본문 바로가기
KERD
논문KCI 등재

뇌졸중 환자를 위한 심리사회적 개입의 효과: 체계적 문헌고찰 및 메타분석

Effects of Psychosocial Interventions for Stroke Patients: A Systematic Review and Meta-analysis

심은정|함봉진|하혜주|서현지|염찬우
한국건강심리학회 (Korean Health Psychological Association)|2020.09|한국심리학회지: 건강 (Korean Journal of Health Psychology)|제25권 제5호|pp. 975-1005|DOI 10.17315/kjhp.2020.25.5.007

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

메타분석디스트레스distress뇌졸중Strokemeta analysis심리사회적 개입psychosocial intervention
주제분류심리과학

초록

본 연구는 뇌졸중 환자 대상 심리사회적 개입 연구의 현황 및 특성을 확인하고 개입의 전반적인 효과크기를 확인하였다. 2019년 10월까지 국내외 학술지에 게재된 61편의 연구를 대상으로 체계적 문헌고찰을 진행하였다. 그 중 37편을 대상으로 메타분석을 수행하였고, 개입 효과크기가 개입 유형, 형태 및 환경, 통제 집단 유형, 결과 지표 종류, 연구 설계, 비뚤림 위험에 따라 달라지는지 확인하기 위해 하위집단분석을 수행하였다. 뇌졸중 환자 대상 심리사회적 개입은 주로 심리치료, 심리사회교육, 지지치료, 결합치료였으며, 병원 장면(i.e., 외래, 입원)에서 개인이나 집단 개입 형태로 우울, 불안, 삶의 질, 자기효능감에 초점을 맞추었다. 메타분석 결과, 뇌졸중 환자 대상 심리사회적 개입은 작은 효과크기(g = 0.40; 95% CI, 0.31-0.50)를 보였고, 개입 유형 및 환경에 따른 차이가 관찰되었다. 심리치료가 결합치료, 심리사회교육, 지지치료보다 더 효과적이며, 입원 환경에서 제공되는 개입이 외래나 환자 가정, 지역사회에서 제공하는 것보다 효과적이었다. 분석 대상 연구들의 출판 편향 경향으로 Trim-fill 방법으로 효과크기를 교정하였으나 여전히 유의하였다. 본 연구 결과는 심리사회적 개입이 뇌졸중 환자의 디스트레스 개선에 효과적임을 시사한다.

Abstract

This study reviewed and analyzed the characteristics and overall effect size (ES) of psychosocial interventions for stroke patients. The systematic review included 61 articles published in domestic and international journals up to October 2019, and the meta-analysis analyzed data from 37 articles. The subgroup analysis was conducted to determine the study characteristics (i.e., intervention type, format, and setting, control group, outcome, study design, and level of risk of bias) influencing the intervention effect. The psychosocial interventions for stroke patients were mainly provided in the form of psychotherapy, psychosocial education, supportive therapy, or combined therapy in inpatient or outpatient settings. The interventions were provided in individual or group format focusing on depression, anxiety, quality of life, and self-efficacy. The result of the meta-analysis observed low ES (g = 0.40; 95% CI, 0.31-0.50), and that ES varied depending on the intervention types and settings. The psychotherapy was more effective than other types, and a larger ES was observed in interventions provided in an inpatient setting than outpatient or home settings. The estimated ESs were corrected using the trim-fill method because of possible publication bias, but it remained significant, suggesting that psychosocial interventions are effective in improving distress in stroke patients.

