The Treatment of Stroke: King's Fund Forum - Consensus Conference.

The Treatment of Stroke: King's Fund Forum--Consensus Conference

Mead J (Chartered Society of Physiotherapy, London, England), Physiotherapy 74:358-359, 1988

This article is a summary of the full consensus statement on the treatment of stroke, King's Fund Forum, held in London in June 1988; the full consensus statement was published in the British Medical Journal (297:126-128, 1988).

A panel of 12 listened to evidence from 16 experts and an audience of professional health personnel and patients. A report was compiled, and a statement was then presented at a press conference. The conference participants were reminded that there are at any one time about 1,500 survivors of stroke in a typical health district and that cardiovascular accidents will continue to remain an important cause of suffering in the future. Agreement was that services for patients who have had a cerebrovascular accident (CVA) were haphazard and that a lack of convincing data exist on the effectiveness of medical, psychological, and specific rehabilitative treatments.

This article included 21 recommendations on the care of patients who have had CVAs in the health districts of the United Kingdom. Generally, these suggestions concerned the monitoring and supervision of care; assessment and treatment; reassessment; complex psychosocial dynamics among involved individuals; delivery of care; standards of practice; specific professional responsibilities; interdisciplinary cooperation, communication, and support; communication of patients and care givers; education of staff, the public, and the patient; preparation in research methodology; and research in patient care. Costs of care components and access to research funds and resources also were covered.

Specific references were made to the following: 1) misunderstandings and rivalries among professionals; 2) breakdown of communication among professionals, patients, and care givers; 3) insufficient appreciation of the impact of disease on the patient's family; 4) ill-prepared and unplanned discharge to home; 5) serious shortage in health services; 6) long periods of time during which the patient is unoccupied; 7) ill-considered hospital admission; 8) failure to recognize and respond to mood disturbances in patients; 9) delegation of care to inadequately trained medical staff; and 10) confusion caused by the participation of too many people. According to the article, although the cost of better patient services will increase, the fees could be offset by concentrating existing resources, avoiding unnecessary investigations and ineffective treatment, and establishing monitoring standards. The report stated that there are opportunities for physical therapists. Most important, therapists must clearly demonstrate the value of their techniques, before credibility to other colleagues and the community is lost. The author stated that physical therapists working with patients who have had CVAs must take up the challenge; there has never been a better time to undertake this work.