Recovery Outcomes of Acute Stroke Patients who are Receiving The Post-Acute Care Model

• Main Authors: CHEN,HSIU-KUEI, 陳秀桂
• Other Authors: TSAY,SHIOW-LUAN
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/ejx58h

碩士 === 大葉大學 === 健康產業管理碩士在職學位學程 === 105 === Abstract This aim of this study was to follow-up the recovery outcome of the stroke patients who receive Post-Acute Care (PAC) model. This was a correlational study by using the registration of the platform of PAC model in the hospital based on the model of Donabedian. For the purpose of the accessibility, the study materials were acquired from the acute stroke patients from a medical center in Taichung, Taiwan. The inclusion criteria were the stroke patients whose functional status between Modified Rankin Scale 2 to 4 and willing to accept the PAC model. The care protocol of PAC model was building on the consensus of the medical staff that was specialized in stroke care and evidenced based medicine. We enrolled 229 stroke patients. Data were collected at first day admitting, the third week and the sixth week of hospitalization and the endpoint of the study. The recovery indexes included functional status, disability status, swallowing function and quality of life index. The statistics used SPSS 21.0 to analyze numbers, percentiles, mean, standard deviation, correlation, t-test and Generalized Estimating Equation (GEE). Participates are mainly male (59.8%). The mean age was 62.1 years old and most of them (62.4%) were received junior high school education or below. 76.4% of them were ischemic stroke and the average of NIHSS(National Institute of Health Stroke Scale, NIHSS) score was 8.9. The initial Modified Rankin Scale was 4 (81.2%). 96.5 % of patients were associated with chronic medical condition, including mainly hypertension (86%), hyperlipidemia (67.2%) and diabetes mellitus (47.6%). The GEE disclosed that the factors affected the recovery of daily activity function in stroke patients who received PAC model including higher level of education (p＝.02), inserted nasogastric tube (p＜.001), and severe initial disability status (p＜.001). Age (p＜.001) and inserted nasogastric tube (p＝.01) was related to the recovery of disability. The recovery of swallowing function was associated with the age (p＜.05), severity of stroke (p＝.03), previous history of stroke (p＝.02), insert of nasogastric tube (p＜.001) and the initial disability score(p＝.01). The study results provide important information for professionals who are caring for stroke patients with the PAC model.