title: Provision of palliative and end-of-life care in stroke units: a qualitative study.
abstract: BACKGROUND
  Stroke is a leading cause of death; between 20% and 30% of people die within 30 days of a stroke. High-quality palliative and end-of-life care are advocated for patients not expected to recover from stroke.
  
  
  OBJECTIVE
  To explore the perspectives of health professionals regarding the provision of palliative and end-of-life care in UK stroke units.
  
  
  METHODS
  Qualitative focus groups and individual interviews were held with 66 health professionals working in UK specialist stroke units. Data were analysed thematically.
  
  
  RESULTS
  Three themes emerged from the data. Palliative care was recognised as an important component of stroke care; however, there was uncertainty when initiating transitions to palliative care in stroke, and issues were identified with the integration of acute stroke care and palliative care.
  
  
  CONCLUSIONS
  The findings provide encouraging evidence that palliative and end-of-life care have been adopted as key components of specialist stroke care in UK stroke units. However, many patients stand to benefit from earlier identification of palliative care need and a consideration of quality-of-life approaches during active care. Encouraging collaboration and partnership when working with specialist palliative care services would optimise palliative care service delivery and may provide patients and their families with greater opportunities for documenting and achieving preferences for care and achieving a better quality of death.
authors.affiliation: School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Gardiner
authors.forename: Madeleine
authors.initials: M
authors.lastname: Harrison
authors.forename: Tony
authors.initials: T
authors.lastname: Ryan
authors.forename: Amanda
authors.initials: A
authors.lastname: Jones
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003266:Continuity of Patient Care / Q000592:standards*; D004739:England / Q000453:epidemiology; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006801:Humans; D033183:Interdisciplinary Communication; D008503:Medical Staff; D009740:Nursing Staff; D010166:Palliative Care / Q000458:organization & administration / Q000592:standards*; D036301:Qualitative Research; D020521:Stroke / Q000628:therapy*; D013727:Terminal Care / Q000458:organization & administration / Q000592:standards*
keywords: Stroke; end-of-life care; palliative care; palliative medicine; palliative treatment