BACKGROUND: despite a mortality rate of approximately 30% in acute stroke, little is known about the palliative care needs of this group of patients. DESIGN: prospective study of 191 acute stroke patients admitted to hospital in England. Biographical, medical and stroke-related data were collected. Participants completed the Sheffield Profile for Assessment and Referral to Care (SPARC), a screening tool for referral to specialist palliative care. FINDINGS: over 50% reported moderate to significant fatigue-related problems. Approximately 50% reported symptom-related problems (e.g. pain) or psychological distress (e.g. anxiety). Approximately 25% had concerns about death or dying, and 66% had concerns about dependence and disability. Over 50% were worried about the impact of stroke on family members. There were significant main effects of dependence (Barthel Index) (F(1,123) = 12.640 P = 0.001) and age (F(4,123) = 3.022 P = 0.020), and a significant three-factor interaction between dependence, age and co-morbidities (F(9,123) = 2.199 P = 0.026) in predicting total SPARC scores. CONCLUSIONS: acute stroke patients have a high prevalence of palliative care needs. Acute stroke services should use the SPARC for needs assessment. Priority for assessment should be given to patients with a score of <15/20 on the Barthel Index, a tool already used in most stroke services.
BACKGROUND: despite a mortality rate of approximately 30% in acute stroke, little is known about the palliative care needs of this group of patients. DESIGN: prospective study of 191 acute strokepatients admitted to hospital in England. Biographical, medical and stroke-related data were collected. Participants completed the Sheffield Profile for Assessment and Referral to Care (SPARC), a screening tool for referral to specialist palliative care. FINDINGS: over 50% reported moderate to significant fatigue-related problems. Approximately 50% reported symptom-related problems (e.g. pain) or psychological distress (e.g. anxiety). Approximately 25% had concerns about death or dying, and 66% had concerns about dependence and disability. Over 50% were worried about the impact of stroke on family members. There were significant main effects of dependence (Barthel Index) (F(1,123) = 12.640 P = 0.001) and age (F(4,123) = 3.022 P = 0.020), and a significant three-factor interaction between dependence, age and co-morbidities (F(9,123) = 2.199 P = 0.026) in predicting total SPARC scores. CONCLUSIONS:acute strokepatients have a high prevalence of palliative care needs. Acute stroke services should use the SPARC for needs assessment. Priority for assessment should be given to patients with a score of <15/20 on the Barthel Index, a tool already used in most stroke services.
Authors: Brystana G Kaufman; David Klemish; Andrew Olson; Cordt T Kassner; Jerome P Reiter; Matthew Harker; Laura Sheble; Benjamin A Goldstein; Donald H Taylor; Nrupen A Bhavsar Journal: J Palliat Med Date: 2019-08-19 Impact factor: 2.947
Authors: E G Boland; J W Boland; Y Ezaydi; D M Greenfield; S H Ahmedzai; J A Snowden Journal: Support Care Cancer Date: 2014-04-15 Impact factor: 3.603
Authors: Christopher R Burton; Sheila Payne; Mary Turner; Tracey Bucknall; Jo Rycroft-Malone; Pippa Tyrrell; Maria Horne; Lupetu Ives Ntambwe; Sarah Tyson; Helen Mitchell; Sion Williams; Salah Elghenzai Journal: BMC Palliat Care Date: 2014-12-05 Impact factor: 3.234