Self-Awareness And Its Association With Functional Performance In Sub-Acute Stroke: A Cross-Sectional Study
Notice bibliographique
Résumé
Introduction Awareness is the key to successful stroke rehabilitation and in practice poor knowledge of self-awareness and failure to recognise stroke deficits hinders efforts in the rehabilitation of patients. Stroke is associated with both functional and cognitive impairment, but the individual correlation between impairment, daily activities and self-awareness of deficit of stroke patients in the acute and sub-acute environment has yet to be explored. This research study aims to address the gap in the current evidence base, by identifying the degree of patient’s self-awareness of stroke-deficit in a sample of patients with sub-acute stroke and determine the strength of relationship between self-awareness and functional performance. Aim and Objectives The primary aim of this research was to examine the association between self- awareness and functional performance deficits across three domains (Basic ADL; Instrumental ADL and Cognition) in sub-acute stroke. The objectives were: 1. To identify patients’ self-awareness of stroke-deficit within three months of stroke. 2. To investigate the association between functional outcomes of ADL performance and self-awareness. Methods A cross sectional study using a sample of convenience was completed. Nineteen participants admitted to an acute hospital with first event stroke were assessed for awareness of deficit post stroke. Self-awareness was measured using the Self- Regulation Skills Interview (SRSI). A range of outcome measures were used to assess functional and cognitive performance. They included the Modified Barthel Index (MBI), Kettle Test (KT), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB). Results The majority of participants presented with right sided stroke infarct of mild severity (74%). The majority of participants presented with low-moderate levels of awareness (53%) and were female (58%). Significant correlations were demonstrated between the SRSI, MoCA and KT. The strongest correlation was found between the SRSI and the MoCA (r= -0.814), with a strong relationship also demonstrated between the SRSI and the KT (r=0.521). There was no relationship between the SRSI and the MBI (p=0.951; r=-0.015). The association between functional performance outcome measures and other variables was further examined using linear regression analysis. The SRSI explained no variance on the MBI (0%), however explained 23.3% variance on the Kettle Test. Conclusion More than half of the participants in this study presented with only low-moderate self- awareness levels of stroke deficit. There was a strong association between self- awareness, cognition and one component of IADL performance as measured on the KT. No correlation was demonstrated between SRSI and MBI. Implications of Findings Self-awareness deficits are prevalent in the mild sub-acute stroke population. There is a high association between self-awareness, cognition and higher order activities of daily living (IADL). Screening of mild stroke patients for awareness deficits should be included as a standard measure of care. Future research should address the development of a stroke-specific measure of awareness and standardisation of assessment.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».