The key challenges of discussing end-of-life stroke care with patients and families: a mixed-methods electronic survey of hospital and community healthcare professionals

Doubal, F. et al. (2018) The key challenges of discussing end-of-life stroke care with patients and families: a mixed-methods electronic survey of hospital and community healthcare professionals. Journal of the Royal College of Physicians of Edinburgh, 48(3), pp. 217-224. (doi: 10.4997/JRCPE.2018.305) (PMID:30191909)

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Abstract

Background: Communication between professionals, patients and families about palliative and end-of-life care after stroke is complex and there is a need for educational resources in this area. Methods: To explore the key learning needs of healthcare professionals, a multidisciplinary, expert group developed a short electronic survey with open and closed questions, and then distributed it to six UK multiprofessional networks and two groups of local clinicians. Results: A total of 599 healthcare professionals responded. Educational topics that were either definitely or probably needed were: ensuring consistent messages to families and patients (88%); resolving conflicts among family members (83%); handling unrealistic expectations (88%); involving families in discussions without them feeling responsible for decisions (82%); discussion of prognostic uncertainties (79%); likely mode of death (72%); and oral feeding for 'comfort' in patients at risk of aspiration (71%). The free-text responses (n = 489) and 82 'memorable' cases identified similar themes. Conclusion: Key topics of unmet need for education in end-of-life care in stroke have been identified and these have influenced the content of an open access, web-based educational resource.

Item Type:Articles
Keywords:Acute stroke, health communication, health personnel, healthcare survey, palliative care, terminal care
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cowey, Professor Eileen
Authors: Doubal, F., Cowey, E., Bailey, F., Murray, S.A., Borthwick, S., Somerville, M., Lerpiniere, C., Reid, L., Boyd, K., Hynd, G., and Mead, G.E.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Journal of the Royal College of Physicians of Edinburgh
Publisher:Royal College of Physicians of Edinburgh
ISSN:1478-2715
ISSN (Online):2042-8189
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Journal of the Royal College of Physicians of Edinburgh 48(3):217-224
Publisher Policy:Reproduced under a Creative Commons License

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