London, United Kingdom 2013 Poster Session Nurses/AHP’s Cerebrovasc Dis 2013; 35 (suppl 3)1-854 217 2041 Stroke care problems Ageism and sexism in care and rehabilitation of Danish stroke patients: a thing of the past. A nation-wide Danish quality control study of 93 931 stroke patients M. Lehmkuhl1, G. Walløe2, C. Dehlendorff3, T.S. Olsen4 The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK1, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK2, Danish Cancer Society Re-search Center, Copenhagen, DENMARK3, The Stroke Unit, Frederiksberg University Hospital, Frederiksberg, DENMARK4 Background: Ageism and sexism in rehabilitation/care of stroke patients are still being reported. This has contributed to an increased focus on rehabilitation/care in stroke and establishment of a Danish nationwide stroke register in 2003 with the aim of monitoring quality of stroke care/rehabil-itation. We studied relations between age and sex and indicators of quality in stroke care/rehabilita-tion. Methods: A registry of all hospitalized stroke patients in Denmark included 93 931 patients with evaluations of age, sex, civil status, residence, stroke severity (Scandinavian Stroke Scale (SSS) 0-58), computed tomography and cardiovascular risk. We studied the independent association be-tween sex and age and fulfillment of quality-of-care criteria of physiotherapy (PT), occupational therapy (OC) and nursing care (NC) (in regard to dysphagia/nutrition) set by the National Board of Health i.e. assessment within 2 days from admission. Analyses were based on logistic regression modeling. Results: Mean age 72.0 years, 48% women, mean SSS 41.5. PT: no significant relation between timely assessment and sex (OR 1.03; CI 0.94-1.13); timely assessment increased significantly as age increased (OR 1.19; CI 1.05-1.36). OC: no significant relation between timely assessment and sex (OR 1.03; CI 0.94-1.12) and age (OR 1.03; CI 0.91-1.16). NC (dysphagia): no significant relation between timely assessment and sex (OR 0.96; CI 0.86-1.07), and age (OR 0.91; CI 0.78-1.06). NC (nutrition): no significant relation between timely assessment and sex (OR 0.99, CI 0.94-1.05); time-ly assessment decreased significantly as age increased (OR 0.86; CI 0.80-0.93). Conclusion: Monitoring of quality of stroke care/rehabilitation in Denmark revealed no evidence of sexism. There was an inverse relation between age and assessment of nutritional status but no asso-ciation regarding PT, OC and dysphasia indicating that ageism is being a thing of the past in care/ rehabilitation of stroke patients in Denmark. 2042 Stroke care problems Facilitators and barriers to undertaking a Constraint Induced Movement Therapy (CIMT) protocol in sub-acute stroke: a synthesis of the literature K.A. Jarvis1, S.M. Hunter2, N.M.J. Edelstyn3 University of Liverpool, Liverpool, UNITED KINGDOM1, Keele University, Keele, UNITED KINGDOM2, Keele University, Keele, UNITED KINGDOM3 Background Quantitative systematic reviews indicate that, for a sub-group of stroke survivors, Constraint In-duced Movement Therapy (CIMT) is effective in increasing function in the contralesional upper limb. However, CIMT is not routinely provided. Therefore, there is a need to understand the issues that might facilitate or deter use of CIMT. Objective: To synthesise the reported facilitators and barriers to undertaking CIMT in sub-acute stroke, as perceived by therapists and stroke survivors. Method A systematic search was conducted using keywords: stroke, cerebrovascular accident, constraint induced movement therapy, constraint induced therapy, forced use, upper limb, upper extremity, in MEDLINE, CINAHL, SCOPUS, AMED and PsycINFO databases. All studies reporting relevant qualitative data were included. Two researchers independently selected studies and assessed meth-odological quality of the included studies. Data were analysed using thematic content analysis. Results Ten studies were included. All studies were predominately quantitative in design; the qualitative findings were not underpinned with an appropriate theoretical perspective or study design. Three themes emerged: satisfaction in provision of the CIMT protocol, impact on functional tasks and po-tential risks. Conclusions about the facilitators and barriers to undertaking CIMT in sub-acute stroke were not possible, due to the poor methodological quality, and the limited amount of qualitative evi-dence. Conclusion There is very limited qualitative evidence about this complex intervention. To further the implemen-tation of CIMT, additional qualitative studies are required. Future studies should have a clear theo-retical perspective, follow an established qualitative study design and take measures to ensure over-all rigour and trustworthiness.
Karger_ESC London_2013
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