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Published on: January 15, 2017
Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitative
Madeleine J Murtagh1, Duika L Burges Watson, K Neil Jenkings
1Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom. mm399@le.ac.uk
Plos One
|June 8, 2012
Summary
Effective communication strategies are crucial for shared decision-making in acute ischemic stroke treatment. Relational support and tailored information help patients and families navigate complex choices regarding thrombolysis (rtPA) amid stroke
Area of Science:
- Neuroscience
- Medical Communication
- Health Services Research
Background:
- Acute ischemic stroke requires timely treatment with recombinant tissue plasminogen activator (rtPA).
- While rtPA reduces long-term disability, it increases immediate bleeding risks.
- Effective knowledge translation and decision support are vital in hyperacute stroke care.
Purpose of the Study:
- To explore challenges in knowledge translation and decision-making for rtPA in hyperacute stroke.
- To inform the development of effective decision support tools for stroke patients, families, and clinicians.
Main Methods:
- Qualitative study involving interviews with patients, families, and healthcare professionals.
- Analysis of communication strategies and decision-making processes in emergency stroke settings.
Main Results:
- Decision-making is complicated by time constraints, reduced patient/family capacity, and reliance on clinician expertise.
- Effective strategies include face-to-face communication, shared decision-making, incremental information delivery, and tailored communication.
- Relational interactions build trust, alleviate anxiety, and provide hope; neutral information increases uncertainty.
Conclusions:
- Relational decision support and situationally-sensitive knowledge translation are key to addressing challenges in rtPA decision-making.
- Tailored communication acknowledging social and emotional contexts improves patient and family engagement.
- Strategies that 'make time' for reflection are essential in time-critical stroke care.
