In the acute care setting, stroke patients often experience intense physical and emotional distress, including severe pain, anxiety, and a host of other symptoms. Palliative care focuses on improving the quality of life for both patients and their families by managing such distressing symptoms, providing psychological support, and assisting in complex decision-making. Routine integration of palliative care in stroke management can be beneficial as it allows for early identification and alleviation of suffering, thereby improving patient satisfaction and outcomes. This interdisciplinary approach adds another layer of support, complementing the often aggressive interventions aimed at neurological restoration. It facilitates open communication among patients, families, and medical teams, and helps guide informed decisions about treatments and end-of-life care when needed. In sum, integrating palliative care routinely into acute stroke care can provide a more holistic and compassionate approach to patient management.
References
2023
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Evaluating the Effectiveness of the SPIKES Model to Break Bad News - A Systematic Review.
Meera Mahendiran, Herman Yeung, Samantha Rossi, Houman Khosravani, and Giulia-Anna Perri
The American journal of hospice & palliative care, 2023
Introduction: Breaking bad news to patients and families can be challenging for healthcare providers. The present study conducted a systematic review of the literature to determine if formal communication training using the SPIKES protocol improves learner satisfaction, knowledge, performance, or system outcomes. Method: MEDLINE, Embase, CINAHL Plus (Nursing & Allied Health Sciences), and PsycINFO Databases were searched with keywords BAD NEWS and SPIKES. Studies were required to have an intervention using the SPIKES model and an outcome that addressed at least one of the four domains of the Kirkpatrick model for evaluating training effectiveness. The Cochrane Risk of Bias Tool was used to conduct a risk of bias assessment. Due to heterogeneity in the interventions and outcomes, meta-analysis was not undertaken and instead, a narrative synthesis was used with the information provided in the tables to summarise the main findings of the included studies. Results: Of 622 studies screened, 37 publications met the inclusion criteria. Interventions ranged from the use of didactic lecture, role play with standardised patients (SPs), video use, debriefing sessions, and computer simulations. Evaluation tools ranged from pre and post intervention questionnaires, OSCE performance with rating by independent raters and SPs, and reflective essay writing. Conclusions: Our systematic review demonstrated that the SPIKES protocol is associated with improved learner satisfaction, knowledge and performance. None of the studies in our review examined system outcomes. As such, further educational development and research is needed to evaluate the impact of patient outcomes, including the optimal components and length of intervention.
2022
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Attitudes of Canadian stroke physicians regarding palliative care for patients with acute severe stroke: A national survey.
Houman Khosravani, Meera Mahendiran, Sandra Gardner, Camilla Zimmermann, and Giulia-Anna Perri
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022
Palliative care (PC) aims to enhance the quality of life for patients and their families when confronted with serious illness. As stroke continues to inflict high morbidity and mortality, the integration of palliative care within acute stroke care remains an important aspect of quality inpatient care.
2021
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Team debriefs during the COVID-19 pandemic in long-term care homes: Essential elements
Giulia-Anna Perri, Warren Harris Lewin, and Houman Khosravani
Canadian Family Physician, 2021