The palliative care needs of acute stroke patients: a prospective study of hospital admissions

• DOI: 10.1093/ageing/afq077
• Publication Date: 2010-07-21T04:37:05Z
• Authors: C. R. Burton; S. Payne; J. Addington-Hall; A. Jones
• Keywords: Aged, 80 and over; Male; Health Services for the Aged; Palliative Care; 610; Comorbidity; Anxiety; Middle Aged; 3. Good health; Stroke; 03 medical and health sciences; 0302 clinical medicine; England; Acute Disease; Prevalence; Humans; Female; Prospective Studies; Referral and Consultation; Fatigue; Needs Assessment; Stress, Psychological; Aged

despite a mortality rate of approximately 30% in acute stroke, little is known about the palliative care needs of this group of patients.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.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.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.