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    The study protocol of: 'initiating end of life care in stroke: clinical decision-making around prognosis'

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    The study proctocol 1472-684X-13-55.pdf (130.0Kb)
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    Publication date
    2014-12-05
    Author
    Burton, C.R.
    Payne, S.
    Turner, M.
    Bucknall, T.
    Rycroft-Malone, J.
    Tyrrell, P.J.
    Horne, Maria
    Ntambwe, L.I.
    Mitchell, H.
    Williams, S.
    Elghenzai, S.
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    Keyword
    Acute stroke; Palliative care; End of life care; Decision making; Dying trajectories
    Peer-Reviewed
    yes
    
    Metadata
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    Abstract
    Background 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.
    URI
    http://hdl.handle.net/10454/6761
    Version
    published version paper
    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)
    Link to publisher’s version
    http://dx.doi.org/10.1186/1472-684X-13-55
    Type
    Article
    Collections
    Health Studies Publications

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