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Knowledge, Attitude, Perception and Current Practices of Health Personnel in Managing Post-Stroke Delirium in a New Stroke Centre in Malaysia

Mohd Yosli HN, Hong W, Kazura K, Abdul Salim NH, Md Pauzi AL, Mat Din H, et al.

Malays J Med Sci, 2023 Aug;30(4):157-174.
PMID: 37655142 DOI: 10.21315/mjms2023.30.4.14

INTRODUCTION: Despite the high prevalence of post-stroke delirium in Malaysia, there are no studies on good practices related to its management. This study aimed to analyse the knowledge, attitude, perception, and factors associated with current practices related to delirium in acute stroke patients among health personnel at Hospital Sultan Abdul Aziz Shah (HSAAS) (formerly known as Hospital Pengajar Universiti Putra Malaysia).
METHODS: This cross-sectional study was conducted from 26 April 2021 to 9 May 2021 (17 weeks). All health personnel from various departments managing patients with acute stroke in our centre were invited to participate. An online questionnaire was disseminated to assess their knowledge, attitude, perception, and current practices concerning delirium. Multiple logistic regression was used to examine the association between the independent and dependent variables. The level of significance was set at P < 0.05.
RESULTS: The response rate was 22.49% (47 of 209 participants). More than half (61.7%, n = 29) had good current practices towards delirium in acute stroke patients. A significant association was found between knowledge and current practices related to delirium (P = 0.024). However, there was no significant association between current practices and sociodemographic factors (age, ethnicity, gender and job position), attitude, perceptions, screening barriers, or health service organisation.
CONCLUSION: Most respondents had good current practices and knowledge in managing post-stroke delirium. Therefore, upskilling health personnel for managing this illness is essential to ensure good post-stroke care and improve prognosis related to delirium.
Fulltext Video head impulse test in stroke: a review of published studies

Jaganathan N, Mohamed MH, Md Pauzi AL, Mahayidin H, Hanapai AF, Wan Sulaiman WA, et al.

Front Neurol, 2024;15:1339039.
PMID: 38497038 DOI: 10.3389/fneur.2024.1339039

Accurate and timely diagnosis of posterior circulation stroke in patients with acute dizziness is a challenge that can lead to misdiagnosis and significant harm. The present review sought to identify and describe published research on the clinical application of vHIT in posterior circulation stroke. vHIT, a portable device, has gained prominence in evaluating peripheral vestibular disorders and offers potential applications in diagnosing neurological disorders, particularly posterior circulation stroke. Several studies have shown that vHIT can differentiate between stroke and vestibular neuritis based on VOR gain values, with high sensitivity and specificity. The manuscript also discusses vHIT's performance in differentiating between types of posterior circulation stroke, such as PICA, AICA, and SCA strokes. While vHIT has demonstrated promise, the review emphasizes the need for further research to validate its use as a tool to rule out stroke in acute dizziness patients in the emergency department. In conclusion, the manuscript underscores the potential of vHIT as a valuable addition to the diagnostic arsenal for acute dizziness, particularly in the context of posterior circulation stroke. It calls for further research and wider adoption of vHIT in clinical settings to improve patient care and reduce unnecessary costs associated with misdiagnoses.
Fulltext On the rising potential of interdisciplinary rehabilitation in neurological disorders: A mini-review

Tomeh A, Yusof Khan AHK, Abu Zaid Z, Ling KH, Inche Mat LN, Basri H, et al.

Medicine (Baltimore), 2025 Mar 21;104(12):e41947.
PMID: 40128024 DOI: 10.1097/MD.0000000000041947

Collaboration among health and non-health professionals is growing exponentially as we approach the personalized medicine era, where the intervention plan is tailored according to the patient's needs. This collaboration aims to develop highly efficient, patient-centered, holistic approaches, rather than singular interventions. Interdisciplinary rehabilitation is a rising theme to coordinate the efforts of various professionals, with the ultimate goal of increasing rehabilitants' satisfaction and improving their overall quality of life. A typical rehabilitation team may comprise a rehabilitation physician, rehabilitation nurse, occupational therapist, physiotherapist, speech and language therapist, clinical psychologist, social worker, prosthetist, orthotist, rehabilitation engineer, and dietician. The need for inclusion of additional professions in the rehabilitation team is dynamic and varies depending on the population and health condition. Recently, various countries have begun incorporating interdisciplinary rehabilitation models into their healthcare frameworks. For example, the U.S. Veterans Affairs Polytrauma Rehabilitation Centers have set a precedent for integrating interdisciplinary approaches into neurological rehabilitation, while European nations such as Germany and Sweden have successfully implemented stroke and pain rehabilitation programs. Although interdisciplinary rehabilitation has demonstrated effectiveness in improving patient outcomes, further research is required to explore its long-term benefits, cost-effectiveness, and adaptability in resource-limited settings. In this mini-review, we summarize the current evidence on employing interdisciplinary rehabilitation in patients with neurological disorders and highlight the implications for future research and clinical practice.

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