Implicit bias in stroke care: A recurring old problem in the rising incidence of young stroke

Bhat, A.; Mahajan, Vipul; Wolfe, Nigel

doi:10.1016/j.jocn.2020.12.017

Cited by 11 publications

(13 citation statements)

References 62 publications

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“…Newman-Toker et al ( 74 ) found that adult patients under the age of 44 were seven times more likely to be misdiagnosed following stroke when compared to patients over the age of 75. Bhat et al ( 75 ) have highlighted the role of “implicit bias” within clinicians in contributing to stroke misdiagnosis in younger survivors, believed to be a result of the way clinicians are taught to recognize stroke through identifying classical symptoms, signs and patient risk profiles. This can reinforce the idea of a “stereotypic presentation” of stroke through pattern recognition; resulting in those who do not meet these criteria being at increased risk of misdiagnosis ( 75 ) (p. 30).…”

Section: Discussionmentioning

confidence: 99%

“…Bhat et al ( 75 ) have highlighted the role of “implicit bias” within clinicians in contributing to stroke misdiagnosis in younger survivors, believed to be a result of the way clinicians are taught to recognize stroke through identifying classical symptoms, signs and patient risk profiles. This can reinforce the idea of a “stereotypic presentation” of stroke through pattern recognition; resulting in those who do not meet these criteria being at increased risk of misdiagnosis ( 75 ) (p. 30). This profiling extends beyond age and can include a variety of criteria such as gender, typical stroke symptoms or traditional risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

Hall

Kroll

Wijck

et al. 2022

Front. Rehabilit. Sci.

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BackgroundStroke survivor narratives can provide valuable insight into experiences of healthcare and beyond. There is need to further understand collective lessons from stroke survivor narratives, yet prior studies utilizing digital storytelling tend to not synthesize lessons from individual experiences. This study aims to develop a novel method to co-create digital stories with stroke survivors that will aim to synthesize and portray important collective lessons from individual stroke survivors' experiences of interacting with healthcare professionals.MethodsThis study follows-up a qualitative study conducted with 30 stroke survivors exploring factors that help or hinder survivors to positively reconfigure their identity post-stroke. Five co-creation workshops were conducted with a subset of UK-based stroke survivors from this previous study. Participants were invited to join through: online workshops, an online bulletin board, and as an advisor. A four-stage workshop framework was developed through the integration of UK Design Council's Double Diamond method, digital storytelling strategies and the Behavior Change Wheel (BCW) framework for developing behavioral change interventions.FindingsSix online workshop participants (three male, three female; aged 33–63; time since stroke 2–16 years) co-created digital stories that share six collective lessons aimed at increasing empathy and encouraging behavior change in healthcare professionals (HCPs) working with stroke survivors. Online bulletin board participants (n = 1) and advisors (n = 5) supported the co-creation process. Collective lessons identified were: (1) Stroke has a variety of symptoms that must all be considered; (2) Stroke can affect anyone of any age and not just the elderly; (3) Assumptions should not be made about a survivor's lifestyle or habits; (4) It is important to acknowledge the person behind the stroke and ensure that they are communicated with and listened to; (5) Stroke survivors can often feel unprepared for the reality of life after stroke; (6) Adapting to life after stroke is a long-term process requiring long-term support.ConclusionStroke survivor stories highlighted preconceptions, attitudes and behaviors embedded within healthcare that negatively impacted their experiences and recovery. The novel methodology employed in this study enabled these stories to be synthesized into collective lessons to bring about improvements in these behaviors in future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

Hall

Kroll

Wijck

et al. 2022

Front. Rehabilit. Sci.

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“…Conversely, the intuition decision-making process can also be hypothesised as an explicit and implicit decision-making style (Tabesh and Vera, 2020), where explicit decision utilises feelings or emotion and implicit decisions refer to the experience of the relevant situation (Bhat et al ., 2021; Remmers et al ., 2016). Moreover, intuitive decision-making styles also utilise the subconscious processing of verbalised and nonverbalised facts or information (Tabesh and Vera, 2020).…”

Section: Strategic Managementmentioning

confidence: 99%

A strategic management process: the role of decision-making style and organisational performance

Sinnaiah

Adam

Mahadi

2023

JWAM

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PurposeThe purpose of this paper is to present a conceptual framework for integrating strategic thinking factors, organisational performance and the decision-making process.Design/methodology/approachThe methodology involves a synthesis of literature and proposes a framework that explores the relationship between strategic thinking enabling factors, organisational performance and the moderating effect of decision-making styles.FindingsThe framework includes strategic thinking enabling factors (systems perspective, focused intent, intelligent opportunism, thinking in time and hypothesis-driven analysis), organisational performance and the moderating effect of decision-making styles (intuitive and rational).Research limitations/implicationsThis research results in a conceptual model only; it remains to be tested in actual practice. The expanded conceptual framework can serve as a basis for future empirical research and provide insights to practitioners on how to strengthen policy development in a strategic planning process.Originality/valueA paradigm shift in the literature proves that strategic management and decision-making styles are vital in determining organisational performance. This paper highlights the importance of decision-making styles and develops a framework for strategic management by analysing the existing strategic management literature.

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“…Over the last two decades, the incidence of stroke in young people (< 65 years of age) has increased by 25%, with 10 to 14% of all strokes observed in people younger than 50 years of age [1,3]. Despite the increasing incidence of strokes in young people, stroke continues to be more prevalent in older individuals meaning the prevention, diagnosis, treatment, rehabilitation, and management of strokes continues to primarily accommodate older, rather than younger individuals [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Public health campaigns are aimed at reducing risk factors for stroke more commonly associated with stroke in those over 65 years of age, particularly modi able risk factors such as hypertension, hyperlipidaemia, and smoking [1,3]. They are also aimed at reducing the impact of stroke through symptom recognition and early intervention, of which the FAST acronym is an example (facial drooping, arm weakness, or speech di culties should instigate a timely response re ecting a medical emergency) [4]. The success of these campaigns and overall interventions are not as effective in younger stroke survivors as they are for older people.…”

Section: Introductionmentioning

confidence: 99%

The experience of young stroke survivors: An interpretative phenomenological study

Thompson

Moss

Hooper

et al. 2023

Preprint

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Background: While stroke is becoming increasingly prevalent in young people (<65 years), diagnosis, treatment, rehabilitation, and management continue to reflect the needs of older people. Health services are not accommodating young stroke survivors' distinct needs, trajectories, preferences, and risk factors. Objectives: The purpose of this study was to characterise and appreciate the experience of young stroke survivors. Methods: Qualitative in-depth semi-structured interviews were conducted with 11 stroke survivors aged between 18 and 49 (via virtual conferencing software). Interview data were analysed using interpretative phenomenological analysis. Results: Young stroke survivors experience a sense of alienation when healthcare providers imply their stroke is an anomaly and are surrounded by elderly patients in stroke units. Alienation and additional emotional concerns, coupled with memory and communication difficulties, compromised survivors’ sense of agency. Many participants also developed and exhibited resilience, gratitude, and acceptance, preserving their mental health. Conclusions: The experience of young stroke survivors is distinct. By considering the unique trajectory of young stroke survivors, health services will be better able to facilitate the rehabilitation of this population.

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Implicit bias in stroke care: A recurring old problem in the rising incidence of young stroke

Cited by 11 publications

References 62 publications

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

A strategic management process: the role of decision-making style and organisational performance

The experience of young stroke survivors: An interpretative phenomenological study

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