Abstract 149: Identifying the Psychosocial Needs of New Stroke Patients: A Retrospective Chart Review of Stroke Patients with Previous Psychiatric Diagnosis

Abstract

Introduction: The patient experience for a newly diagnosed stroke patient can be psychologically devastating. Limited research exists on stroke patients with pre-existing psychiatric conditions, including implications on quality of life, outcomes, readmissions, compliance and utilization of resources. The majority of the research focuses on depression post stroke diagnosis or discharge. Stroke patients are known to be vulnerable to psychological issues after a stroke diagnosis. However, we are limited in understanding how the hospital experience is for new stroke patients with preexisting psychiatric illness including: whether or not sufficient support is being provided during their hospital admission; is the underlying psychiatric illness preventing them from meeting functional milestones; and are they prepared for discharge? Methods: The study design is a retrospective chart review of newly diagnosed stroke patients with a previous psychiatric diagnosis admitted between January to June 2018. Data on sociodemographic, disease, treatment, assessment and utilization of resources were collected in a retrospective chart tool. Psychiatric variables were collected from consultation and progress notes dictated by psychiatry, social work, care coordination and other care providers. Results: We reviewed forty-six charts that met the eligibility criteria. Gender was 56.5% female/43.5% male; average age 72 (age range 41-100) and average length of stay 9 days. Of these patients 39.1% had two or more psychiatric diagnoses. Common psychiatric diagnoses were anxiety (50%), depression (39.1%), “Other” was schizophrenia, bipolar disorder and delirium. Higher rates of substance use, distress, current family conflict and no social support or caregiver concerns were found in this subset of stroke patients. Conclusion: Data from this study provides a glance at the psychosocial issues new stroke patients with previous psychiatric history experience. Areas for further research in the realm of education, psychosocial support and distress screening are needed. Results can be used as a foundation for developing and/or refining hospital assessments and may assist those in planning services and resources needed for stroke survivors.