참고문헌 (118)

  1. 김규온, "뇌졸중 후 불안의 유병률 및 예측인자", 노인정신의학, 22(2), pp.89~95 (2018), 대한노인정신의학회[DOI]
  2. 김수영, "NECA 체계적 문헌고찰 매뉴얼" (2011), 한국보건의료연구원
  3. 김준엽, "뇌졸중 역학보고서, 2018", 주간 건강과 질병, 12(43), pp.1845~1860 (2019)
  4. 뇌졸중임상연구센터, "뇌졸중 진료지침", 보건복지부지정 뇌졸중임상연구센터, ~ (2013)
  5. 방요순, "뇌졸중 후 우울과 장애수용 및 사회적 지지와의 관계", 대한작업치료학회지, 17(2), pp.29~40 (2009), 대한작업치료학회
  6. 양영옥, "뇌졸중 환자의 삶의 질과 관련된 사회 심리적 요인에 대한메타분석", 지역사회간호학회지, 29(4), pp.510~519 (2018), 한국지역사회간호학회[DOI]
  7. 이봉춘, "인지행동적 집단상담프로그램이 뇌졸중환자와 가족의 삶의 질에미치는 영향", 한국동서정신과학회지, 12(1), pp.45~59 (2009)
  8. Aboulafia-Brakha, T., "Effects of group psychotherapy on anger management following acquired brain injury", Brain Injury, 30(9), pp.1121~1130 (2016)[DOI]
  9. Alexopoulos, G. S., "Ecosystem focused therapy in poststroke depression : a preliminary study", International Journal of Geriatric Psychiatry, 27(10), pp.1053~1060 (2012)
  10. Ayerbe, L., "Natural history, predictors and associated outcomes of anxiety up to 10years after stroke : the South London Stroke Register", Age and Ageing, 43(4), pp.542~547 (2014)
  11. Ayerbe, L., "Natural history, predictors and outcomes of depression after stroke : Systematic review and meta-analysis", British Journal of Psychiatry, 202(1), pp.14~21 (2013)
  12. Backhaus, S. L., "Brain injury coping skills group: a preventative intervention for patients with brain injury and their caregivers", Archives of Physical Medicine & Rehabilitation, 91(6), pp.840~848 (2010)[DOI]
  13. Backhaus, S., "Examination of an intervention to enhance relationship satisfaction after brain injury : A feasibility study", Brain Injury, 30(8), pp.975~985 (2016)[DOI]
  14. Bakas, T., "Evidence for stroke family caregiver and dyad interventions : a statement for healthcare professionals from the American Heart Association and American Stroke Association", Stroke, 45(9), pp.2836~2852 (2014)
  15. Barker-Collo, S. L., "Depression and anxiety 3months post stroke : prevalence and correlates", Archives of Clinical Neuropsychology, 22(4), pp.519~531 (2007)
  16. Bartoli, F., "Depression after stroke and risk of mortality : a systematic review and meta-analysis", Stroke Research and Treatment, 2013, pp.862978~ (2013)
  17. Baylan, S., "Incidence and prevalence of post-stroke insomnia : A systematic review and meta-analysis", Sleep Medicine Reviews, 49, pp.101222~ (2020)
  18. Bhardwaj, M., "Efficacy of cranial electrical stimulation and rational emotive behavior therapy in improving psychological illness among chronic stroke survivors : A pilot randomized controlled trial", Annals of Indian Academy of Neurology, 21(3), pp.188~192 (2018)[DOI]
  19. Blöchl, M., "Does depression after stroke negatively influence physical disability? A systematic review and meta-analysis of longitudinal studies", Journal of Affective Disorders, 247, pp.45~56 (2019)
  20. Borenstein, M., "Introduction to meta-analysis" (2011), John Wiley &Sons
  21. Bowen, A., "Royal College of Physicians 2016 National clinical guideline for stroke" (2016), Royal College of Physicians
  22. Bradbury, C. L., "The efficacy of cognitive behavior therapy in the treatment of emotional distress after acquired brain injury", Archives of Physical Medicine & Rehabilitation, 89(12), pp.S61~S68 (2008)
  23. Brebach, R., "Psychological intervention targeting distress for cancer patients : a meta‐analytic study investigating uptake and adherence", Psycho-Oncology, 25(8), pp.882~890 (2016)
  24. Broomfield, N. M., "Depression and anxiety symptoms post-stroke", TIA : prevalence and associations in cross-sectional data from a regional stroke registry, 2014, pp.14(1), 198~
  25. Chalmers, C., "The efficacy of problem solving therapy to reduce post stroke emotional distress in younger(18-65)stroke survivors", Disability & Rehabilitation, 41(7), pp.753~762 (2019)[DOI]
  26. Chang, K., "Testing the Effectiveness of Knowledge and Behavior Therapy in Patients of Hemiplegic Stroke", Topics in Stroke Rehabilitation, 18(5), pp.525~535 (2011)[DOI]
