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The study protocol of: 'initiating end of life care in stroke: clinical decision-making around prognosis'
Burton, C.R. Payne, S. Turner, M. Bucknall, T. Rycroft-Malone, J. Tyrrell, P.J. Horne, Maria Ntambwe, L.I. Mitchell, H. Williams, S.
Burton, C.R.
Payne, S.
Turner, M.
Bucknall, T.
Rycroft-Malone, J.
Tyrrell, P.J.
Horne, Maria
Ntambwe, L.I.
Mitchell, H.
Williams, S.
Publication Date
2014-12-05
End of Embargo
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Rights
� 2014 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0)
Peer-Reviewed
Yes
Open Access status
openAccess
Accepted for publication
2014-11-27
Institution
Department
Awarded
Embargo end date
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Abstract
The initiation of end of life care in an acute stroke context should be focused on those
patients and families with greatest need. This requires clinicians to synthesise information on
prognosis, patterns (trajectories) of dying and patient and family preferences. Within acute
stroke, prognostic models are available to identify risks of dying, but variability in dying
trajectories makes it difficult for clinicians to know when to commence palliative
interventions. This study aims to investigate clinicians’ use of different types of evidence in
decisions to initiate end of life care within trajectories typical of the acute stroke population.
Methods/design
This two-phase, mixed methods study comprises investigation of dying trajectories in acute
stroke (Phase 1), and the use of clinical scenarios to investigate clinical decision-making in
the initiation of palliative care (Phase 2). It will be conducted in four acute stroke services in
North Wales and North West England. Patient and public involvement is integral to this
research, with service users involved at each stage.
Discussion
This study will be the first to examine whether patterns of dying reported in other diagnostic
groups are transferable to acute stroke care. The strengths and limitations of the study will be
considered. This research will produce comprehensive understanding of the nature of clinical
decision-making around end of life care in an acute stroke context, which in turn will inform
the development of interventions to further build staff knowledge, skills and confidence in
this challenging aspect of acute stroke care.
Version
Published version
Citation
Burton CR, Payne S, Turner M et al (2014) The study protocol of: 'initiating end of life care in stroke: clinical decision-making around prognosis'. BMC Palliative Care. 13(55)
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Type
Article