| Summary: | 碩士 === 美和科技大學 === 護理系健康照護碩士班 === 107 === Background: Stroke is the leading cause of disability in the elderly. Important sequelae of stroke include the possible occurrence of functional disability and medial comorbidities, which can lead to overly dependence of the current health care system, and increase the burden on the family and social care. There is therefore an on-going incentive to investigate the prognostic factors for outcomes after stroke.
Purpose: This study intended to investigate the effect of demographic variables, stroke severities and comorbid conditions on the outcomes of stroke patients in a regional hospital in Taitung County.
Methods: We collected 566 first-ever stroke patients from a single hospital-based stroke registry in Taitung County from 1 January 2015 to 31 December 2016. Inclusion criteria were patients diagnosed of infarct stroke admitted to hospital within 7 days after onset and hospitalized for at least 24 hours. All descriptive and inferential statistics, including logistic regression, were performed with the use of software package SPSS 22.0 for Windows®.
Results: Patients who were female, older, underweighted, unmarried, without primary school education, and no occupation; with past medical history of stroke, heart disease, diabetes, and greater extent of stroke; had higher score on NIHSS scale at admission; first infarction stroke patients who went to the regional hospital for medical treatment, and had longer hospital stay were more likely to have poor prognosis at hospital discharge as well as 3-months and one-year after hospital discharge. In addition, those who lived in Taitung County, with medical history of hyperlipidemia and stroke infarction at hospital discharge were also more likely to have poor prognosis one-year after hospital discharge. Results from logistic regression models suggested that score on NIHSS scale at admission, length of hospital stay, and residents of Taitung County, were important prognostic factors for poor prognosis at 3-months and one-year after hospital discharge.
Conclusion: The results from the current study indicated that the score on NIHSS scale was an effective prognostic factor for stroke patient one-year after hospital discharge. To enhance the quality of care and rehabilitation among stroke patients, we recommend that the in-service education for clinical nursing should focus and place emphasis on the assessment of NIHSS scale. The life quality of patients and their family members will also benefit from this recommendation.
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