  27. Cheng, H. Y., "The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors : a systematic review and meta-analysis", Patient Education and Counseling, 95(1), pp.30~44 (2014)
  28. 최동호, "Psychiatric Comorbidity and Quality of Life in Patients with Post-Stroke Emotional Incontinence", PSYCHIATRY INVESTIGATION, 10(4), pp.382~387 (2013), 대한신경정신의학회
  29. Clark, M. S., "A randomized controlled trial of an education and counselling intervention for families after stroke", Clinical Rehabilitation, 17(7), pp.703~712 (2003)
  30. Cohen, J., "Statistical power analysis for the behavioral sciences" (1988), Lawrence Earlbaum Associates
  31. Damush, T. M., "Implementation of a stroke self-management program : A randomized controlled pilot study of veterans with stroke", Translational Behavioral Medicine, 1(4), pp.561~572 (2011)[DOI]
  32. Dou, D. M., "Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China", Psychology, Health &Medicine, 23(5), pp.541~547 (2018)
  33. Duncan, F., "Frequency and natural history of fatigue after stroke : a systematic review of longitudinal studies", Journal of Psychosomatic Research, 73(1), pp.18~27 (2012)
  34. Duval, S., "Trim and fill : a simple funnel‐plot–based method of testing and adjusting for publication bias in meta‐analysis", Biometrics, 56(2), pp.455~463 (2000)
  35. Egger, M., "Bias in meta-analysis detected by a simple, graphical test", BMJ, 315(7109), pp.629~634 (1997)
  36. Faessler, L., "Psychological distress in medical patients seeking ED care for somatic reasons : results of a systematic literature review", Emergency Medicine Journal, 33(8), pp.581~587 (2016)
  37. Fang, Y., "Reducing depressive or anxiety symptoms in post-stroke patients : Pilot trial of a constructive integrative psychosocial intervention", International Journal of Health Sciences, 11(4), pp.53~58 (2017)
  38. Fleming, J., "Evaluation of an outpatient, peer group intervention for people with acquired brain injury based on the ICF 'Environment'dimension", Disability & Rehabilitation, 31(20), pp.1666~1675 (2009)[DOI]
  39. Forster, A., "Cluster randomized controlled trial : clinical and cost-effectiveness of a system of longer-term stroke care", Stroke, 46(8), pp.2212~2219 (2015)
  40. Friedland, J. F., "Social support intervention after stroke : results of a randomized trial", Archives of Physical Medicine &Rehabilitation, 73(6), pp.573~581 (1992)
  41. Caroline E Fryer, "Self management programmes for quality of life in people with stroke", Cochrane Database of Systematic Reviews, (8) (2016), Wiley[DOI]
  42. Gallacher, K. I., "A conceptual model of treatment burden and patient capacity in stroke", BMC Family Practice, 19(1), pp.9~ (2018)[DOI]
  43. Gao, J., "Different interventions for post-ischaemic stroke depression in different time periods : a single-blind randomized controlled trial with stratification by time after stroke", Clinical Rehabilitation, 31(1), pp.71~81 (2017)[DOI]
  44. Gillen, R., "Depressive symptoms and history of depression predict rehabilitation efficiency in stroke patients", Archives of Physical Medicine and Rehabilitation, 82(12), pp.1645~1649 (2001)
  45. Godwin, K. M., "Long-term health related quality of life of survivors of stroke and their spousal caregivers", Journal of Neuroscience Nursing, 45(3), pp.147~154 (2013)
  46. Golding, K., "A pilot randomized controlled trial of self-help relaxation to reduce post-stroke depression", Clinical Rehabilitation, 32(6), pp.747~751 (2018)[DOI]
  47. Golding, K., "Self-help relaxation for post-stroke anxiety : a randomised, controlled pilot study", Clinical Rehabilitation, 30(2), pp.174~180 (2016)[DOI]
  48. Groeneveld, I. F., "The longer-term unmet needs after stroke questionnaire : cross-cultural adaptation, reliability, and concurrent validity in a Dutch population", Journal of Stroke and Cerebrovascular Diseases, 27(1), pp.267~275 (2018)
  49. Hackett, M. L., "Interventions for preventing depression after stroke", Cochrane Database of Systematic Reviews, (3), pp.CD003689~ (2008)[DOI]
