Neurology, OLVG, Amsterdam, The Netherlands
Neurology, OLVG, Amsterdam, The Netherlands.
BMJ Open. 2021 Aug 12;11(8):e046316. doi: 10.1136/bmjopen-2020-046316.
After stroke, many patients experience cognitive and/or emotional problems. While national guidelines recommend screening for these problems, actual screening rates might be limited.
This study aimed to examine the clinical practice at neurology departments regarding screening, information provision and follow-up care for cognitive and emotional problems after transient ischaemic attack (TIA) and ischaemic stroke.
A nationwide, cross-sectional, online survey was conducted between October 2018 and October 2019 among neurologists in all hospitals in the Netherlands.
Neurologists in 78 hospitals were invited to join the survey, and 52 (67%) of them completed it. Thirty-one (59%) neurologists reported that screening for cognitive problems after TIA and ischaemic stroke was mostly or always performed. When cognitive screening was performed, 42 (84%) used validated screening instruments. Twenty-nine (56%) of the respondents reported that screening for emotional problems was mostly or always performed. When emotional screening was performed, 31 (63%) reported using validated screening instruments. Timing of screening and information provision was highly variable, and the majority reported that there was no protocol for follow-up care when cognitive or emotional problems were found.
This study demonstrates that clinical practice at neurology departments is highly variable regarding screening, information provision and follow-up care for cognitive and emotional problems in patients after TIA or ischaemic stroke. Approximately half of the participating neurologists reported that screening was performed only sometimes or never for cognitive and emotional problems after TIA and ischaemic stroke.
中风后，许多患者会出现认知和/或情绪问题。尽管国家指南建议对这些问题进行筛查，但实际筛查率可能有限。
本研究旨在检查神经内科在短暂性脑缺血发作（TIA）和缺血性中风后对认知和情绪问题进行筛查、提供信息和随访护理的临床实践情况。
2018 年 10 月至 2019 年 10 月期间，在荷兰所有医院的神经内科医生中进行了一项全国性的、横断面的、在线调查。
邀请 78 家医院的神经内科医生参加调查，其中 52 名（67%）完成了调查。31 名（59%）神经内科医生报告说，对 TIA 和缺血性中风后的认知问题进行筛查主要或总是进行。当进行认知筛查时，42 名（84%）使用了经过验证的筛查工具。29 名（56%）的受访者报告说，主要或总是进行情绪问题的筛查。当进行情绪筛查时，31 名（63%）报告使用了经过验证的筛查工具。筛查和信息提供的时间差异很大，大多数医生报告说，当发现认知或情绪问题时，没有跟进护理的方案。
本研究表明，神经内科的临床实践在对 TIA 或缺血性中风后患者的认知和情绪问题进行筛查、提供信息和随访护理方面差异很大。大约一半的参与神经内科医生报告说，他们只是偶尔或从不对 TIA 和缺血性中风后的认知和情绪问题进行筛查。
