Ethical Concerns Caring for the Stroke Patient

Mahanes, Dea

doi:10.1016/j.cnc.2019.11.001

Cited by 6 publications

(5 citation statements)

References 49 publications

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Section: Goals-of-care Conversations: Determining Patients' Wishesmentioning

confidence: 99%

“…In the absence of ACPs, clinicians typically follow a prioritized list of relatives according to state law ( 71 ). When no surrogate is available, protocols may involve committees or judiciary involvement ( 71 ). Great variation exists in the use of these resources by clinicians who make decisions to limit life-sustaining treatment in the ICU, suggesting further work is needed to develop procedures in these cases ( 72 ).…”

Section: Goals-of-care Conversations: Determining Patients' Wishesmentioning

confidence: 99%

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End-of-Life Care Decision-Making in Stroke

2021

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Stroke is one of the leading causes of death and long-term disability in the United States. Though advances in interventions have improved patient survival after stroke, prognostication of long-term functional outcomes remains challenging, thereby complicating discussions of treatment goals. Stroke patients who require intensive care unit care often do not have the capacity themselves to participate in decision making processes, a fact that further complicates potential end-of-life care discussions after the immediate post-stroke period. Establishing clear, consistent communication with surrogates through shared decision-making represents best practice, as these surrogates face decisions regarding artificial nutrition, tracheostomy, code status changes, and withdrawal or withholding of life-sustaining therapies. Throughout decision-making, clinicians must be aware of a myriad of factors affecting both provider recommendations and surrogate concerns, such as cognitive biases. While decision aids have the potential to better frame these conversations within intensive care units, aids specific to goals-of-care decisions for stroke patients are currently lacking. This mini review highlights the difficulties in decision-making for critically ill ischemic stroke and intracerebral hemorrhage patients, beginning with limitations in current validated clinical scales and clinician subjectivity in prognostication. We outline processes for identifying patient preferences when possible and make recommendations for collaborating closely with surrogate decision-makers on end-of-life care decisions.

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Section: Goals-of-care Conversations: Determining Patients' Wishesmentioning

confidence: 99%

Section: Goals-of-care Conversations: Determining Patients' Wishesmentioning

confidence: 99%

End-of-Life Care Decision-Making in Stroke

2021

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“…In the past, when evaluating the effectiveness of complex signage in underground tunnels from the perspective of ergonomics, scholars mostly focused on the visual characteristics, cognitive load, or certain individual elements of the driving behavior of drivers [11][12][13][14][15] . There has been a lack of a comprehensive and effective evaluation of driver characteristics and their cognitive response throughout the entire process of interacting with signs.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of apparent effectiveness of safety sign group in underground cavern construction

Zeng,

Chen,

2024

Fourth International Conference on Smart City Engineering and Public Transportation (SCEPT 2024)

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“…Moreover, communication is another element in the professional-patient relationship [ 13 ], which facilitates treatment efficacy [ 14 ] and improves patient satisfaction [ 15 ]. In the case of stroke patients, communication between trained professionals and patients promotes shared decision making and prevents ethical conflicts [ 16 ]. Finally, the participation of patients facilitates their adherence to treatment, improves the perceived quality of care, and facilitates shared decision making with professionals [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Professional Care Experience of Patients with Stroke: A Qualitative Study Using In-Depth Interviews

Martin-Sanz

Salazar-de-la-Guerra

Cuenca-Zaldívar

et al. 2022

International Journal of Integrated Care

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Background: Professional support and communication stimulates the professionalpatient relationship and supports the recovery of stroke patients. Objectives:To describe the perspectives of patients with stroke regarding communication, professional support, and their ability to participate in processes and integrated care with health providers.Methods: A qualitative study was conducted. A purposeful sampling and snowballtechnique were used. Patients diagnosed with moderate or severe stroke in the postacute or chronic stage of the disease were included. Data collection consisted of indepth interviews and researcher field notes. A thematic analysis was performed.Results: Thirty-one patients were included. Three themes were identified: 1) Providing support, with four categories, professional behavior, personalized attention, the heart of the professional and building a bond with the patient; 2) Facilitating communication, with three categories, the patient as the recipient, the content of the message and the channel, and the professional as the person that conveys the message; and 3) Promoting participation, with two categories, barriers, and incentives to participate. Conclusions:When providing support, professionals should consider communicating information and encouraging the participation of stroke patients for integrated care.

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Ethical Concerns Caring for the Stroke Patient

Cited by 6 publications

References 49 publications

End-of-Life Care Decision-Making in Stroke

End-of-Life Care Decision-Making in Stroke

Evaluation of apparent effectiveness of safety sign group in underground cavern construction

Understanding the Professional Care Experience of Patients with Stroke: A Qualitative Study Using In-Depth Interviews

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