  50. Harrington, R., "A community-based exercise and education scheme for stroke survivors : a randomized controlled trial and economic evaluation", Clinical Rehabilitation, 24(1), pp.3~15 (2010)
  51. Hartke, R. J., "The use of writing groups to facilitate adaptation after stroke", Topics in Stroke Rehabilitation, 14(1), pp.26~37 (2007)
  52. Hedges, L. V., "Statistical methods for meta-analysis" (1985), Academic Press
  53. Higgins, J. P., "The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)
  54. Hill, K., "Prevention of mood disorder after stroke : a randomised controlled trial of problem solving therapy versus volunteer support", BMC Neurology, 19(1), pp.128~ (2019)[DOI]
  55. Hinojosa, R., "Social isolation poststroke : relationship between race", ethnicity, depression, and functional independence, 2011, pp.18(1), 79~86
  56. Hjelle, E. G., "Effect of a dialogue-based intervention on psychosocial wellbeing 6 months after stroke in Norway : a randomized controlled trial", Journal of Rehabilitation Medicine, 51(8), pp.557~565 (2019)[DOI]
  57. Hoffmann, T., "Evaluation of brief interventions for managing depression and anxiety symptoms during early discharge period after stroke : a pilot randomized controlled trial", Topics in Stroke Rehabilitation, 22(2), pp.116~126 (2015)
  58. Jaglal, S. B., "Increasing access to chronic disease self-management programs in rural and remote communities using telehealth", Telemedicine and e-Health, 19(6), pp.467~473 (2013)[DOI]
  59. Johansson, B., "Mindfulness-based stress reduction (MBSR)improves long-term mental fatigue after stroke or traumatic brain injury", Brain Injury, 26(13, pp.14) (2012), 1621~1628
  60. Jones, F., "Feasibility study of an integrated stroke self-management programme: a clusterrandomised controlled trial", BMJ Open, 6(1), pp.e008900~ (2016)
  61. Jones, F., "Changing self-efficacy in individuals following a first time stroke : preliminary study of a novel self-management intervention", Clinical Rehabilitation, 23(6), pp.522~533 (2009)[DOI]
  62. Jones, K. M., "Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context : a randomized controlled pilot study", Clinical Rehabilitation, 32(8), pp.1086~1097 (2018)[DOI]
  63. Kendall, E., "Recovery following stroke : the role of self-management education", Social Science & Medicine, 64(3), pp.735~746 (2007)
  64. Jun Yup Kim, "Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society", 대한뇌졸중영문학회지, 21(1), pp.42~59 (2019), 대한뇌졸중학회[DOI]
  65. Kim, S. Y., "Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity", Journal of Clinical Epidemiology, 66(4), pp.408~414 (2013)
  66. Klimas, J., "Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users : Cochrane Review", Systematic reviews, 2(1), pp.3~ (2013)[DOI]
  67. Kneebone, I., "Relaxation training after stroke : potential to reduce anxiety", Disability &Rehabilitation, 36(9), pp.771~774 (2014)[DOI]
  68. Kootker, J. A., "Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms : A Randomized Controlled Trial", Archives of Physical Medicine & Rehabilitation, 98(4), pp.687~694 (2017)[DOI]
  69. Lennon, S., "Self-management programmes for people post stroke : a systematic review", Clinical Rehabilitation, 27(10), pp.867~878 (2013)
  70. Lincoln, N. B., "Cognitive behavioral psychotherapy for depression following stroke : a randomized controlled trial", Stroke, 34(1), pp.111~115 (2003)
  71. Lincoln, N. B., "Evaluation of cognitive behavioural treatment for depression after stroke : a pilot study", Clinical Rehabilitation, 11(2), pp.114~122 (1997)
  72. Liu, T. W., "Decreasing Fear of Falling in Chronic Stroke Survivors Through Cognitive Behavior Therapy and Task-Oriented Training", Stroke, 50(1), pp.148~154 (2019)[DOI]
  73. Majumdar, S., "Brief group-based acceptance and commitment therapy for stroke survivors", British Journal of Clinical Psychology, 58(1), pp.70~90 (2019)[DOI]
  74. Mant, J., "Family support for stroke : a randomised controlled trial", The Lancet, 356(9232), pp.808~813 (2000)
