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Cognitive assessment after stroke: A qualitative study of patients’ experiences

OBJECTIVES: Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of posts...

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Autores principales: Hobden, Georgina, Tang, Eugene, Demeyere, Nele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314571/
https://www.ncbi.nlm.nih.gov/pubmed/37385749
http://dx.doi.org/10.1136/bmjopen-2023-072501
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author Hobden, Georgina
Tang, Eugene
Demeyere, Nele
author_facet Hobden, Georgina
Tang, Eugene
Demeyere, Nele
author_sort Hobden, Georgina
collection PubMed
description OBJECTIVES: Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of poststroke cognitive assessments. DESIGN: Stroke survivors were purposively sampled in an iterative process through a pool of research volunteers who had previously taken part in the Oxford Cognitive Screen Recovery study. Stroke survivors and their family caregivers were invited to participate in a semistructured interview steered by a topic guide. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Demographic, clinical and cognitive data were acquired from patients’ previous research data. SETTING: Stroke survivors were originally recruited from the acute inpatient unit at Oxford University Hospital (John Radcliffe), UK. Participants were interviewed after discharge either at their homes or via telephone or videocall. PARTICIPANTS: Twenty-six stroke survivors and eleven caregivers participated in semi-structured interviews. RESULTS: We identified three key phases of the cognitive assessment process and themes pertaining to each phase. The phases (numbered) and themes (lettered) were as follows: (1) before the cognitive assessment: (A) lack of explanation, (B) considering the assessment useless; (2) during the cognitive assessment: varied emotional responses, moderated by (D) perception of the purpose behind cognitive assessment, (E) perception of cognitive impairment, (F) confidence in cognitive abilities, (G) assessment administration style and (3) after the cognitive assessment: (H) feedback can impact self-confidence and self-efficacy, (I) vague feedback and clinical jargon are unhelpful. CONCLUSIONS: Stroke survivors require clear explanations about the purpose and outcomes of poststroke cognitive assessments, including constructive feedback, to promote engagement with the process and protect their psychological wellbeing.
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spelling pubmed-103145712023-07-02 Cognitive assessment after stroke: A qualitative study of patients’ experiences Hobden, Georgina Tang, Eugene Demeyere, Nele BMJ Open Neurology OBJECTIVES: Clinical guidelines recommend early cognitive assessment after stroke to inform rehabilitation and discharge decisions. However, little is known about stroke survivors’ experiences of the cognitive assessment process. This qualitative study aimed to explore patients’ experiences of poststroke cognitive assessments. DESIGN: Stroke survivors were purposively sampled in an iterative process through a pool of research volunteers who had previously taken part in the Oxford Cognitive Screen Recovery study. Stroke survivors and their family caregivers were invited to participate in a semistructured interview steered by a topic guide. Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Demographic, clinical and cognitive data were acquired from patients’ previous research data. SETTING: Stroke survivors were originally recruited from the acute inpatient unit at Oxford University Hospital (John Radcliffe), UK. Participants were interviewed after discharge either at their homes or via telephone or videocall. PARTICIPANTS: Twenty-six stroke survivors and eleven caregivers participated in semi-structured interviews. RESULTS: We identified three key phases of the cognitive assessment process and themes pertaining to each phase. The phases (numbered) and themes (lettered) were as follows: (1) before the cognitive assessment: (A) lack of explanation, (B) considering the assessment useless; (2) during the cognitive assessment: varied emotional responses, moderated by (D) perception of the purpose behind cognitive assessment, (E) perception of cognitive impairment, (F) confidence in cognitive abilities, (G) assessment administration style and (3) after the cognitive assessment: (H) feedback can impact self-confidence and self-efficacy, (I) vague feedback and clinical jargon are unhelpful. CONCLUSIONS: Stroke survivors require clear explanations about the purpose and outcomes of poststroke cognitive assessments, including constructive feedback, to promote engagement with the process and protect their psychological wellbeing. BMJ Publishing Group 2023-06-29 /pmc/articles/PMC10314571/ /pubmed/37385749 http://dx.doi.org/10.1136/bmjopen-2023-072501 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Neurology
Hobden, Georgina
Tang, Eugene
Demeyere, Nele
Cognitive assessment after stroke: A qualitative study of patients’ experiences
title Cognitive assessment after stroke: A qualitative study of patients’ experiences
title_full Cognitive assessment after stroke: A qualitative study of patients’ experiences
title_fullStr Cognitive assessment after stroke: A qualitative study of patients’ experiences
title_full_unstemmed Cognitive assessment after stroke: A qualitative study of patients’ experiences
title_short Cognitive assessment after stroke: A qualitative study of patients’ experiences
title_sort cognitive assessment after stroke: a qualitative study of patients’ experiences
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314571/
https://www.ncbi.nlm.nih.gov/pubmed/37385749
http://dx.doi.org/10.1136/bmjopen-2023-072501
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