밀기증후군을 가진 뇌졸중 환자에 대한 임상 실기와 문서화: 사례보고

Abstract

This study purposes to conduct visual feedback and body posture control training on stroke patients with pusher syndrome in order to reduce their pusher syndrome. This study also examines changes resulting from the training and applies the guidelines necessary for documentation of patient/customer management. The participant for this study was one patient with pusher syndrome. The study progressed from a medical examination of the subject followed by evaluation, diagnosis, prognosis, intervention and treatment plan, and finally re-examination in order of precedence. Problems in the participant's functional activities, difficulties in changes from sitting postures into standing postures, and maintaining standing postures were determined as primary restrictions on activities and the improvement of these activities was set up as a goal through discussions with the patient. Interventions were mainly implemented to reduce the pusher syndrome with visual feedback provided using mirrors and exercises focusing on leaning in order to maintain posture while sitting. Changes from supine postures to sitting postures and the degree of changes in maintaining standing postures were compared between before and after the intervention by measuring times in the same environment and the degree of pusher syndrome was measured using the SCP tool. The process of this clinical practice was documented. The SCP score that indicates the degree of changes in the participant's pusher syndrome changed from 3.75 points to 0.8 point indicating a decrease in pushing. Among functional activities, posture changes from sitting postures to standing postures and maintaining standing postures were improved. In addition, since the patient could maintain standing postures, the patient could walk indoors. In this case study, mirrors and body posture control training used as interventions to relieve pusher syndromes can be easily applied in clinics to examine the form of functional recovery. The results indicated that these intervention methods were effective and thus it is thought that the results can be used as basic data to utilize these intervention methods diversely. In addition, the documentation of patient/client management was applied as actual documentation in Korean and based on the results, we could show decision making processes for patients' functional goals and objectively explain problems, prognoses and changes made through the interventions.