Knowledge, attitudes and behaviours of cardiac health professionals towards cognitive screening in acute coronary syndrome patients

Abstract

Funding Acknowledgements Type of funding sources: None. Background Cognitive impairment (CI) is common in acute coronary syndrome (ACS) patients but is often undetected and may impact recovery and secondary prevention uptake. Health professionals play a vital role in the early detection of CI through screening and managing CI in ACS patients. Purpose To explore health professionals’ knowledge, attitudes, and behaviours toward CI screening in ACS patients Methods Cardiac health professionals were recruited via acute and outpatient cardiac wards in three metropolitan teaching hospitals and from emailing members of two cardiac professional associations in Australia. All completed a 38-item survey administered in either paper or electronic format. Results 100 health professionals responded (95 nurses and five allied health workers). Respondents identified the prevalence of CI, dementia, or delirium at 25% post-ACS (50% of respondents), and 74% identified difficulties in recalling recent information as the most common indicator of CI. The cognitive screening was performed at least some of the time in ACS patients by 73%. After accounting for age, receiving training in CI, work experience, and profession, cognitive screening was conducted more than eight times more often by health professionals who work in acute settings (OR=8.78, 95%CI 2.13, 36.25) versus non-acute. Participants identified the main reasons for conducting cognitive screening as early detection of change/establishing a baseline (n=27) and when they suspected any cognitive issue or decline (n=26). The most common barriers to both screening for CI and taking further actions when CI was detected were patients being unable to communicate well (60% and 49%), patients being too unstable/unwell (59% and 42%), and the priority being the patient’s clinical care (53% and 44%). Conclusions Health professionals working in acute settings are most likely to screen for CI regardless of experience or training in CI, leaving CI likely to be undetected in ACS patients receiving care in other settings. Barriers to screening are common and challenging to address due to time shortages and the appropriateness of tools. A standardised screening guideline and more feasible screening tools are needed to overcome the barriers to cognitive screening in ACS patients. Pre-professional education should also be implemented in the future.