Ш.Батчимэг
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Ш.Батчимэг
Бүтэн нэр
Ширмэн Батчимэг
Латин нэр
Shirmen Batchimeg
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Тэнхимийн эрхлэгч
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Item type:Publication, Stroke from Prospective Acute Inpatient Rehabilitation Data: Functional Outcomes Using the Functional Independence Measure(Mongolian National University of Medical Sciences, 2020-06-25); ; ; Objectives: Stroke is a second leading cause of mortality and results often to severely lasting disability in worldwide. We studied the long-term effects of rehabilitation after stroke as a key factor in improving the quality of life, due to the reason that Mongolia has one of highest rates of ischemic heart disease. The aim of this study was to evaluate functional outcomes of all patients admitted to an inpatient rehabilitation unit in a tertiary hospital using Functional Independence Measure (FIM), and analyze factors that are associated significantly with progression of discharge functional scores and higher functional gains. Methods: In this longitudinal study over a two-month period, functional data for 104 patients admitted consecutively to the Stroke Center at Third State Central Hospital inpatient rehabilitation unit in Mongolia were charted into a custom designed rehabilitation database. The primary outcome measures were the discharge total FIM scores, FIM gain and FIM efficiency. Multiple linear regression analysis were used to identify independent variables associated with better discharge FIM scores and FIM gain. Results: The mean age was 56.3 ±11.6 years and 55.7% of the patients were male. Ischemic stroke (28.8%) followed by hemorrhagic stroke (71.2%) were more common diagnoses. The average rehabilitation length of stay was 9.3 ± 2.2 days. The mean admission total FIM score was 42.3 ± 20.7 and the mean discharge total FIM score was 61.3 ± 24.6, with this gain being highly significant (P < 0.001). The mean FIM gain was 18.6 ± 17.4 and FIM efficiency was 2.1 ± 1.0 points per day. Factors associated with better functional outcomes were higher admission motor and cognitive FIM scores, male gender and a longer rehabilitation length of stay. Conclusions: The FIM is an easy-to-use, standardized and robust general measure of functional disability. The total FIM scores of all patients, participated in this study, significantly improved. Moreover, longer rehabilitation LOS resulted in a negative effect on discharge FIM scores. To our knowledge, this study is the first study that examines the stroke rehabilitation using FIM scores as the primary outcome measure in Mongolia. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effectiveness of Long-Term Rehabilitation Treatment After Stroke(Mongolian National University of Medical Sciences, 2020-09-25); ; ; Objectives: Stroke is the leading cause of long-term disability. Therefore, we studied the effects of comprehensive long-term rehabilitation after stroke in improving the quality of life. Methods: Participants were compared in an experimental intervention model, with 120 control subjects, which received conventional short-stay inpatient hospitalization rehab, with 105 study subjects who received comprehensive rehabilitation program using the Guidelines for Adult Stroke Rehabilitation and Recovery from the American Heart Association/American Stroke Association starting in the hospital and extending for 6 months. The effects of rehabilitation were assessed Modified Rankin Scale (mRS), Functional Independence Measure (FIM), Barthel Index (BI) methods at admission, discharge, and 3 and 6 months after discharge. Results: There was no significant difference in the NIHSS, mRS, BI, and FIM scores between study and control patients at admission (p > 0.05). For the mRS, BI, and FIM scores, there was a significant interaction between treatment and time, indicating that the scores improved more rapidly for patients in the study group than the control group over the six-month study period (p < 0.001). A significant improvement in the scores with time was observed in the study and control groups at each time interval (p < 0.001). However, by 3 months after discharge the mRS, BI, and FIM scores of the study group were significantly better than the control group and the gap widened at 6 months, indicating further improvement. Conclusions: We found that providing prolonged by a multidisciplinary rehabilitation team results in higher functional independence and improvements in daily living activities. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Organization of Post-Stroke Rehabilitation Services: Changes between 2013 and 2018 in Services Provided by Health System in Mongolia(Mongolian National University of Medical Sciences, 2019-06-25); ; ; Ryenchindorj ErkhembayarObjectives: Stroke related disabilities significantly decrease patients’ quality of life and post-stroke rehabilitation service is essential. Therefore, we studied post-stroke rehabilitation services and facilities provided in Mongolia between 2013 and 2018. Methods: A longitudinal study was performed in a total of 47 Mongolian hospitals that provide stroke rehabilitation services. A questionnaire regarding the organizational structure of rehabilitation units, equipment used, human resources, and adherence to recommended guidelines was developed and administered to specialists in these hospitals. Results: We recruited 47 (89%) out of 50 and 47 (94%) out of 53 hospitals delivering stroke rehabilitation service in 2013 and 2018 respectively. 25-34% of these hospitals provided post-stroke rehabilitation, with the majority being incapable of providing multidisciplinary team rehabilitation. The number of physiatrists and physical therapists increased significantly from 2013 to 2018 (p<.001) although the number of physical (p<.002) and occupational therapists (p<.001) was significantly lower in the rural areas. Utilization of Functional independence measures, namely, the Barthel index and modified Rankin scales were increased in 2018 compared to 2013. Conclusion: The majority of post-stroke rehabilitation services are not improved since 2013. Consistent national programs and policies are required to provide adherence to post-stroke rehabilitation guideline recommendations and implementation in clinical practice.