Background
Palliative care in the context of life-threatening stroke is strongly recommended throughout international clinical practice guidelines (Braun et al, 2016). Palliative care is well established in diseases such as cancer yet evidence to support the complex enormous palliative care needs of patients with life-threatening stroke and their families is scant. There is an urgent need for research in this area.
Aims
This systematic review aimed to examine the evidence of quantitative studies for palliative care stroke patients and families
Methods
A systematic search of bibliographic databases was conducted including; CINAHL, Medline, Embase, Ovid, Proquest and Scopus for quantitative studies published between 1989 and November 2019 including hand searching of included article reference lists. Reporting original quantitative studies focusing on stroke and palliative care patients and/or their carer. Study quality was appraised by three independent researchers using the Covidence platform and an established checklist.
Results
An initial search yielded 1031 citations with a total of 28 included studies were included. Synthesis of the main domains identified four key elements: (1) Trajectory mapping: (characteristics and predictors); (2) Palliative care consultation, needs and timing; (3) Communication, shared decisions and advanced care directives; (4) Symptoms and supportive care.
Implication for practice
There is a need for high quality intervention research to inform the best evidence based care for patients with life-threatening stroke and their families.
Conclusion
There is a paucity of high quality evidence for palliative care in the context of stroke. Whilst there is international guideline recommendations on the importance of palliative care in life-threatening stroke research included in this review demonstrates low levels of evidence. There is an urgent need to generate new evidence to support palliative care in stroke.