Factors Associated to Returning Home in the First Year after Stroke

Seung Han Kim; Yong-Il Shin; Seung Chan Kim; Sung Hwa Ko; Deog Young Kim; Jongmin Lee; Min Kyun Sohn; Sam-Gyu Lee; Gyung-Jae Oh; Yang-Soo Lee; Min Cheol Joo; Eun Young Han; Junhee Han; Won Hyuk Chang; Ji Hong Min; Yun-Hee Kim

doi:10.12786/bn.2020.13.e1

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Kim, Shin, Kim, Ko, Kim, Lee, Sohn, Lee, Oh, Lee, Joo, Han, Han, Chang, Min, and Kim: Factors Associated to Returning Home in the First Year after Stroke

Original Article

Brain Neurorehabil 2020;13(1):e1.

Published online: 4 March 2020

DOI: https://doi.org/10.12786/bn.2020.13.e1

Factors Associated to Returning Home in the First Year after Stroke

Seung Han Kim^1,², Yong-Il Shin^1,², Seung Chan Kim^1,², Sung Hwa Ko¹, Deog Young Kim³, Jongmin Lee⁴, Min Kyun Sohn⁵, Sam-Gyu Lee⁶, Gyung-Jae Oh⁷, Yang-Soo Lee⁸, Min Cheol Joo⁹, Eun Young Han¹⁰, Junhee Han¹¹, Won Hyuk Chang¹², Ji Hong Min^1,, Yun-Hee Kim¹²

¹Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea

²Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea

³Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea

⁴Department of Rehabilitation Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

⁵Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Korea

⁶Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea

⁷Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea

⁸Department of Rehabilitation Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea

⁹Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea

¹⁰Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University, School of Medicine, Jeju, Korea

¹¹Department of Statistics, Hallym University, Chuncheon, Korea

¹²Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to Ji Hong Min Department of Rehabilitation Medicine, School of Medicine, Pusan National University, 20 Geumo-ro, Yangsan 50612, Korea. E-mail: papered@hanmail.net

Received 20 March 2019 Revised 2 September 2019 Accepted 12 September 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the ‘Return home' group and 99 subjects in the ‘Rehabilitation hospitalization' group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be

Keywords: Rehabilitation, Stroke, Patient discharge

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Fig. 1.

Summary of the study population. ASHA, American Speech Language Hearing Association.

Table 1.

Distribution of demographic and Environmental patient characteristics

Variables	Home group (n = 464)	Rehabilitation hospital group (n = 99)	p value
Sex (male:female)	61.6:38.4	54.5:45.5	0.231
Age	63.0 ± 12.3	61.2 ± 13.7	0.207
Educational level			0.902
No educational	10.1	13.1
Elementary school	15.9	15.2
Middle school	20.0	21.1
High school	33.6	30.3
College graduates	20.3	20.2
Religion			0.494
Religion Atheists	49.1	47.5	0.494
Buddhists	23.9	28.3
Christians	18.5	13.1
Catholic	8.0	11.1
Another religion	0.4	0
Job (yes:no)	23.9:76.1	6.1:93.9	0.000^*
Marital status			0.863
Married living together	75.1	72.7
Married not living with	2.8	2.0
Widowed	13.1	17.2
Divorcees	3.2	3.0
Single	4.7	5.1
Type of family			0.300
Living alone	8.6	13.1
Immediate family	85.8	79.8
Large family	5.6	7.1
Housing type			0.043^*
Apartments	45.0	38.4
Apartment unit in a house	43.5	42.4
Detached dwelling	10.6	15.2
Others	0.9	4.0
Uncomfortable residence structures (yes:no)	23.1:76.9	54.5:45.5	0.000^*

All values are expressed as mean ± standard deviation or percentage (%).

^* p < 0.05 analyzed by analysis of variance.

Table 2.

Distribution of clinical and psychological patient characteristics

Variables	Home group (n = 464)	Rehabilitation hospital group (n = 99)	p value
Location of brain lesion			0.565
Right	48.7	55.6
Left	45.9	40.4
Both	5.4	4.0
Diagnosis (ischemic:hemorrhagic)	75.9:24.1	60.6:39.4	0.003^*
ASHA NOMS	6.817 ± 0.435	6.717 ± 0.535	0.085
FAC	4.4 ± 1.1	2.6 ± 1.5	0.000^*
mRS	1.5 ± 1.2	3.1 ± 1.2	0.000^*
K-MBI	92.0 ± 14.5	68.5 ± 23.1	0.000^*
FIM	114.8 ± 15.7	91.4 ± 20.7	0.000^*
FMA-affected	87.4 ± 21.5	54.0 ± 29.4	0.000^*
FMA-unaffected	98.9 ± 3.0	97.5 ± 8.0	0.095
K-MMSE	26.5 ± 4.2	25.6 ± 4.4	0.049^*
K-FAST	24.3 ± 6.7	22.2 ± 7.1	0.003^*
PWI-SF	17.1 ± 10.0	21.6 ± 7.4	0.000^*
GDS-SF	5.7 ± 4.2	6.8 ± 3.5	0.007^*
EQ-5D	0.8 ± 0.2	0.6 ± 0.2	0.000^*
Family support	47.8 ± 7.2	47.3 ± 7.1	0.523

All values are expressed as mean ± standard deviation or percentage (%).

ASHA NOMS, American Speech Language Hearing Association National Outcomes Measurement System; FAC, Functional Ambulation Categories; mRS, modified Rankin Scale; K-MBI, Korea-Modified Barthel Index; FIM, Function Independence Measure; FMA, Fugl-Meyer Assessment; K-MMSE, Korean version of Mini-Mental State Examination; K-FAST, Korean version of Frenchay Aphasia Screening Test; GDS-SF, Geriatric Depression Scale-Short Form; PWI-SF; Psychosocial Well-being Index-Short Form; EQ-5D; EuroQol-five Dimensional.

^* p < 0.05 analyzed by analysis of variance.

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