Stroke Severity and Level of Dependence Against Risk  of  Falls  in  Stroke Patients

Puji Astuti Wiratmo; Sandi Irvanta; Sari Narulita

doi:10.21776/ub.jik.2022.010.02.4

Authors

Puji Astuti Wiratmo FKK Universitas Binawan
Sandi Irvanta RS Pusat Otak Nasional
Sari Narulita FKK Universitas Binawan

DOI:

https://doi.org/10.21776/ub.jik.2022.010.02.4

Keywords:

National Institute of Health Stroke Scale (NIHSS), Barthel Index, Fall risk, Stroke patient

Abstract

A stroke is a neurological disease caused by the blockage or rupture of blood vessels in the brain. Functional dysfunction due to stroke causes stroke patients to be very susceptible to falls. This research aimed to identify the association between the severity of stroke with the level of patient dependence on the risk of falls. This research was a quantitative observational design with a cross-sectional approach. The sample of this study was 66 hospitalized stroke patients who were recruited by quota sampling method. The National Institute of Health Stroke Scale (NIHSS) and Barthel Index are used to measure stroke severity and level of dependence. We assessed the risk of falls using the operational procedure from the hospital. Based on the Spearman rho test, it is found that there is a significant relationship between stroke severity and the level of risk of falls (p=0.000394). Similarly, a significant correlation was found between the level of patient dependence and the level of risk of falls (0.000016). Nurses need to set the nursing care plan for stroke patients who are at risk of falls to prevent further injuries and complications. Continuity of care and family support will help the patient's dependency, reduce the risk of falls, and promote quality of life.

References

Ainuddin H,A., Romli MH, Hamid TA, Salim MSF and Mackenzie L. (2021). Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders’ Consultation. Front. Public Health 9:611793. doi: 10.3389/fpubh.2021.611793
Djurovic, O., Mihaljevic, O., Radovanovic, S., Kostic, S., Vukicevic, M., Brkic, B,J., Stankovic, S., Radulovic, D., Vukomanovic, I.S., & Radevic, S.R. (2021). Risk Factors Related to Falling in Patients after Stroke. Iran J Public Health. 50(9).
Dokuzlar, O., Koc Okudur, S., Soysal, P., Kocyigit, SE, Yavuz, I., Smith, L., Ates Bulut, E., & Isik, AT (2020). Factors that Increase Risk of Falling in Older Men according to Four Different Clinical Methods. Experimental Aging Research, 46(1), 83–92. https://doi.org/10.1080/0361073X.2019.1669284
Hadi, I. (2017). Patient Safety Management (Theory & Application) (1st ed.). Depublish.
Hiraga, A. (2017). Gender Differences and Stroke Outcomes. Neuroepidemiology. 48:61–62 DOI: 10.1159/000475451
Kuriakose,D. & Xiao, Z. (2020). Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. International Journal of Molecular Sciences. 21, 7609. doi:10.3390/ijms21207609
Lewis S.L, Dirksen S. R, Heitkemper M.M, Bucher L, Harding M. M, (2014). Medical-Surgical Nursing, Assessment and Management of Clinical Problems. Canada: Elsevier.
Linga, L. (2013). All about stroke: life before and after stroke. Elex Media Komputindo.
Mahdy, ME, Ghonimi, NA, Elserafy, TS, & Mahmoud, W. (2019). The nihss score can predict the outcome of patients with primary intracerebral hemorrhage. Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 55(1), 1–5. https://doi.org/10.1186/s41983-019-0056-0
Miertová, M., Bóriková, I., Tomagová, M., & iaková, K. (2018). Risk factors of falling in patients with neurological diseases. Kontakt, 20(3), e217–e222. https://doi.org/10.1016/j.kontakt.2018.07.002
Musuka, T.D.; Wilton, S.B.; Traboulsi, M.; Hill, M.D. Diagnosis and management of acute ischemic stroke: Speed is critical. CMAJ 2015, 187, 887–893.
Perrson, C.U. & Hansson, P. (2021). Determinants of falls after stroke based on data on 5065 patients from the Swedish Väststroke and Riksstroke Registers. Scientific reports. 11:24035. https://doi.org/10.1038/s41598-021-03375-9
Reeves, M., Khoury, J., Alwell, K., Moomaw, C., Flaherty, M., Woo, D., Khatri, P., Adeoye, O., Ferioli, S., Kissela, B., & Kleindorfer, D. (2013). Distribution of national institutes of health stroke scale in the Cincinnati/Northern Kentucky stroke study. Strokes, 44(11), 3211–3213. https://doi.org/10.1161/STROKEAHA.113.002881
Samuelsson, CM, Hansson, PO, & Persson, CU (2019). Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT). Clinical Rehabilitation, 33(4), 773–783. https://doi.org/10.1177/0269215518819701
Sekeon, SAS, & Kembuan, MAHN (2015). RELATIONSHIP BETWEEN SLEEP QUALITY AND STRENGTH OF STROKE. E-CliniC, 3(3). https://doi.org/10.35790/ecl.3.3.2015.10445
Walsh ME, Horgan NF, Walsh CD, Galvin R (2016). Systematic review of risk pre- diction models for falls after stroke. J Epidemiol Community Health, 70:513-9.
Wei, W.e., De Silva, D.A., Chang, H.M., Yao, J., Matchar, D.B., Ypung, S.H.Y., See, J.S., Lim, G.H., Wong, T.H., & Venketasubramanian, N. (2019). Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study. BMC Geriatrics. 19 (373). https://doi.org/10.1186/s12877-019-1377-7
WHO. (2018). Falls. https://www.who.int/news-room/fact-sheets/detail/falls
Wurzinger, H.E., Abzhandadze, T., Rafsten, L., & Sunnerhagen, K.S. (2021). Dependency in Activities of Daily Living During the First year After stroke. Frontiers in Neurologi. 12:736684. doi: 10.3389/fneur.2021.736684
Yuneiwati, Y. (2015). Early Detection of Ischemic Stroke: with Vascular Ultrasound Examination and ... - Yuyun Yueniwati - Google Books. https://books.google.co.id/books?id=tUJRDwAAQBAJ&pg=PA19&dq=nicotine+cause+atherosclerosis&hl=en&sa=X&ved=2ahUKEwiz_6Huu7HuAhXFlOYKHW5oBwAQ6AEwAnoECAkQAg=vseorosisk&Ag#