Lanctôt Krista L, Lindsay M Patrice, Smith Eric E, Sahlas Demetrios J, Foley Norine, Gubitz Gord, Austin Melissa, Ball Kristyn, Bhogal Sanjit, Blake Treena, Herrmann Nathan, Hogan David, Khan Aisha, Longman Stewart, King Andrea, Leonard Carol, Shoniker Tricia, Taylor Trudy, Teed Moira, de Jong Andrea, Mountain Anita, Casaubon Leanne K, Dowlatshahi Dar, Swartz Richard H
Sunnybrook Research Institute, Toronto, Canada.
University of Toronto Faculty of Medicine, Toronto, Canada.
Int J Stroke. 2020 Aug;15(6):668-688. doi: 10.1177/1747493019847334. Epub 2019 Jun 21.
The 2019 update of the is a comprehensive set of evidence-based guidelines addressing three important issues that can negatively impact the lives of people who have had a stroke. These include post-stroke depression and anxiety, vascular cognitive impairment, and post-stroke fatigue. Following stroke, approximately 20% to 50% of all persons may be affected by at least one of these conditions. There may also be overlap between conditions, particularly fatigue and depression. If not recognized and treated in a timely matter, these conditions can lead to worse long-term outcomes. The theme of this edition of the CSBPR is which stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care to optimize recovery and outcomes. Accordingly, these recommendations place strong emphasis on the importance of timely screening and assessments, and timely and adequate initiation of treatment across care settings. Ideally, when screening is suggestive of a mood or cognition issue, patients and families should be referred for in-depth assessment by healthcare providers with expertise in these areas. As the complexity of patients treated for stroke increases, continuity of care and strong communication among healthcare professionals, and between members of the healthcare team and the patient and their family is an even bigger imperative, as stressed throughout the recommendations, as they are critical elements to ensure smooth transitions from acute care to active rehabilitation and reintegration into their community.
《2019年更新版》是一套全面的循证指南,涉及三个会对中风患者生活产生负面影响的重要问题。这些问题包括中风后抑郁和焦虑、血管性认知障碍以及中风后疲劳。中风后,约20%至50%的患者可能会受到至少其中一种情况的影响。这些情况之间也可能存在重叠,尤其是疲劳和抑郁。如果不能及时识别和治疗,这些情况会导致更差的长期预后。本版《加拿大中风最佳实践建议》的主题是“整合与协调”,强调了医疗系统内整合与协调的重要性,以确保及时、无缝的护理,从而优化康复和预后。因此,这些建议高度强调及时筛查和评估的重要性,以及在各个护理环节及时、充分地开始治疗。理想情况下,当筛查提示存在情绪或认知问题时,患者及其家属应被转介给在这些领域有专业知识的医疗服务提供者进行深入评估。随着中风治疗患者的复杂性增加,医疗专业人员之间以及医疗团队成员与患者及其家属之间的护理连续性和强有力的沟通变得更加迫切,正如整个建议中所强调的,因为它们是确保从急性护理顺利过渡到积极康复并重新融入社区的关键要素。