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KMID : 1143420200130423009
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Public Health Weekly Report
2020 Volume.13 No. 42 p.3009 ~ p.3026
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Multidimensional Approach for Rehabilitation Status and Social Adaptation in Stroke Patients after Discharge - Interim Analysis -
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Kim Won-Seok
Jung Yun-Sun
Paik Nam-Jong
Shon Min-Kyun
Jee Sung-Ju
Shin Yong-Il
Ko Sung-Hwa
Kim Su-Jin
Lee Seung-Hee
Kim Won-Ho
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Abstract
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Stroke can cause aftereffects such as quadriplegia and dysphasia after acute treatment, requiring continuous treatment and management even after discharge. However, no survey has been conducted on stroke patients to comprehensively identify changes in health conditions, subjective obstacles and demands for rehabilitation after discharge. The goals of this study were to collect data that could be used by healthcareworkers to support outpatients and to establish a stroke outpatient rehabilitation system by comprehensively mapping the rehabilitation status after discharge, changes in health status, subjective obstacles and demands for treatment.
Data collection began in May 2020 on patients diagnosed with stroke at Seoul National University Bundang Hospital, Chungnam National University Hospital, and Busan National University Yangsan Hospital each, and onthose who visited their respective hospital after being discharged. Data was collected through a self-administered survey, and if it was difficult to fill out the questionnaire themselves due to insufficient understanding of the questionnaire or difficulty in moving, an accompanying guardian or a researcher who conducted the survey helped. The surveys of 165 patients were analyzed (see Table 1).
The highest proportion of demand for rehabilitation treatment walking/transfer 56.9% followed by self-management 50.3%, stiffness 48.7%, pain/discomfort 43.5%. Unmet need for rehabilitation treatment was the highest for anxiety/depression (80.4%), followed by communication (64.3%) and falls (63.3%)(see Figure1). And 20.1% of the respondents had unplanned readmission within 3 months after being discharged home, but 26.5% of the respondents were re-hospitalized due to difficulty in nursing and outpatient treatment, not medical reasons, indicating that additional hospitalization is being used(see Figure2). The high demand for outpatient rehabilitation support, day care, daytime ward, and visiting rehabilitation treatment as a necessary factor to support post-stroke recovery can be seen as a result of the caregiver´s burden of care or difficulty in transfer(see Figure5). Therefore, these key factors should be considered in future policies as a way to come up with measures to alleviate the burden on the family.
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KEYWORD
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Stroke, Rehabilitation, Medical utilization, Unmet needs, Welfare service
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