Background Stroke is often associated with long term morbidity and increased mortality risks of up to 30% within the first year.1 Advance Care Planning (ACP) has a role in ensuring good delivery of care by considering one’s values and preferences. In Asian cultures, it may be considered taboo to talk about end-of-life (EoL) issues, especially among the elderly. The objective of this study is to examine the readiness and awareness of ACP and demand for ACP referrals in a cohort of Asian stroke patients admitted to a rehabilitation centre.
Methods A single centre cross-sectional face to face structured interview conducted in a tertiary stroke rehabilitation centre in Singapore. Data collected on demographics, severity of stroke, functional status, health perception, awareness and keenness for ACP is obtained.
Results From June 2022 to Dec 2022, a total of 304 patients were screened and 41 patients were recruited of the 41 recruited participants, only 36.6% (n=15) are aware of ACP or other EoL directives. There are no significant association between ACP awareness and age (p=0.508), different ethnicity (p=0.225), education level (p=0.071), employment status (p=0.322), previous hospitalisation (p=0.393), and functional status (p=0.819). Despite this, 82.9% (n=34) are keen for further information, and 80.5% (n=33) are keen for an ACP referral.
Conclusions In this cohort of Asian stroke patients, there is a clear lack of awareness of ACP. What is encouraging though, is that the majority of stroke survivors are keen for further ACP discussion. As such, we propose that ACP discussion should be initiated in stroke patients admitted to rehabilitation. Furthermore, the extended inpatient stay required for rehabilitation (in our centre, the average rehabilitation length of stay is 1 month) allows for establishment of rapport and trust between the patient and rehabilitation which are important for honest and frank discussions of ACP.
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