ABSTRACT

Spatial neglect has profound implications for quality of life after stroke, yet we lack consensus for screening/diagnosing this heterogeneous syndrome. Our first step in a multi-stage research programme aimed to determine which neglect tests are used (within four categories: cognitive, functional, neurological and neuroimaging/neuromodulation), by which stroke clinicians, in which countries, and whether choice is by professional autonomy or institutional policy. 454 clinicians responded to an online survey: 12 professions (e.g., 39% were occupational therapists) from 33 countries (e.g., 38% from the UK). Multifactorial logistic regression suggested inter-professional differences but fewer differences between countries (Italy was an outlier). Cognitive tests were used by 82% (particularly by psychologists, cancellation and drawing were most popular); 80% used functional assessments (physiotherapists were most likely). 20% (mainly physicians, from Italy) used neuroimaging/ neuromodulation. Professionals largely reported clinical autonomy in their choices. Respondents agreed on the need for a combined approach to screening and further training. This study raises awareness of the translation gap between theory and practice. These findings lay an important foundation to subsequent collaborative action between clinicians, researchers and stroke survivors to reach consensus on screening and diagnostic measures. The immediate next step is a review of the measures’ psychometric properties.

摘要

空间忽视对中风后的生活质量具有深远的影响，但我们对筛查/诊断这种异质综合征缺乏共识。我们在多阶段研究计划中的第一步旨在确定使用哪些忽视测试（在四个类别中：认知、功能、神经和神经影像学/神经调节）、哪些中风临床医生、在哪些国家以及是否由专业自主选择或体制政策。454 名临床医生回答了一项在线调查：来自 33 个国家（例如，38% 来自英国）的 12 个职业（例如，39% 是职业治疗师）。多因素逻辑回归表明专业间存在差异，但国家之间的差异较小（意大利是一个异常值）。82% 的人使用了认知测试（尤其是心理学家，取消和绘图最受欢迎）；80% 使用功能评估（最有可能是物理治疗师）。20%（主要是来自意大利的医生）使用神经影像学/神经调节。专业人士在很大程度上报告了他们选择的临床自主权。受访者同意需要采用综合方法进行筛查和进一步培训。这项研究提高了人们对理论与实践之间翻译差距的认识。这些发现为随后临床医生、研究人员和中风幸存者之间的协作行动以就筛查和诊断措施达成共识奠定了重要基础。紧接着的下一步是审查这些措施的心理测量特性。专业人士在很大程度上报告了他们选择的临床自主权。受访者同意需要采用综合方法进行筛查和进一步培训。这项研究提高了人们对理论与实践之间翻译差距的认识。这些发现为随后临床医生、研究人员和中风幸存者之间的协作行动以就筛查和诊断措施达成共识奠定了重要基础。紧接着的下一步是审查这些措施的心理测量特性。专业人士在很大程度上报告了他们选择的临床自主权。受访者同意需要采用综合方法进行筛查和进一步培训。这项研究提高了人们对理论与实践之间翻译差距的认识。这些发现为随后临床医生、研究人员和中风幸存者之间的协作行动以就筛查和诊断措施达成共识奠定了重要基础。紧接着的下一步是审查这些措施的心理测量特性。研究人员和中风幸存者就筛查和诊断措施达成共识。紧接着的下一步是审查这些措施的心理测量特性。研究人员和中风幸存者就筛查和诊断措施达成共识。紧接着的下一步是审查这些措施的心理测量特性。