22. European Stroke Conference 2039 Stroke care problems Neurological characteristics of acute stroke patients who accidentally fall during hospitaliza-tion Y. Hatakeyama1, M. Nakazaki2, T. Mori3, S. Sone4, Y. Oshimi5, Y. Eguchi6, Y. Naitou7, H. suzuki8, I. tuchiya9 Stroke Center Shonan Kamakura General Hosupital,, Kamakura, JAPAN1, Department Of Stroke Treatment. Shonan Kamakura General Hosupital, Stroke Center, Kamakura, JAPAN2, De-partment Of Stroke Treatment. Shonan Kamakura General Hosupital, Stroke Center, Kamakura, JAPAN3, Stroke Center Shonan Kamakura General Hosupital,, Kamakura, JAPAN4, Stroke Center Shonan Kamakura General Hosupital, Kamakura, JAPAN5, Stroke Center Shonan Kamakura Gener-al Hosupital, Kamakura, JAPAN6, Stroke Center Shonan Kamakura General Hosupital, Kamakura, JAPAN7, Stroke Center Shonan Kamakura General Hosupital, Kamakura, JAPAN8, Stroke Center Shonan Kamakura General Hosupital, Kamkura, JAPAN9 Purpose: Along with improvement of motor function and expanding of activity area in a stroke ward, the risk of accidental falls increases in acute stroke patients. To prevent such accidents, we ret-rospectively analyzed characteristics of patients who accidentally fell during hospitalization. Meth-ods: We analyzed consecutive acute stroke patients 1) who were admitted from September 2010 to December 2012 inclusive, 2) with a diagnosis of acute stroke within five days, and 3) who acciden-tally fell during hospitalization. We investigated the patients’ baseline characteristics, neurological findings on admission, stroke subtypes, stroke location, and neurological findings including motor function, higher cortical dysfunctions, and activity status on the day of the fall. We evaluated mo-tor function by the Brunnstrom recovery stage (BRS). Results: During the study period, 1784 acute stroke patients were admitted to our stroke center, and we analyzed 41(2.3%) patients who met the inclusion criteria. Their mean age was 77.0 years old, 14 (34%) patients were female. There were 31 (75%) patients with cerebral infarction and 10 (25%) with intracranial hemorrhage. 33 (56%) patients had ischemic core lesions or hematoma of the right supratentorial region, 11 (27%) at left supratentorial region, and 7 (17%) at infratentorial region. Median NIHSS score on admission and discharge was 4, respectively. The average duration from admission to the day of the fall was 5.3 days. On the day of the fall, 22 (54%) patients had higher cortical dysfunction including agnosia or neglect in 12 patients, aphasia in 6 patients, and dementia in 4 patients respectively. Median BRS at the fall wasⅤ-Ⅳ-Ⅴ. Conclusion: In acute stroke patients who fell during hospitalization, there were more patients with right supratentorial lesions, higher cortical dysfunction, especially neglect or ag-nosia, and mild hemiparesis. In a setting of acute stroke, these patients might have a higher risk of 216 © 2013 S. Karger AG, Basel 7. Nurses & AHP‘s Meeting falling. 2040 Stroke care problems The impact of stroke on couple relationship functioning P.R. Jones1, C.R. Burton2, J. Rycroft-Malone3 Bangor University, Bangor, UNITED KINGDOM1, Bangor University, Bangor, UNITED KING-DOM2, Bangor University, Bangor, UNITED KINGDOM3 Background Stroke survivors who have limited functional disease usually return home to be supported by their close family. While physical functioning can remain relatively unaffected, emotional and cognitive impairments are higher than age-matched healthy individuals. Informal caregivers experience severe strain and burden, often resulting in isolation and burn out. The aim of this qualitative study was to examine the impact of a stroke on couple relationship functioning 12 months after discharge. Methods Six spousal couples (patient median Barthel Index score = 14.5, Range = 13-18) were recruited from a larger quantitative study. Each couple was interviewed as a pair rather than separately, with the interviews being digitally audio-taped and the transcripts analysed to identify key themes associated with the couples’ relationships. Results The couples did not return to their pre-stroke relationship status 12 months post-stroke. Significant issues related to the way spouses coped with mood and cognitive changes in their partner; highlight-ing gender differences that influenced role responsibilities. There was a lack of tailored information that responded to their identified needs; and a lack of support from health care professionals for both the stroke survivor and family carer. Adapting to a stroke reduced life satisfaction, particularly in terms of social and leisure activities. Conclusion These findings suggest that the effects of a stroke lead to greater family disruption than is recognised by health care professionals. Due to better acute provision the disabling effects of a stroke are be-coming less severe; however the impact of such trauma on family relationships persists into the long-term. Health professionals should focus on the way the stroke affects the relationship between the stroke survivor and spouse. Recognising and strengthening the spousal role in stroke recovery will reinforce their resilience leading to improved quality of life for both partners.
Karger_ESC London_2013
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