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Background: The role of stroke nurses in patient selection and administration of recombinant tissue plasminogen activator (rt‐PA) for acute ischaemic stroke is evolving. Objectives: To compare differences in stroke nurses' practices related to rt‐PA administration in Australia and the United Kingdom (UK) and to examine whether these differences influence rt‐PA treatment rates. Methods: A cross‐sectional, self‐administered questionnaire administered to a lead stroke clinician from hospitals known to provide rt‐PA for acute ischaemic stroke. Chi‐square tests were used to analyse between‐country differences in ten pre‐specified rt‐PA practices. Non‐parametric equality of medians test was used to assess within‐country differences for likelihood of undertaking practices and association with rt‐PA treatment rates. Reporting followed STROBE checklist. Results: Response rate 68%; (Australia: 74% [n = 63/85]; UK: 65% [n = 93/144]). There were significant differences between countries for 7/10 practices. UK nurses were more likely to: request CT scan; screen patient for rt‐PA suitability; gain informed consent; use telemedicine to assess, diagnose or treat; assist in the decision for rt‐PA with Emergency Department physician or neurologist; and undergo training in rt‐PA administration. Reported median hospital rt‐PA treatment rates were 12% in the UK and 7.8% in Australia: (7.8%). In Australia, there was an association between higher treatment rates and nurses involvement in 5/10 practices; read and interpret CT scans; screen patient for rt‐PA suitability; gain informed consent; assess suitability for rt‐PA with neurologist/stroke physician; undergo training in rt‐PA administration. There was no relationship between UK treatment rates and likelihood of a stroke nurse to undertake any of the ten rt‐PA practices. Conclusion: Stroke nurses' active role in rt‐PA administration can improve rt‐PA treatment rates. Models of care that broaden stroke nurses' scope of practice to maximise rt‐PA treatment rates for ischaemic stroke patients are needed. Relevance to clinical practice: This study demonstrates that UK and Australian nurses play an important role in thrombolysis practices; however, they are underused. Formalising and extending the role of stroke nurses in rt‐PA administration could potentially increase thrombolysis rates with clinical benefits for patients. [ABSTRACT FROM AUTHOR]

Psychoeducation can provide information and support to cope with the physical and emotional effects of a health condition. This scoping review aimed to identify the evidence regarding psychoeducational interventions for people after a Transient Ischemic Attack (TIA) and minor stroke. This review was conducted in accordance with the PRISMA Extension for Scoping Reviews. Three electronic databases (MEDLINE, Embase, PsycINFO) were searched for articles on interventions related to psychoeducational support post-TIA and minor/mild stroke. Search retrieved 3722 articles. Three reviewers independently screened titles, abstracts, full-texts, and extracted data for included studies. Study quality was assessed using the JADAD scale. TIDieR checklist was used to describe interventions. Fifteen RCTs were included. Twelve studies were of high quality (JADAD score ≥2), two were of low quality. A total of 1500 participants were recruited across studies. Definition of TIA and minor stroke was unclear, leading to the exclusion of several studies. Various interventions were included, including education/psychoeducation (n = 4); exercise and lifestyle advice (n = 3); telephone-based education/counseling (n = 3); secondary prevention education (n = 1); motivational interviewing (n = 2); self-management (n = 2). Interventions were inconsistently described, with information missing about who delivered it and tailoring. Definitions of stroke severity are not adequately reported. There are a variety of interventions including education about a range of stroke-specific topics. Many interventions are not adequately described, thus making it difficult to determine if the aim was to provide information or support post-TIA/minor stroke. There is a need for an in-depth systematic review to develop a clear definition of psychoeducation. [ABSTRACT FROM AUTHOR]

Several studies have assessed the link between psychosocial risk factors and stroke; however, the results were inconsistent. We have conducted a systemic review and metaanalysis of cohort or case-control studies to ascertain the association between psychosocial risk factors (psychological, vocational, behavioral, interpersonal, and neuropsychological) and the risk of stroke. Systematic searches were undertaken in MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews between 2000 and January 2017. Two reviewers independently screened titles, abstracts, and full texts. One reviewer assessed quality and extracted data, which was checked by a second reviewer. For studies that reported risk estimates, a meta-analysis was performed. We identified 41 cohort studies and 5 case-control studies. No neuropsychological papers were found. Overall, pooled adjusted estimates showed that all other psychosocial risk factors were independent risk factors for stroke. Psychological factors increased the risk of stroke by 39% (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.27-1.51), vocational by 35% (HR, 1.35; 95% CI, 1.20-1.51), and interpersonal by 16% (HR, 1.16; 95% CI, 1.03-1.31), and the effects of behavioral factors were equivocal (HR, 0.94; 95% CI, 0.20-4.31). The meta-analyses were affected by heterogeneity. Psychosocial risk factors are associated with an increased risk of stroke. [ABSTRACT FROM AUTHOR]