title: Effectiveness of the "Elevated Position" Nursing Care Program in promoting the reconditioning of patients with acute cerebrovascular disease.
abstract: OBJECTIVE
  Over 34,000 Japanese patients suffer from a persistent disturbance of consciousness. The purpose of this study was to investigate the effectiveness of the "Elevated Position" Nursing Care Program (EPNCP) in promoting the reconditioning of patients with acute cerebrovascular disease (ACD). The primary assumption of this study was that they could experience the reconditioning process and would reach a reconditioned state through their involvement in the EPNCP, thus improving their level of consciousness and quality of life.
  
  
  METHODS
  A historical controlled trial study, based on an intention-to-treat analysis of hospitalized patients with ACD who became participants the day after starting medical or surgical treatment, was used. Trained nurses implemented the EPNCP from May to September 2005 for an experimental group of 45 participants. The data on two independent control groups of 92 and 40 patients with ACD were gathered from historical medical records. The six measures were: Japan Coma Scale; Level of Cognitive Functioning Assessment Scale; number of days from the intervention to sitting in a wheelchair; number of participants who left the intensive care unit (ICU) by wheelchair; Barthel Index; and modified Rankin Scale.
  
  
  RESULTS
  Significant differences were found regarding the number of participants who left the ICU by wheelchair, length of time from the EPNCP's commencement to the wheelchair-sitting position, and the Barthel Index 1 week after leaving the ICU.
  
  
  CONCLUSIONS
  The EPNCP was safe for the reconditioning of patients with ACD and somewhat effective in improving their physical function. A comprehensive nursing care program now exists for elevating patients with cerebrovascular disease during the early phase following the onset of symptoms or immediately after surgery. Further research should be conducted, extending the duration of the intervention program and the length of the measurement period, followed by a careful analysis of the results.
authors.affiliation: St. Luke's College of Nursing, Tokyo, Japan. nobu-okubo@slcn.ac.jp
authors.forename: Nobuko
authors.initials: N
authors.lastname: Okubo
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000451:nursing* / Q000534:rehabilitation*; D003244:Consciousness Disorders / Q000451:nursing / Q000534:rehabilitation; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007564:Japan; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000592:standards*; D019145:Rehabilitation Nursing / Q000592:standards*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014910:Wheelchairs