| 1. |
- Skarin, Monica, et al.
(författare)
-
Acute stroke patient mobilisation practices and concerns. A survey of 202 stroke professionals
- 2009
-
Ingår i: European Stroke Conference, Stockholm, Sweden, May.
-
Konferensbidrag (refereegranskat)abstract
- Background Stroke unit care is proven to improve outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively, but there is lack of unambiguous scientific evidence. Therefore current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study sought to determine different health professionals´ beliefs regarding early mobilisation (EM) in acute stroke. EM was defined as intensive out of bed activities within the first 24 hours after stroke onset. Methods A 9 item anonymous questionnaire on benefits and harms with early mobilisation after stroke was used to interview stroke care professionals during the integrated Stroke Society of Australasia (SSA) and Australasian Nursing and Allied Health Conference in Sydney in August 2008. Data were collected using personal digital assistants. Five point Likert scales sought levels of agreement with harm and benefit of EM. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. 65% were females, 50% under 40 years old, 46% worked in an acute stroke unit and 31% in rehabilitation, 35% were nurses, 26% were medical doctors, 19% were physiotherapists and 12% were occupational therapists. Two thirds had less than 10 years experience in stroke care overall. Sixty percent of professionals had concerns about possible harm of early mobilisation and more so for hemorrhagic (59%) than ischemic (23%) stroke (p<0.001). Cardiovascular stability was the major concern (12% ischemic, 34% hemorrhagic). Conclusion Our results show that most professionals had concerns about early mobilisation of stroke patients and these concerns were stronger for hemorrhagic than for ischemic stroke patients. This is surprising given the lack of evidence to support such a dichotomy and the potential harms of bed-confining hemorrhagic stroke patients.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Cumming, Toby B, et al.
(författare)
-
Hemispatial neglect and rehabilitation in acute stroke.
- 2009
-
Ingår i: Archives of physical medicine and rehabilitation. - : Elsevier BV. - 1532-821X .- 0003-9993. ; 90:11, s. 1931-6
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare 2 methods for determining neglect in patients within 2 days of stroke, and to investigate whether early neglect was related to rehabilitation practice, and whether this relationship was affected by an early, intensive mobilization intervention. DESIGN: Data were collected from patients participating in a phase II randomized controlled trial of early rehabilitation after stroke. SETTING: Acute hospital stroke unit. PARTICIPANTS: Stroke patients (N=71). INTERVENTION: The 2 arms of the trial were very early mobilization (VEM) and standard care (SC). MAIN OUTCOME MEASURES: Neglect was assessed using the Star Cancellation Test and the National Institutes of Health Stroke Scale (NIHSS) inattention item within 48 hours of stroke onset, and therapy details were recorded during the hospital stay. RESULTS: Assessing neglect so acutely after stroke was difficult: 29 of the 71 patients were unable to complete the Star Cancellation Test, and agreement between this test and the NIHSS measure was only .42. Presence of neglect did not preclude early mobilization. SC group patients with neglect had longer hospital stays (median, 11d) than those without neglect (median, 4d); there was no difference in length of stay between patients with and without neglect in the VEM group (median, 6d in both). CONCLUSION: Early mobilization of patients with neglect was feasible and may contribute to a shorter acute hospital stay.
|
|
| 8. |
|
|
