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Palliative care needs and specialist services post stroke: national population-based study
  1. Huiqin Liu1,2,
  2. Angus Cook3,
  3. Jinfeng Ding4,5,
  4. Hongwei Lu1,2,
  5. Jingjing Jiao4,
  6. Wenhui Bai6 and
  7. Claire E Johnson7
  1. 1 Health Management Center, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
  2. 2 Department of Cardiology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
  3. 3 School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
  4. 4 Xiangya School of Nursing, Central South University, Changsha, Hunan, China
  5. 5 Yale School of Internal Medicine, New Haven, Connecticut, USA
  6. 6 Department of Nursing, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China
  7. 7 AHSRI, University of Wollongong Faculty of Business, Wollongong, New South Wales, Australia
  1. Correspondence to Dr Jinfeng Ding, Central South University, Changsha, Hunan, 410017, China; jinfeng.ding{at}


Objectives (1) To compare palliative care needs of patients admitted primarily with stroke and (2) to determine how the care needs of these patients affect their use of different types of specialist palliative care services.

Methods Observational study based on point-of-care data from the Australian Palliative Care Outcomes Collaboration. Multivariate logistic regression models were used to explore the association between patients’ palliative care needs and use of community versus inpatient specialist palliative care services.

Results The majority of patients who had a stroke in this study population had mild or no symptom distress, but experienced a high degree of functional impairment and needed substantial help with basic tasks of daily living. A lower Australia-modified Karnofsky Performance Status score (OR=1.82, 95% CI 1.06 to 3.13) and occurrence of an ‘unstable’ palliative care phase (OR=28.34, 95% CI 9.03 to 88.94) were associated with use of inpatient versus community palliative care, but otherwise, no clear association was observed between the majority of symptoms and use of different care services.

Conclusions Many people with stroke could potentially have been cared for and could have experienced the terminal phases of their condition in a community setting if more community support services were available for their families.

  • Stroke
  • Terminal care
  • Symptoms and symptom management

Data availability statement

Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data may be obtained from a third party and are not publicly available.

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  • Contributors JD conceived the concept, developed the study design, led the data application from Palliative Care Outcomes Collaboration and conducted data analysis and interpretation. JD is also the author acting as the guarantor. H Liu drafted the manuscript. JD, AC, H Liu, H Lu, JJ, WB and CEJ critically reviewed and commented on the manuscript. All authors provided final approval for this submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.