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- Sjöholm, Anna, et al.
(författare)
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Does evidence really matter? Professionals’ opinions on the practice of early mobilization after stroke
- 2011
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Ingår i: Journal of multidisciplinary health care. - 1178-2390. ; 2011:4, s. 367-376
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Early mobilization after stroke may be important for a good outcome and it is currently recommended in a range of international guidelines. The evidence base, however, is limited and clear definitions of what constitutes early mobilization are lacking. Aims: To explore stroke care professionals’ opinions about (1) when after stroke, first mobilization should take place, (2) whether early mobilization may affect patients’ final outcome, and (3) what level of evidence they require to be convinced that early mobilization is beneficial. Methods: A nine-item questionnaire was used to interview stroke care professionals during a conference in Sydney, Australia. Results: Among 202 professionals interviewed, 40% were in favor of mobilizing both ischemic and hemorrhagic stroke patients within 24 hours of stroke onset. There was no clear agreement about the optimal time point beyond 24 hours. Most professionals thought that patients’ final motor outcome (76%), cognitive outcome (57%), and risk of depression (75%) depends on being mobilized early. Only 19% required a large randomized controlled trial or a systematic review to be convinced of benefit. Conclusion: The spread in opinion reflects the absence of clear guidelines and knowledge in this important area of stroke recovery and rehabilitation, which suggests further research is required.
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| 2. |
- Skarin, Monica, et al.
(författare)
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'Better wear out sheets than shoes': a survey of 202 stroke professionals' early mobilisation practices and concerns
- 2011
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Ingår i: International Journal of Stroke. - 1747-4949. ; 6:1, s. 10-15
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Tidskriftsartikel (refereegranskat)abstract
- Background Stroke unit care improves the outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively. An ongoing randomised controlled trial is investigating the potential benefits of early mobilisation, but currently there is limited evidence for the practice. Therefore, current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study aims to examine different health professionals' concerns regarding early mobilisation in acute stroke. In this study, early mobilisation was defined as frequent out of bed activities within the first 24 h after stroke onset. Methods A nine-item anonymous questionnaire exploring benefits and harms with early mobilisation after stroke was used during interviews of stroke care professionals attending the annual Australasian stroke conference in 2008. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. Sixty-five per cent were females, 50% under 40-years old, 46% worked in acute stroke and 31% in rehabilitation. Thirty-five per cent were nurses, 26% medical doctors, 19% physiotherapists and 12% occupational therapists. Two-thirds had <10-years experience with stroke. Sixty per cent of the surveyed professionals had concerns about early mobilisation and there were significantly more professionals concerned about early mobilisation for haemorrhagic (59%) than ischaemic (23%) stroke patients. Conclusion Our study shows that most clinicians had concerns in relation to early mobilisation of stroke patients and more clinicians had concerns for haemorrhagic than for ischaemic stroke. The evidence underlying these concerns is shallow.
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