Satisfaction with stroke care among dementia patients with stroke: A Swedish register study

Abstract

AbstractBackgroundPrevious studies showed that patient satisfaction with stroke care relates to age, care demands, functioning, mood, quality of life, and self‐rated health. Dementia and stroke are frequent comorbidities. It is still unknown how satisfied dementia patients are with stroke care compared to non‐dementia patients. Our study aimed to compare the satisfaction with stroke care between dementia and non‐dementia patients.MethodsIn this longitudinal observational registry study, 5,932 dementia patients (2007‐2017) who suffered a first stroke after dementia diagnosis were compared with 39,457 non‐dementia stroke patients (2007‐2017). Data on stroke was obtained through the Swedish Stroke Register (Riksstroke), linked to the Swedish Dementia Registry (SveDem), the Swedish National Patient Register and the Swedish Prescribed Drug Register. Questionnaires were completed by patients themselves, patients with the help of caregivers, patients’ family, or healthcare staffs on behalf of the patient three months after stroke. Outcomes comprised satisfaction with acute stroke care at hospital, inpatient rehabilitation, outpatient rehabilitation, healthcare staff’s attitude, communication with doctors and stroke information.ResultsCompared to non‐dementia patients, dementia patients who answered the questionnaire themselves reported lower odds of satisfaction with acute stroke care at hospital 0.72 (0.61 – 0.87), healthcare staff’s attitude 0.80 (0.67 – 0.97), communication with doctors 0.80 (0.68 – 0.95 ), and stroke information 0.63 (0.53 – 0.76); but not regarding inpatient rehabilitation 0.95 (0.77 – 1.19), or outpatient rehabilitation 0.96 (0.76 ‐1.23). When patients answered the questionnaire with the help of their caregivers, dementia patients reported significantly lower satisfaction for all items. Differences between dementia and non‐dementia patients disappeared in proxy‐reported satisfaction, except for family‐reported satisfaction with outpatient rehabilitation and stroke information, which was significantly lower in dementia group.ConclusionLower satisfaction in the dementia group is a sign of unfulfilled care needs among dementia patients. Further studies on the provision of stroke care for dementia patients and their care demands should be performed.