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认知相关行为评估严重程度阶段与脑卒中患者出院后日常生活活动需求的关系:一项横断面研究。

Association between the Cognitive-Related Behavioral Assessment Severity Stage and Activities of Daily Living Required for Discharge to Home in Patients with Stroke: A Cross-Sectional Study.

机构信息

Department of Rehabilitation, Ukai Rehabilitation Hospital, Nagoya 453-0811, Japan.

Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima 890-0065, Japan.

出版信息

Int J Environ Res Public Health. 2023 Feb 9;20(4):3005. doi: 10.3390/ijerph20043005.

DOI:10.3390/ijerph20043005
PMID:36833700
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9957480/
Abstract

This study aimed to characterize cognitive function examined using Cognitive-related Behavioral Assessment (CBA) in activities of daily living (ADLs). According to CBA severity at discharge, 791 patients were assigned to five groups (most severe, severe, moderate, mild, and normal). The total scores for Functional Independence Measure (FIM) motor items were compared for each group. Multiple logistic regression analysis was performed to clarify the association between CBA severity and independence in ADL items. Independence in each ADL according to CBA severity was 0-4.8%, 26.8-45.0%, 84.3-91.0%, and 97.2-100% for all ADLs in the most severe to severe, moderate, mild, and normal groups, respectively. Significant differences were found in the FIM motor score according to CBA severity between the groups ( < 0.01). A mild or normal CBA was associated with a higher odds ratio (OR) for dressing the upper body (OR = 21.90; 95% confidence interval (CI), 13.50-35.70), bladder management (OR = 11.60; 95% CI, 7.21-18.60), transfers to the bed/chair/wheelchair (OR = 18.30; 95% CI, 11.40-29.40), transfers to the toilet (OR = 18.30; 95% CI, 11.40-29.30), and walking (OR = 6.60; 95% CI, 10.60-26.10). A CBA severity greater than mild (23 points) was associated with independence in ADLs that are important for discharge to home.

摘要

本研究旨在描述日常生活活动(ADL)中使用认知相关行为评估(CBA)检查的认知功能。根据出院时 CBA 的严重程度,将 791 名患者分为五组(最严重、严重、中度、轻度和正常)。比较了每个组的功能性独立性测量(FIM)运动项目的总分。进行了多变量逻辑回归分析,以阐明 CBA 严重程度与 ADL 项目独立性之间的关系。根据 CBA 严重程度,ADL 各项的独立性分别为最严重到严重组的 0-4.8%、26.8-45.0%、84.3-91.0%和 97.2-100%,中度、轻度和正常组分别为 84.3-91.0%和 97.2-100%。组间 CBA 严重程度与 FIM 运动评分之间存在显著差异(<0.01)。轻度或正常的 CBA 与穿衣上身(OR=21.90;95%置信区间(CI),13.50-35.70)、膀胱管理(OR=11.60;95%CI,7.21-18.60)、床上/椅子/轮椅转移(OR=18.30;95%CI,11.40-29.40)、厕所转移(OR=18.30;95%CI,11.40-29.30)和行走(OR=6.60;95%CI,10.60-26.10)的更高优势比(OR)相关。CBA 严重程度大于轻度(23 分)与对出院回家至关重要的 ADL 独立性相关。

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本文引用的文献

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Burden of informal care in stroke survivors and its determinants: a prospective observational study in an Asian setting.卒中幸存者的非正式照护负担及其决定因素:亚洲前瞻性观察研究。
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Impaired consciousness at stroke onset in large hemisphere infarction: incidence, risk factors and outcome.大面积半球梗死患者发病时意识障碍:发生率、危险因素和结局。
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Int J Rehabil Res. 2019 Sep;42(3):249-255. doi: 10.1097/MRR.0000000000000359.
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: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019.《中风后的情绪、认知与疲劳》,2019年第6版更新
Int J Stroke. 2020 Aug;15(6):668-688. doi: 10.1177/1747493019847334. Epub 2019 Jun 21.
8
Risk Factors for Falls in Community Stroke Survivors: A Systematic Review and Meta-Analysis.社区脑卒中幸存者跌倒的危险因素:系统评价和荟萃分析。
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Patient-specific prediction of functional recovery after stroke.基于个体患者的脑卒中后功能恢复预测。
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Fall-related experiences of stroke survivors: a meta-ethnography.中风幸存者与跌倒相关的经历:一项元民族志研究
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