Cognitive assessment after stroke: A qualitative study of patients’ experiences
Objectives Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of postst...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e072501.full |
| _version_ | 1797749046265249792 |
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| author | Nele Demeyere Eugene Tang Georgina Hobden |
| author_facet | Nele Demeyere Eugene Tang Georgina Hobden |
| author_sort | Nele Demeyere |
| collection | DOAJ |
| description | Objectives Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of poststroke cognitive assessments.Design Stroke survivors were purposively sampled in an iterative process through a pool of research volunteers who had previously taken part in the Oxford Cognitive Screen Recovery study. Stroke survivors and their family caregivers were invited to participate in a semistructured interview steered by a topic guide. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Demographic, clinical and cognitive data were acquired from patients’ previous research data.Setting Stroke survivors were originally recruited from the acute inpatient unit at Oxford University Hospital (John Radcliffe), UK. Participants were interviewed after discharge either at their homes or via telephone or videocall.Participants Twenty-six stroke survivors and eleven caregivers participated in semi-structured interviews.Results We identified three key phases of the cognitive assessment process and themes pertaining to each phase. The phases (numbered) and themes (lettered) were as follows: (1) before the cognitive assessment: (A) lack of explanation, (B) considering the assessment useless; (2) during the cognitive assessment: varied emotional responses, moderated by (D) perception of the purpose behind cognitive assessment, (E) perception of cognitive impairment, (F) confidence in cognitive abilities, (G) assessment administration style and (3) after the cognitive assessment: (H) feedback can impact self-confidence and self-efficacy, (I) vague feedback and clinical jargon are unhelpful.Conclusions Stroke survivors require clear explanations about the purpose and outcomes of poststroke cognitive assessments, including constructive feedback, to promote engagement with the process and protect their psychological wellbeing. |
| first_indexed | 2024-03-12T16:13:46Z |
| format | Article |
| id | doaj.art-ba78a654b2e04cd3a4d2bdc8308a0905 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T16:13:46Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-ba78a654b2e04cd3a4d2bdc8308a09052023-08-09T08:35:08ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2023-072501Cognitive assessment after stroke: A qualitative study of patients’ experiencesNele Demeyere0Eugene Tang1Georgina Hobden2Department of Experimental Psychology, Radcliffe Observatory Quarter, Cognitive Neuropsychology Centre, University of Oxford, Oxford, UK1 Institute of Health and Society, Newcastle University, Newcastle, UKExperimental Psychology, University of Oxford, Oxford, UKObjectives Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of poststroke cognitive assessments.Design Stroke survivors were purposively sampled in an iterative process through a pool of research volunteers who had previously taken part in the Oxford Cognitive Screen Recovery study. Stroke survivors and their family caregivers were invited to participate in a semistructured interview steered by a topic guide. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Demographic, clinical and cognitive data were acquired from patients’ previous research data.Setting Stroke survivors were originally recruited from the acute inpatient unit at Oxford University Hospital (John Radcliffe), UK. Participants were interviewed after discharge either at their homes or via telephone or videocall.Participants Twenty-six stroke survivors and eleven caregivers participated in semi-structured interviews.Results We identified three key phases of the cognitive assessment process and themes pertaining to each phase. The phases (numbered) and themes (lettered) were as follows: (1) before the cognitive assessment: (A) lack of explanation, (B) considering the assessment useless; (2) during the cognitive assessment: varied emotional responses, moderated by (D) perception of the purpose behind cognitive assessment, (E) perception of cognitive impairment, (F) confidence in cognitive abilities, (G) assessment administration style and (3) after the cognitive assessment: (H) feedback can impact self-confidence and self-efficacy, (I) vague feedback and clinical jargon are unhelpful.Conclusions Stroke survivors require clear explanations about the purpose and outcomes of poststroke cognitive assessments, including constructive feedback, to promote engagement with the process and protect their psychological wellbeing.https://bmjopen.bmj.com/content/13/6/e072501.full |
| spellingShingle | Nele Demeyere Eugene Tang Georgina Hobden Cognitive assessment after stroke: A qualitative study of patients’ experiences BMJ Open |
| title | Cognitive assessment after stroke: A qualitative study of patients’ experiences |
| title_full | Cognitive assessment after stroke: A qualitative study of patients’ experiences |
| title_fullStr | Cognitive assessment after stroke: A qualitative study of patients’ experiences |
| title_full_unstemmed | Cognitive assessment after stroke: A qualitative study of patients’ experiences |
| title_short | Cognitive assessment after stroke: A qualitative study of patients’ experiences |
| title_sort | cognitive assessment after stroke a qualitative study of patients experiences |
| url | https://bmjopen.bmj.com/content/13/6/e072501.full |
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