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Palliative care needs and specialist services post stroke: national population-based study.

Huiqin Liu1,2, Angus Cook3, Jinfeng Ding4,5

  • 1Health Management Center, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

BMJ Supportive & Palliative Care
|July 27, 2023
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Summary

Stroke patients often require significant support with daily living, not just symptom management. Increased community palliative care services could enable more patients to spend their final stages at home.

Keywords:
StrokeSymptoms and symptom managementTerminal care

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Area of Science:

  • Gerontology
  • Neurology
  • Palliative Care Medicine

Background:

  • Stroke is a leading cause of long-term disability.
  • Palliative care needs in stroke survivors are complex, involving functional impairment and daily living support.
  • Understanding these needs is crucial for optimizing care services.

Purpose of the Study:

  • To compare the palliative care needs of patients admitted primarily for stroke.
  • To determine how these needs influence the utilization of specialist palliative care services (community vs. inpatient).

Main Methods:

  • Observational study utilizing Australian Palliative Care Outcomes Collaboration data.
  • Multivariate logistic regression analysis to assess associations between palliative care needs and service use.

Main Results:

  • Most stroke patients experienced mild symptom distress but significant functional impairment.
  • Lower Australia-modified Karnofsky Performance Status and an 'unstable' palliative care phase predicted inpatient palliative care use.
  • Few other symptom-related factors clearly associated with service type.

Conclusions:

  • Stroke patients often require substantial assistance with activities of daily living.
  • Enhanced community palliative care support could facilitate more home-based end-of-life care for stroke survivors and their families.