Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 49

POSTERS / 33R0 SNC & 2ND SCNN
severity of symptoms, based on the Hoehn and Yahr scale, into
homogenous groups. The program involved physiotherapy, occupa-
tional therapy, speech therapy, education regarding Parkinson's
disease and nursing diagnosis and intervention. The Icelandic
Quality of Life scale (IQL) has twelve subscales with age norms.
Reliability and validity have been established and the scale has
been recommended for clinical use and research. IQL was admini-
stered before and after 5 weeks of treatment. Twenty-three indivi-
duals were also retested at a follow-up visit 3 months post treat-
ment.
Results: Significant differences (p<,05) were found before and
after treatment in six of the twelve subscales, i.e. general health,
depression, social functioning, anxiety, general well-being and pain;
and in overall health related quality of life (HRQL). This change
was still observed at follow-up in general health, social functioning,
depression, general well-being and HRQL.
Conclusion: The results show a general improvement in quality of
life after rehabilitation. Some subscales of the IQL may be useful
to locate hidden problems like depression and anxiety. Improve-
ments in physical strength and endurance were not directly obser-
ved by the IQL, although objective differences were documented
by use of other assessment tools and the patients reported improve-
ments in those areas.
P37 - Benefits of rehabilitation after stroke.
Siguröardóttir KR, Bjarnadóttir ÓH
Reykjalundur Rehabilitation Center. Mosfellsbær, Iceland
Objective: To determine the benefits of post-stroke rehabilitaton
using the Barthel Index, and to see if treatment in excess of 3
months post-stroke further improves ADL function as measured by
the Barthel Index.
Material and methods: From January 2000 to November 2001, 40
patients underwent rehabilitation in a rehabilitation center, after
initial diagnosis and treatment in an acute hospital facility. Nine
patients had been discharged to their homes a few days before
rehabilitation commenced. The Barthel Index (BI) was filled out at
admission and discharge. For the six individuals who where in the
rehabilitation setting longer than 3 months post-stroke, the BI was
filled out for the third time. The Barthel Index measures the
individual's performance on 10 Activity of Daily Living (ADL)
functions. A total score of 100 indicates independence. Six patients
dropped out; for four the Barthel had not been filled out, one had
not been discharged, and one died.
Results: Mean age was 64 years (range 33-80). For 34 individuals
the Barthel subclasses showed statistic differences (p<,05) from
admission to disharge in: eating, personal hygiene, independent
bathing, stair climbing, going to the toilet, dressing, “chair to bed”
and walking.
Admission Discharge
Bl (mean) (p=<,001) 78,14 (18-100) 93,06 (48-100)
Days post-stroke (median)27,5 (12-92) 102 (42-193)
The six individuals who were still inpatients at 3 months post-stroke
showed little or no further improvements as measured by the BI.
Condusion: The results show distinctive improvements in 8 of 10
parameters in the BI in the first three months post-stroke. Rehabili-
tation after 3 months have lapsed post stroke appears to add little or
no improvement in ADL.
P38 - The need for nursing care rehabilitation in patients with
acute stroke. The copenhagen stroke study
Mosegaard D, Jorgensen HS
Department of Neurology, Gentofte Hospital, Copenhagen, Denmark
Purpose: Rehabilitation in specialized stroke units has proven
effective. A large part of the rehabilitation is performed by the
nursing staff focusing on disabilities in basic activities of daily living
(ADL). We describe the need of nursing care in a community-
based stroke population.
Methods: Included were 1197 unselected patients with acute stroke
from the community-based Copenhagen Stroke Study. All patients
had all their treatment and rehabilitation within the stroke unit. We
used the Barthel Index to measure basic ADL at the time of acute
admission and again at discharge after completed rehabilitation.
Only items in the Barthel Index specifically related to nursing care
rehabilitation are described.
Results: Mean age was 74.3 years (SD 11.1). 54% were women and
46% were men. The need for nursing care intervention in the
rehabilitation of ADL was as follows: 65% of the patients needed
training in transfers, 54% in feeding, 52% in grooming, 60% in
toiletting, 65% in bathing, 63% in dressing, and 48% in training
urinary continence. 72% needed rehabilitation of at least one of the
mentioned activities. After completed rehabilitation, 35% were still
dependent in transfers, 22% in feeding, 20% in grooming, 29% in
toiletting, 37% in bathing, 35% in dressing, and 28% were urinary
incontinent.
Conclusions: A large part of patients with acute stroke need rehabi-
litation in a number of basic ADL. The most of this rehabilitation is
performed by the nursing staff. The organization of nursing care
rehabilitation of ADL is probably important to the improved
outcome of patients treated in a stroke unit. Currently, efforts to
improve therapy is directed towards medical intervention, but
should also focus on improving nursing care with seems to be an
important parl of the rehabilitation program.
Læknablaðið/Fylgirit 43 2002/88 49