Recommendations in terms of the group programme included investigating methods of providing transportation, providing childcare facilities and expanding the content of educational sessions. Further recommendations were to maintain the positive attitude of staff and the current activities of the programme. Frequency of group outings should also be increased and compensatory strategies for inclement weather must be explored.

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Kong, Yin-ying, and 江燕瑩. "Telenursing program for supporting family caregivers of stroke survivors: an evidence-based clinicalguideline." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44623525.

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Yip, Yun-chi, and 葉潤芝. "Barriers to implement evidence-based Chinese medicine." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46373524.

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Joice, Sara A. "Adherence in behavioural interventions for stroke patients : measurement and prediction." Thesis, University of St Andrews, 2005. http://hdl.handle.net/10023/7262.

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Background: With the increasing incidence in stroke and the resultant high prevalence of residual disability resources are not adequately meeting the needs of the patients. Furthermore patients continue to express dissatisfaction with their care. New interventions are being developed and evaluated. However, when offered these new interventions, patients may refuse or not participate fully. A stroke workbook intervention was developed through a line of research examining the role of perceived control in recovery. During the randomised controlled trial (RCT) evaluating its efficacy patients failed to fully participate in the activities proposed in the workbook. Why, when there is such a dearth of treatment available, do stroke patients not fully participate in or adhere to the interventions offered? Methods: Three studies were conducted, a predictive study using the intervention group of the RCT exploring the demographic, clinical and psychological factors predicting adherence; a predictive study using one of the intervention groups from a larger 2x2 RCT to examine the predictors of adherence to an easier intervention (video); and a third longitudinal study examining the efficacy of an even simpler intervention (letter) on increasing adherence to the video. The theoretical framework of Leventhal's Self Regulation Model was used to develop the letter intervention and to explain the findings. Results: Five types of adherence behaviours emerged from the three studies, all with their own difficulties of definition, measurement and their individual predictor variables. Gender, impairment and illness representations were all predictive of adherence. An easier intervention promoted adherence especially for men and the more impaired. Women appeared to adhere more readily to the complex intervention. These gender differences may be associated with illness representations. A theoretical-based letter does not increase adherence per se but may increase the amount of adherence to an easier intervention. Conclusion: Adherence behaviour is not one type of behaviour and is associated with measurement difficulties. The Self-Regulation model appeared to offer some logical explanations to the findings. The findings have clinical implications and could possibly be associated with patients' satisfaction with care.

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Mok, Siu-wai Kanness, and 莫小慧. "Use of elderly mobility scale as a functional predictor in stroke patients during inpatient rehabilitation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972056.

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Tsang, Sai-ling, and 曾細玲. "Community readjustment of discharged stroke patients: an exploratory study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31247568.

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45

Chan, Chi-wing Martin, and 陳志榮. "Is bilateral isokinematic training (BIT) more effective than unilateral limb training in improving the hemiplegic upper-limbfunction." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B45009909.

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46

Tsang, Yuen, and 曾苑. "The relationship between balance and functional outcomes of subacute in-patient rehabilitation in stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B3197224X.

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47

陳淑玲 and Shuk-ling Chan. "Development, implementation and evaluation of a structural stroke education program for informal caregivers of stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40720251.

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Cheung, Yuk-fai, and 張煜暉. "Clinical and health-related quality of life evaluation of acute strokeunit care versus conventional medical care for minor stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48422800.

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The efficacy of stroke units has been extensively investigated in clinical trials. However, little information is available to the health care providers and policy makers on the benefits of stroke unit care in Hong Kong. The quality of life of our local stroke patients is largely unknown. The objective of this study was to compare the 2-month outcomes after stroke admitted to either a stroke unit or a non-stroke unit. Outcomes included mortality, dependency, institutional care and quality of life. This was a prospective observational study conducted in a regional, tertiary hospital in Hong Kong. Baseline demographic and clinical data were collected from the subjects. The 36-Item Short-Form health survey (SF-36) questionnaire was administered to them. Follow up assessment at two months were made for mortality, dependency, institutionalisation, length of hospital stay and SF-36. Eligible subjects were Cantonese-speaking Chinese aged 18 years or over. They should provide written informed consent, and verbally and cognitively competent in completing the SF-36 questionnaire 162 patients with acute stroke were included in the analysis. 106 patients were solely managed in the stroke unit. 41 patients were managed in other wards (as the control group). There were no statistically significant differences found between the two groups for death alone, death or dependency, and death or institutionalisation. Multivariate logistic regression analyses showed similar findings. Mean lengths of acute and total hospital stay were similar between the two groups. Quality of life was impaired during the acute phase of stroke as reflected by low Physical Functioning (PF) and Social Functioning (SF) dimensions of the SF-36. At two months, significant improvement was observed in five out of eight dimensions of the SF-36 as well as its two summary scores, Physical Component Summary (PCS) and Mental Component Summary (MCS). There were several limitations in our study, namely small number of patients, minor stroke severity and tertiary hospital setting. In conclusion, no significant differences in the clinical outcomes were found between the stroke unit group and the control group. These findings were inconclusive in view of limitations in this study. Stroke affected quality of life. Future researches with larger sample size are warranted.
published_or_final_version
Public Health
Master
Master of Public Health

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Andrews, Sheila Bernadette. "Skilled nursing facility based rehabilitation outcomes of the geriatric stroke patient." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/1000.

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Li, Geng, and 李耕. "Brain activations on functional magnetic resonance imaging during acupuncture and/or physiological tasks in healthy volunteers andstable stroke patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B29157511.

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