Institutionalized stroke patients: status of functioning of an under researched population

In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their status of functioning in the physical, cognitive, emotional, communicative and social domains. In addition, we explored the relation between...

Full description

Saved in:
Bibliographic Details
Published inJournal of the American Medical Directors Association Vol. 13; no. 7; p. 634
Main Authors van Almenkerk, Suzanne, Depla, Marja F I A, Smalbrugge, Martin, Eefsting, Jan A, Hertogh, Cees M P M
Format Journal Article
LanguageEnglish
Published United States 01.09.2012
Subjects
Online AccessGet more information

Cover

Loading…
Abstract In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their status of functioning in the physical, cognitive, emotional, communicative and social domains. In addition, we explored the relation between status of functioning and stroke characteristics. A cross-sectional, observational study. Dutch nursing homes (NHs). Residents with stroke as main diagnosis for NH-admission, who experienced a stroke ≥3 months ago and stayed ≥1 month in a long term care ward. Attending physicians provided information about stroke subtype, stroke location and time post-stroke. Status of functioning was measured through an observation list comprising the Barthel Index, the Neuropsychiatric Inventory Questionnaire, and sections of the Resident Assessment Instrument for Long-Term Care Facilities. The list was filled out in a structured interview with a qualified nurse assistant who knew the resident well. We included 274 residents (mean age 76.6, 58.4% female). The stroke that caused NH-dependency was in 81.3% ischemic, and in 49.8% right-sided. Median time post-stroke was 47 months; 90.9% of the residents were severely dependent in basic activities of daily living and 58% were in pain. Nearly half of the residents showed moderate (24.4%) or severe (23%) cognitive impairment. Irritability (52.9%), depressive symptoms (52.6%) and apathy (34.3%) occurred as the most frequent neuropsychiatric symptoms; 27.7% had a poor ability to express themselves and 30.3% had a low social engagement. We found more severe cognitive impairment, agitation/aggression and poor expression in left-sided strokes, more nighttime behavioral disturbances and delusions in right-sided strokes, and lower social engagement in residents with the largest time-interval post-stroke. This study among institutionalized stroke patients in Dutch NHs revealed very high prevalence of impairments on all domains of functioning, above the well-known severe disabilities in basic activities of daily living. The monitoring and management of both pain and neuropsychiatric symptoms should be key elements in an integrated care and treatment program.
AbstractList In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their status of functioning in the physical, cognitive, emotional, communicative and social domains. In addition, we explored the relation between status of functioning and stroke characteristics. A cross-sectional, observational study. Dutch nursing homes (NHs). Residents with stroke as main diagnosis for NH-admission, who experienced a stroke ≥3 months ago and stayed ≥1 month in a long term care ward. Attending physicians provided information about stroke subtype, stroke location and time post-stroke. Status of functioning was measured through an observation list comprising the Barthel Index, the Neuropsychiatric Inventory Questionnaire, and sections of the Resident Assessment Instrument for Long-Term Care Facilities. The list was filled out in a structured interview