  75. Markle-Reid, M., "Interprofessional stroke rehabilitation for stroke survivors using home care", Canadian Journal of Neurological Sciences, 38(2), pp.317~334 (2011)
  76. Matcham, F., "Self-help interventions for symptoms of depression, anxiety and psychological distress in patients with physical illnesses : a systematic review and meta-analysis", Clinical Psychology Review, 34(2), pp.141~157 (2014)
  77. Meijer, A., "Effects of screening for psychological distress on patient outcomes in cancer : a systematic review", Journal of Psychosomatic Research, 75(1), pp.1~17 (2013)
  78. Minshall, C., "Psychosocial interventions for stroke survivors, carers and survivor-carer dyads : a systematic review and meta-analysis", Topics in Stroke Rehabilitation, 26(7), pp.554~564 (2019)
  79. Mitchell, P. H., "Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant : living well with stroke : randomized, controlled trial", Stroke, 40(9), pp.3073~3078 (2009)[DOI]
  80. Morris, J. H., "Predicting health related quality of life 6 months after stroke : the role of anxiety and upper limb dysfunction", Disability and Rehabilitation, 35(4), pp.291~299 (2013)
  81. Muller, M., "Development and evaluation of a hospital-based peer support group for younger individuals with stroke", Occupational Therapy in Health Care, 28(3), pp.277~295 (2014)[DOI]
  82. Nguyen, S., "Cognitive behavioural therapy for post-stroke fatigue and sleep disturbance : a pilot randomised controlled trial with blind assessment", Neuropsychological Rehabilitation, 29(5), pp.723~738 (2019)[DOI]
  83. Olukolade, O., "Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of First Stroke Attack in Ibadan, Nigeria", Behavioural Neurology, 2017, pp.4058124~ (2017)[DOI]
  84. Ostwald, S. K., "Home-based psychoeducational and mailed information programs for stroke-caregiving dyads post-discharge : a randomized trial", Disability &Rehabilitation, 36(1), pp.55~62 (2014)[DOI]
  85. Pappadis, M. R., "Lived experiences of chronic cognitive and mood symptoms among community-dwelling adults following stroke : a mixed-methods analysis", Aging & Mental Health, 23(9), pp.1227~1233 (2019)
  86. Park, H. K., "Social Issues of Young Adult Stroke Patients", Journal of the Korean Academy of Rehabilitation Medicine, 25(3), pp.418~425 (2001)
  87. Park, J., "The effects of time-use intervention on the quality of life of outpatients with chronic stroke", Journal of Physical Therapy Science, 31(1), pp.36~38 (2019)[DOI]
  88. Peng, Y., "The Effect of a Brief Intervention for Patients with Ischemic Stroke : A Randomized Controlled Trial", Journal of Stroke & Cerebrovascular Diseases, 24(8), pp.1793~1802 (2015)[DOI]
  89. Raphael, D., "Psychosocial distress in haematological cancer survivors: an integrative review", European Journal of Cancer Care, 26(6), pp.e12640~ (2017)
  90. Ringer, T., "Distress in caregivers accompanying patients to an emergency department : a scoping review", The Journal of Emergency Medicine, 53(4), pp.493~508 (2017)
  91. Robinson, R. G., "Escitalopram and problem-solving therapy for prevention of poststroke depression : a randomized controlled trial", JAMA : Journal of the American Medical Association, 299(20), pp.2391~2400 (2008)[DOI]
  92. Robinson‐Smith, G., "Couples' Coping After Stroke—A Pilot Intervention Study", Rehabilitation Nursing, 41(4), pp.218~229 (2016)
  93. Rochette, A., "The YOU CALL-WE CALL randomized clinical trial : Impact of a multimodal support intervention after a mild stroke", Circulation : Cardiovascular Quality and Outcomes, 6(6), pp.674~679 (2013)[DOI]
  94. Rodgers, H., "Randomized controlled trial of a comprehensive stroke education program for patients and caregivers", Stroke, 30(12), pp.2585~2591 (1999)
  95. Sabariego, C., "Evaluation of an ICF-based patient education programme for stroke patients : a randomized, single-blinded, controlled, multicentre trial of the effects on self-efficacy, life satisfaction and functioning", British Journal of Health Psychology, 18(4), pp.707~728 (2013)[DOI]
