Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views
Abstract Background Post stroke cognitive difficulties are common but generally prioritised below other impairments. In the UK, clinical guidelines recommend a holistic review at six-months post-stroke including an assessment of cognitive function. In order to assist clinicians to provide better car...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05558-y |
| _version_ | 1818140049012686848 |
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| author | Eugene Y. H. Tang Louise Robinson Catherine Exley Darren Flynn Blossom C. M. Stephan Christopher Price |
| author_facet | Eugene Y. H. Tang Louise Robinson Catherine Exley Darren Flynn Blossom C. M. Stephan Christopher Price |
| author_sort | Eugene Y. H. Tang |
| collection | DOAJ |
| description | Abstract Background Post stroke cognitive difficulties are common but generally prioritised below other impairments. In the UK, clinical guidelines recommend a holistic review at six-months post-stroke including an assessment of cognitive function. In order to assist clinicians to provide better care for patients with post-stroke cognitive deficits and assist with service planning, our aim was to establish professional consensus on key actions at the six-month review. Methods An electronic Delphi survey was developed with ten potential actions for clinicians to prioritise across five different clinical scenarios describing patients with cognitive difficulties. Scenarios varied in terms of age of the stroke-survivor, stroke severity and use of dementia risk assessment. A panel of professional volunteers was obtained through the British Association of Stroke Physicians and the UK National Stroke Nursing Forum. Results Forty-five stroke clinicians completed round one, with 21 participants completing round two. Priorities consistently supported by professionals included access to psychological services, screening for a mood disorder and ensuring multi-professional input. Direct access to specialist memory services was not generally supported unless a dementia risk assessment tool indicated that the individual was at high risk of dementia. Conclusions Assessment of post-stroke cognitive deficits needs to be routinely considered during the six-month review. A formal risk assessment tool could be a way to streamline direct access to memory clinic services to ensure that individuals at-risk of dementia receive ongoing care. |
| first_indexed | 2024-12-11T10:37:48Z |
| format | Article |
| id | doaj.art-3d1e12167d434eabbcc2421ca295026e |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T10:37:48Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3d1e12167d434eabbcc2421ca295026e2022-12-22T01:10:39ZengBMCBMC Health Services Research1472-69632020-08-012011910.1186/s12913-020-05558-yCare priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional viewsEugene Y. H. Tang0Louise Robinson1Catherine Exley2Darren Flynn3Blossom C. M. Stephan4Christopher Price5Population Health Sciences Institute, Newcastle University, Campus for Ageing and VitalityPopulation Health Sciences Institute, Newcastle University, Campus for Ageing and VitalityPopulation Health Sciences Institute, Newcastle University, Campus for Ageing and VitalityCentre for Rehabilitation, Exercise and Sports Science, School of Health & Life Sciences, Teesside UniversityDivision of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of NottinghamPopulation Health Sciences Institute, Newcastle University, Campus for Ageing and VitalityAbstract Background Post stroke cognitive difficulties are common but generally prioritised below other impairments. In the UK, clinical guidelines recommend a holistic review at six-months post-stroke including an assessment of cognitive function. In order to assist clinicians to provide better care for patients with post-stroke cognitive deficits and assist with service planning, our aim was to establish professional consensus on key actions at the six-month review. Methods An electronic Delphi survey was developed with ten potential actions for clinicians to prioritise across five different clinical scenarios describing patients with cognitive difficulties. Scenarios varied in terms of age of the stroke-survivor, stroke severity and use of dementia risk assessment. A panel of professional volunteers was obtained through the British Association of Stroke Physicians and the UK National Stroke Nursing Forum. Results Forty-five stroke clinicians completed round one, with 21 participants completing round two. Priorities consistently supported by professionals included access to psychological services, screening for a mood disorder and ensuring multi-professional input. Direct access to specialist memory services was not generally supported unless a dementia risk assessment tool indicated that the individual was at high risk of dementia. Conclusions Assessment of post-stroke cognitive deficits needs to be routinely considered during the six-month review. A formal risk assessment tool could be a way to streamline direct access to memory clinic services to ensure that individuals at-risk of dementia receive ongoing care.http://link.springer.com/article/10.1186/s12913-020-05558-yStrokeCognitionRisk assessmentDementiaDelphi |
| spellingShingle | Eugene Y. H. Tang Louise Robinson Catherine Exley Darren Flynn Blossom C. M. Stephan Christopher Price Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views BMC Health Services Research Stroke Cognition Risk assessment Dementia Delphi |
| title | Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views |
| title_full | Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views |
| title_fullStr | Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views |
| title_full_unstemmed | Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views |
| title_short | Care priorities for stroke patients developing cognitive difficulties: a Delphi survey of UK professional views |
| title_sort | care priorities for stroke patients developing cognitive difficulties a delphi survey of uk professional views |
| topic | Stroke Cognition Risk assessment Dementia Delphi |
| url | http://link.springer.com/article/10.1186/s12913-020-05558-y |
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