with a qualified nurse assistant who knew the resident well. We included 274 residents (mean age 76.6, 58.4% female). The stroke that caused NH-dependency was in 81.3% ischemic, and in 49.8% right-sided. Median time post-stroke was 47 months; 90.9% of the residents were severely dependent in basic activities of daily living and 58% were in pain. Nearly half of the residents showed moderate (24.4%) or severe (23%) cognitive impairment. Irritability (52.9%), depressive symptoms (52.6%) and apathy (34.3%) occurred as the most frequent neuropsychiatric symptoms; 27.7% had a poor ability to express themselves and 30.3% had a low social engagement. We found more severe cognitive impairment, agitation/aggression and poor expression in left-sided strokes, more nighttime behavioral disturbances and delusions in right-sided strokes, and lower social engagement in residents with the largest time-interval post-stroke. This study among institutionalized stroke patients in Dutch NHs revealed very high prevalence of impairments on all domains of functioning, above the well-known severe disabilities in basic activities of daily living. The monitoring and management of both pain and neuropsychiatric symptoms should be key elements in an integrated care and treatment program.
Author Depla, Marja F I A
Hertogh, Cees M P M
van Almenkerk, Suzanne
Eefsting, Jan A
Smalbrugge, Martin
Author_xml – sequence: 1
  givenname: Suzanne
  surname: van Almenkerk
  fullname: van Almenkerk, Suzanne
  email: s.vanalmenkerk@vumc.nl
  organization: Department of General Practice and Elderly Care Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands. s.vanalmenkerk@vumc.nl
– sequence: 2
  givenname: Marja F I A
  surname: Depla
  fullname: Depla, Marja F I A
– sequence: 3
  givenname: Martin
  surname: Smalbrugge
  fullname: Smalbrugge, Martin
– sequence: 4
  givenname: Jan A
  surname: Eefsting
  fullname: Eefsting, Jan A
– sequence: 5
  givenname: Cees M P M
  surname: Hertogh
  fullname: Hertogh, Cees M P M
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22705032$$D View this record in MEDLINE/PubMed
BookMark eNo1T8tOhDAUbYzGeegXmJj-AHhbKAV3ZuJjkknc6MbN5EIvWoRCaFno1wtRVyfnnkfu2bBT1zti7EpALEBkN03cYGcwliBkDCoGyE_YWqgkj4pEqxXbeN8AzHKRnbOVlBoUJHLN3vbOBxumYHuHrf0mw30Y-0_iAwZLLvjb-YBh8ryveT25anFa975QdHxyhkY-kiccq485PfTD1OJiumBnNbaeLv9wy14f7l92T9Hh-XG_uztEVSrSEKUGFZFGVPOnRUIFGKWNVHlaaTRUQolQqxKxynSeqKzMDdTCFJnRRaopl1t2_ds7TGVH5jiMtsPx6_g_Uv4Ae0RX4w
CitedBy_id crossref_primary_10_1161_STR_0000000000000015
crossref_primary_10_1017_S1041610217000230
crossref_primary_10_1080_09638288_2018_1555620
crossref_primary_10_1136_jnnp_2017_317327
crossref_primary_10_1007_s12474_014_0061_0
crossref_primary_10_1017_S0033291723001575
crossref_primary_10_1002_gps_4256
crossref_primary_10_5498_wjp_v10_i6_125
crossref_primary_10_1002_prp2_926
crossref_primary_10_1016_j_jamda_2020_07_017
crossref_primary_10_1016_j_jstrokecerebrovasdis_2015_09_036
crossref_primary_10_1080_02699052_2018_1538537
crossref_primary_10_3109_09638288_2015_1059496
crossref_primary_10_1007_s00415_017_8577_x
crossref_primary_10_1016_S1474_4422_14_70016_X
crossref_primary_10_1016_j_apmr_2015_03_011
crossref_primary_10_1016_j_pmrj_2014_10_010
crossref_primary_10_3389_fneur_2024_1345756
crossref_primary_10_1007_s40533_015_0008_7
crossref_primary_10_1136_bcr_2019_230693
crossref_primary_10_3390_ctn7030022
crossref_primary_10_1016_j_jagp_2014_03_011
crossref_primary_10_3390_ijerph17197203
ContentType Journal Article
Copyright Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
Copyright_xml – notice: Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
DBID CGR
CUY
CVF