  96. Schmid, A. A., "Depression improvement is related to social role functioning after stroke", Archives of Physical Medicine and Rehabilitation, 93(6), pp.978~982 (2012)
  97. Schwarzer, G., "Meta: General Package for Meta-Analysis. R package version 4.11-0", ~ (2020)
  98. Shimoda, K., "Effect of anxiety disorder on impairment and recovery from stroke", The Journal of Neuropsychiatry and Clinical Neurosciences, 10(1), pp.34~40 (1998)
  99. Simeone, S., "The experience of stroke survivors three months after being discharged home : A phenomenological investigation", European Journal of Cardiovascular Nursing, 14(2), pp.162~169 (2015)[DOI]
  100. Sit, J. W., "Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial", Clinical Interventions in Aging, 11, pp.1441~1450 (2016)[DOI]
  101. Smith, G. C., "Reducing depression in stroke survivors and their informal caregivers : a randomized clinical trial of a Web-based intervention", Rehabilitation Psychology, 57(3), pp.196~206 (2012)
  102. Stein, L. A., "Association between anxiety, depression, and post-traumatic stress disorder and outcomes after ischemic stroke", Frontiers in Neurology, 9, pp.890~ (2018)
  103. Sugavanam, T., "The effects and experiences of goal setting in stroke rehabilitation–a systematic review", Disability and Rehabilitation, 35(3), pp.177~190 (2013)
  104. Syrowatka, A., "Predictors of distress in female breast cancer survivors : a systematic review", Breast Cancer Research and Treatment, 165(2), pp.229~245 (2017)
  105. Szczepańska-Gieracha, J., "Evaluation of a short-term group psychotherapy used as part of the rehabilitation process in nursing home patients", Disability & Rehabilitation, 36(12), pp.1027~1032 (2014)[DOI]
  106. Thomas, S. A., "Behavioural activation therapy for post-stroke depression : the BEADS feasibility RCT", Health Technology Assessment, 23(47), pp.1~176 (2019)[DOI]
  107. Tielemans, N. S., "Effectiveness of the Restore4Stroke self-management intervention"Plan ahead!" : A randomized controlled trial in stroke patients and partners", Journal of Rehabilitation Medicine, 47(10), pp.901~909 (2015)[DOI]
  108. Vickery, C. D., "Group psychotherapy focusing on self-concept change following acquired brain injury : a pilot investigation", Rehabilitation Psychology, 51(1), pp.30~35 (2006)
  109. Visser, M. M., "Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life : Randomized Controlled Trial", Stroke, 47(1), pp.135~142 (2016)[DOI]
  110. Ward, S. K., "Group cognitive behavioural therapy for stroke survivors with depression and their carers", Topics in Stroke Rehabilitation, 23(5), pp.358~365 (2016)[DOI]
  111. Watkins, C. L., "Motivational interviewing early after acute stroke : a randomized, controlled trial", Stroke, 38(3), pp.1004~1009 (2007)
  112. White, C. L., "Dimensions of uncertainty after stroke : perspectives of the stroke survivor and family caregiver", Journal of Neuroscience Nursing, 46(4), pp.233~240 (2014)[DOI]
  113. Wichowicz, H. M., "Application of Solution-Focused Brief Therapy(SFBT)in individuals after stroke", Brain Injury, 31(11), pp.1507~1512 (2017)[DOI]
  114. Williams, L. S., "Care management of poststroke depression : a randomized, controlled trial", Stroke, 38(3), pp.998~1003 (2007)
  115. Winstein, C. J., "Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2016, pp.47(6), e98~e169
  116. Wong, F. K. Y., "Effects of a 4‐week transitional care programme for discharged stroke survivors in H ong K ong : a randomised controlled trial", Health & Social Care in the Community, 23(6), pp.619~631 (2015)
  117. Neurological disorders: public health challenges, "World Health Organization.", World Health Organization, ~ (2006)
  118. Wu, D. Y., "Clinical effects of comprehensive therapy of early psychological intervention and rehabilitation training on neurological rehabilitation of patients with acute stroke", Asian Pacific Journal of Tropical Medicine, 5(11), pp.914~916 (2012)[DOI]

