Biomedical subjects

F Nouri

Publications and source records attributed to F Nouri.

7 recordsLinked to original sources

PubMed1988

Fitness to drive and the general practitioner.

This study investigates general practitioners' (GPs') knowledge and opinions on fitness to drive after stroke. Questionnaires were sent to 650 GPs. Despite a low response rate (24%) results suggest that most GPs rarely see stroke patients regarding driving fitness. There appears to be some confusion over terms used in the handbook issued to medical practitioners. Only a quarter of GPs knew of any driving assessment facilities and very few had ever referred a patient to a clinical psychologist for cognitive assessment. Almost all responding GPs (98%) wanted the opportunity to refer patients for assessment based on research findings. The current approach to assessment of driving fitness after stroke appears inconsistent. It is hoped that new assessment methods being developed will help to improve on the present system.

Automobile Driving↗

PubMed1987

Affective illness after stroke.

Mood assessments were made after six months of 149 survivors taken from a register of all patients admitted to hospital with acute stroke. Using a General Health Questionnaire score of 12 or more as a criterion of important affective illness, its prevalence was 23%. There was no difference in risk of affective illness between left and right hemisphere strokes. Affective illness was strongly associated with functional ability, with limb weakness and with longer hospital stay in those with good functional recovery. Only 15% of those with high scores were receiving antidepressant drugs. The general practitioner is in the best position to detect psychiatric illness in stroke survivors; the use of mood rating scales such as the GHQ, in conjunction with clinical assessment, may improve detection.

Cerebrovascular Disorders↗

PubMed1987

Caring for stroke patients at home.

The extent and type of care provided by relatives and friends living with a stroke patient was studied among 120 6-month survivors. Eighty-one (68%) carers felt that they had to give more help than before the stroke. The patients looked after by these 81 carers were more functionally disabled, more cognitively impaired, more often had speech impairment and urinary incontinence than the 39 patients whose companions did not give any extra help. Only a third of patients had been left unattended for all or part of the day prior to the interview and 18 per cent required attention every night. The majority (85%) of patients receiving help from companions were under regular review by health or social services. Over two-thirds of carers felt that providing support had had an adverse effect on their lives.

Aged↗

PubMed1987

An audit of follow-up services for stroke patients after discharge from hospital.

A register was kept of all patients admitted to hospital in Nottingham with acute stroke, and survivors were followed up at 1 and 6 months. A quarter of the 183 survivors seen at home 6 months after their strokes were still unable to perform some everyday activities. Only 18% of discharged patients ever received outpatient occupational therapy but 42% received physiotherapy. Those attending outpatient rehabilitation were more likely to improve in functional ability between 1 and 6 months. A third of patients interviewed had not seen their GP since discharge and many with severe disabilities did not receive potentially useful therapy or aids.

Activities of Daily Living↗

PubMed1986

Use of the Nottingham Health Profile with patients after a stroke.

The Nottingham Health Profile (NHP) is easy to use with stroke patients and may be used with those who cannot manage more complicated mood questionnaires, such as the General Health Questionnaire (GHQ). Stroke patients rate their health, and especially emotions and feelings of social isolation, as much worse than that of people of similar age. NHP emotion scores correlate with objective measures of disability, length of hospital stay, and GHQ scores. The NHP is a valid indicator of depressed mood, and combining its components into a total score gives the greatest accuracy in detecting depression. Patients with high scores at one month continued to report large numbers of problems at six months after their stroke. Many patients experienced pain, disturbed sleep, and social isolation, which are important, potentially treatable problems not usually considered in the management of stroke patients. Many patients with problems did not see their general practitioner or any other source of help, and additional follow up was needed.

Cerebrovascular Disorders↗

PubMed1985

Cognitive impairment after stroke.

Cognitive ability was assessed in a consecutive series of 189 six-month survivors of an acute stroke. Twenty-two patients were cognitively impaired at six months. Amongst 10 patients whose cognitive ability deteriorated between one and six months, four also had marked depressive symptoms. Age and severity of stroke were the factors most strongly associated with cognitive impairment at six months. Patients with left hemisphere damage had significantly more difficulty with short-term recall and those with bilateral hemisphere signs were most at risk of cognitive impairment. Patients with cognitive impairment after a stroke should be carefully assessed for depressed mood which may benefit from treatment.

Age Factors↗

PubMed1985

Measuring disability after a stroke.

A ranked activities of daily living (ADL) scale has been developed for stroke patients, on which an individual's score predicts his/her overall function ability. With an unranked scale the same total score can be obtained from different combinations of items and gives little idea of the patient's general pattern or degree of disability. The items in the scale are easy to assess on both inpatients and outpatients, and accepted criteria for valid ranking are fulfilled. A strong relation was found between scale score one month post-stroke and length of stay in hospital. Low scores at one month were also associated with high mortality during the subsequent five months. "Formal" and "informal" methods of ADL assessment were compared, and only small and unimportant differences were found. Assessments by postal questionnaire were also evaluated and agreed well with formal assessments carried out by visiting the patients' homes. Use of some or all of these methods would help to simplify and standardise follow up records for both routine care and research.

Activities of Daily Living↗