ECM
EIF
NPM
DOI 10.1016/j.jamda.2012.05.008
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
DatabaseTitleList MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod no_fulltext_linktorsrc
Discipline Public Health
EISSN 1538-9375
ExternalDocumentID 22705032
Genre Research Support, Non-U.S. Gov't
Journal Article
GeographicLocations Netherlands
GeographicLocations_xml – name: Netherlands
GroupedDBID ---
--K
.1-
.FO
0R~
1B1
1P~
354
4.4
457
4CK
53G
5GY
5VS
AAEDT
AAEDW
AALRI
AAQFI
AAQQT
AAQXK
AAWTL
AAXUO
AAYEP
ABFRF
ABJNI
ABLJU
ABMAC
ACGFS
ADBBV
ADBIZ
ADMUD
ADPAM
AEFWE
AENEX
AEVXI
AFCTW
AFJKZ
AFRHN
AFTJW
AFTRI
AFUWQ
AHRYX
AITUG
AIZYK
AJUYK
ALMA_UNASSIGNED_HOLDINGS
AMRAJ
ASPBG
AVWKF
AZFZN
BELOY
CGR
CS3
CUY
CVF
DU5
EBS
ECM
EFJIC
EIF
EJD
EO8
EX3
F5P
FDB
FEDTE
FGOYB
G-Q
HVGLF
HZ~
IHE
J1W
KMI
KOM
M41
NPM
NQ-
NTWIH
O9-
OD~
OO0
OVD
R2-
RIG
ROL
RPZ
SEL
SES
SEW
TEORI
UNMZH
WOQ
WOW
XH2
Z5R
ZFV
ID FETCH-LOGICAL-c414t-4da5ee7aa593793e90d57d2584c7adeb0ba0f5baac678356b8d0f1d96d7947e82
IngestDate Sat Sep 28 07:55:28 EDT 2024
IsPeerReviewed true
IsScholarly true
Issue 7
Language English
License Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c414t-4da5ee7aa593793e90d57d2584c7adeb0ba0f5baac678356b8d0f1d96d7947e82
PMID 22705032
ParticipantIDs pubmed_primary_22705032
PublicationCentury 2000
PublicationDate 2012-09-01
PublicationDateYYYYMMDD 2012-09-01
PublicationDate_xml – month: 09
  year: 2012
  text: 2012-09-01
  day: 01
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Journal of the American Medical Directors Association
PublicationTitleAlternate J Am Med Dir Assoc
PublicationYear 2012
SSID ssj0020196
Score 2.1505592
Snippet In view of the development of an integrated care and treatment program for institutionalized stroke patients tailored to their needs, we aimed to explore their...
SourceID pubmed
SourceType Index Database
StartPage 634
SubjectTerms Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Hospitalization
Humans
Long-Term Care
Male
Middle Aged
Netherlands
Nursing Assessment - methods
Nursing Homes
Qualitative Research
Stroke - physiopathology
Stroke - psychology
Title Institutionalized stroke patients: status of functioning of an under researched population
URI https://www.ncbi.nlm.nih.gov/pubmed/22705032
Volume 13
hasFullText
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3PT9swFLYKXJAmBBsbv4Z84FYFBcdxEm4IhgBpXAAJ7YLs2NlW2rQq6aV_Fn8h79lOE7WgDS5RardJ5Pf1xf783vsIOeDwElFZFAZJLPKAc80CCbAJWMGynAmlcqta8vNaXNzxq_v4vtN5bkUtTSp1mE9fzSv5iFWhDeyKWbLvsOzsotAA52BfOIKF4fhfNq53-i2d93cKc8enajx8NHW1VBvuhilDExuwge-wmn_F7f_SiuCOu77gzx_4_Wim5_XGrLWVidLs8ji_ibI989b2CVIn_YEpH40Ly76ZTGXZ7OafmVFf-rShnuyedy8bfvVmIPtqPPnt9d9tyYPZGsAUT5VXZLnCe7QJDIwEyWoCw7ScbuQUVGZeOWqhL2m5WOHIzwXX71iI3mFPDjQWlEKSF_mytP1tGPbRwKKBsQRL4bB_987V4667lshSkqJPvUZ-yC_xsdpQXdvKRhEuPA1Wn_ZXmFvJ2BnN7TpZ80alJw5XG6Rjys_kk-NxqUtP-0J-LWCMOozRGmPH1CGMDgvaQhh-lCW1CKMNwmiDsE1yd_7j9vQi8HocQc6PeBVwLWNjEiljMFYWmSzUcaIZTGHzRGqjQiXDIlZS5gL5RKFSHRZHOhManH5iUvaVLJfD0mwRGolI56mQXMiUZwWKBBiO2gOwHOfQvk2-uaF5GLmiKw_1oO282bNLVht47ZGVAv7l5jtMGSu1b630Aukib10
link.rule.ids 786
linkProvider National Library of Medicine
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Institutionalized+stroke+patients%3A+status+of+functioning+of+an+under+researched+population&rft.jtitle=Journal+of+the+American+Medical+Directors+Association&rft.au=van+Almenkerk%2C+Suzanne&rft.au=Depla%2C+Marja+F+I+A&rft.au=Smalbrugge%2C+Martin&rft.au=Eefsting%2C+Jan+A&rft.date=2012-09-01&rft.eissn=1538-9375&rft.volume=13&rft.issue=7&rft.spage=634&rft_id=info:doi/10.1016%2Fj.jamda.2012.05.008&rft_id=info%3Apmid%2F22705032&rft_id=info%3Apmid%2F22705032&rft.externalDocID=22705032