관련 논문AI추천

뇌졸중 환자의 삶의 질에 영향을 끼치는 요인: 체계적 문헌고찰정준식대한신경계작업치료학회 · 재활치료과학2015 · 제4권 제1호뇌졸중 환자를 대상으로 한 지역사회 복귀 중재의 효과에 대한 체계적 고찰김동휘, 김성원, 정민예대한신경계작업치료학회 · 재활치료과학2025 · 제14권 제3호뇌졸중 환자의 재발방지를 위한 자기관리 중재: 체계적 고찰남상훈, 박준태, 박지혁한국노인작업치료학회 · 한국노인작업치료학회지2024 · 제6권 제2호뇌졸중 환자에게 적용한 과제 지향적 중재의 효과: 체계적 문헌 고찰강민혜, 고혜영, 권희연, 김혜경, 이유나, 차현진한국노인작업치료학회 · 한국노인작업치료학회지2025 · 제7권 제1호시간사용중재가 뇌졸중 환자의 생활만족도 및 자아존중감에 미치는 영향김민혁, 류성현, 박수진, 황도연대한신경계작업치료학회 · 재활치료과학2020 · 제9권 제3호과제지향 중재가 뇌졸중 환자의 독립성 및 일상생활 수행에 미치는 영향: 체계적 고찰이유나, 이지은한국노인작업치료학회 · 한국노인작업치료학회지2025 · 제7권 제1호

이 간행물의 다른 논문 (9건)

만성신체질환자의 자살 위험 선별 및 평가도구의 심리측정 속성: 체계적 문헌고찰함봉진, 정동희, 문정윤, 심은정pp. 835-860무아 통찰의 세 가지 의미와 심리치료적 함의: 현상학적 질적 연구윤석인, 김완석pp. 861-890스트레스, 부정 정서 그리고 자기자비가 비자살적 자해에 미치는 영향라영선, 현명호, 김소연pp. 891-909정서 마음챙김 명상이 기능성 소화불량증 경향 여대생들의 상복부 소화기 증상, 스트레스, 우울 및 불안에 미치는 영향박슬기, 김정호, 김미리혜pp. 911-928스트레스, 대처유연성 및 분노의 관계: 성장 글쓰기의 효과를 중심으로이훈진, 현승주pp. 929-954
원문 보기