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      Factors influencing return to work after stroke: the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) Study

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          Abstract

          Objective

          To investigate the rate of return to work and identify key factors associated with return to work between 3 months and 2 years after stroke.

          Design

          Prospective cohort study.

          Setting

          The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) in Korea.

          Participants

          A total of 193 persons with first-ever stroke who reported working status at 3 months after stroke.

          Outcome measures

          Data on baseline characteristics were collected from medical records. Functional assessments were performed using the National Institutes of Health Stroke Scale, the modified Rankin Scale, the Fugl-Meyer Assessment, the Functional Ambulatory Category, the Korean Mini-Mental State Examination, the Korean version of the Frenchay Aphasia Screening Test, the American Speech-Language-Hearing Association National Outcomes Measurement System, the Korean-Modified Barthel Index, the Geriatric Depression Scale-Short Form and the EuroQol-5 dimensions. An enumeration survey included the Reintegration to Normal Living Index, the Psychosocial Well-being Index-Short Form (, the Family Support Index and the Caregivers Burden Index.

          Results

          Overall, 145 (75.1%) patients who had a stroke in the "Continuously-Employed" group and 48 (24.9%) in the "Employed-Unemployed" group returned to work between 3 months and 2 years after stroke. Multivariate logistic analysis demonstrated that in patients who had a stroke, characteristics such as age, PWI-SF Score, and caregiver characteristics, including age, sex (female) and living arrangements, were significantly associated with return to work between 3 months and 2 years after stroke.

          Conclusion

          Age and PWI-SF Score of patients who had a stroke, as well as the age, sex and living arrangements of caregivers, are key factors influencing the return to work after stroke.

          Trial registration number

          NCT03402451.

          Related collections

          Most cited references46

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          Presidential Address-1976. Social support as a moderator of life stress.

          S. Cobb (1976)
          Social support is defined as information leading the subject to believe that he is cared for and loved, esteemed, and a member of a network of mutual obligations. The evidence that supportive interactions among people are protective against the health consequences of life stress is reviewed. It appears that social support can protect people in crisis from a wide variety of pathological states: from low birth weight to death, from arthritis through tuberculosis to depression, alcoholism, and the social breakdown syndrome. Furthermore, social support may reduce the amount of medication required, accelerate recovery, and facilitate compliance with prescribed medical regimens.
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            Stroke Statistics in Korea: Part I. Epidemiology and Risk Factors: A Report from the Korean Stroke Society and Clinical Research Center for Stroke

            The aim of the Part I of Stroke Statistics in Korea is to summarize nationally representative data of the epidemiology and risk factors of stroke in a single document. Every year, approximately 105,000 people experience a new or recurrent stroke and more than 26,000 die of stroke, which indicates that every 5 minutes stroke attacks someone and every 20 minutes stroke kills someone in Korea. Stroke accounts for roughly 1 of every 10 deaths. The estimated stroke prevalence is about 795,000 in people aged ≥30 years. The nationwide total cost for stroke care was 3,737 billion Korean won (US$3.3 billion) in 2005. Fortunately, the annual stroke mortality rate decreased substantially by 28.3% during the first decade of the 21th century (53.2/100,000 in 2010). Among OECD countries, Korea had the lowest in-hospital 30-day case-fatality rate for ischemic stroke and ranked third lowest for hemorrhagic stroke in 2009. The proportion of ischemic stroke has steadily increased and accounted for 76% of all strokes in 2009. According to hospital registry studies, the 90-day mortality rate was 3-7% for ischemic stroke and 17% for intracerebral hemorrhage. For risk factors, among Korean adults ≥30 years of age, one in 3-4 has hypertension, one in 10 diabetes, and one in 7 hypercholesterolemia. One in 3 Korean adults ≥19 years of age is obese. Over the last 10 years, the prevalence of hypertension slightly decreased, but the prevalence of diabetes, hypercholesterolemia, and obesity increased. Smoking prevalence in men has decreased, but is still as high as 48%. This report could be a valuable resource for establishing health care policy and guiding future research directions.
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              The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea.

              This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spieberger's state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                11 July 2019
                : 9
                : 7
                : e028673
                Affiliations
                [1 ] departmentDepartment of Statistics and Institute of Statistics , Hallym University , Chuncheon, The Republic of Korea
                [2 ] departmentDepartment of Rehabilitation Medicine, Pusan National University School of Medicine , Pusan National University Yangsan Hospital , Yangsan, The Republic of Korea
                [3 ] departmentResearch Institute for Convergence of Biomedical Science and Technology , Pusan National University Yangsan Hospital , Yangsan, The Republic of Korea
                [4 ] departmentDepartment and Research Institute of Rehabilitation Medicine , Yonsei University College of Medicine , Seoul, The Republic of Korea
                [5 ] departmentSchool of Medicine, Department of Rehabilitation Medicine , Chungnam National University , Daejeon, The Republic of Korea
                [6 ] departmentDepartment of Rehabilitation Medicine , Konkuk University School of Medicine , Seoul, The Republic of Korea
                [7 ] departmentDepartment of Physical and Rehabilitation Medicine , Chonnam National University Medical School , Gwangju, The Republic of Korea
                [8 ] departmentDepartment of Preventive Medicine, School of Medicine , Wonkwang University , Iksan, The Republic of Korea
                [9 ] departmentDepartment of Rehabilitation Medicine, Kyungpook National University School of Medicine , Kyungpook National University Hospital , Daegu, The Republic of Korea
                [10 ] departmentDepartment of Rehabilitation Medicine, School of Medicine , Wonkwang University , Iksan, The Republic of Korea
                [11 ] departmentDepartment of Rehabilitation Medicine, School of Medicine , Jeju National University , Jeju, The Republic of Korea
                [12 ] departmentDepartment of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul, The Republic of Korea
                [13 ] departmentDepartment of Health Sciences and Technology, Department of Medical Device Management & Research, Department of DigitalHealth, SAIHST , Sungkyunkwan University , Seoul, The Republic of Korea
                Author notes
                [Correspondence to ] Dr. Yong-Il Shin; rmshin01@ 123456gmail.com and Yun-Hee Kim; yunkim@ 123456skku.edu
                Author information
                http://orcid.org/0000-0001-5736-8752
                http://orcid.org/0000-0001-6101-8851
                Article
                bmjopen-2018-028673
                10.1136/bmjopen-2018-028673
                6629413
                31300502
                c4417a84-19d8-40c9-9b2d-9e5c8f92b4db
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 19 December 2018
                : 04 June 2019
                : 05 June 2019
                Funding
                Funded by: Korea Centers for Disease Control and Prevention;
                Categories
                Rehabilitation Medicine
                Research
                1506
                1727
                Custom metadata
                unlocked

                Medicine
                work,return to work,employment,persons with stroke,vocational rehabilitation
                Medicine
                work, return to work, employment, persons with stroke, vocational rehabilitation

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