Published date
Tuesday, 12 January, 2016

What are cognitive problems after stroke?

After a stroke, many patients can experience difficulties thinking and understanding. They may have problems with memory, perception, problem-solving, planning, attention, language and so on. These problems are known as cognitive impairments.

Cognitive impairments after stroke can affect people’s confidence and mood as well as their ability to recover. At present, we do not know how best to rehabilitate these problems. It is important that more research is carried out that will help us understand how to rehabilitate cognitive functions.

An important part of understanding whether rehabilitation is effective is to have appropriate tools that measure outcomes.

What is the PRECiS tool?

PRECiS stands for ‘Patient-Reported Evaluation of Cognitive State’. It is a 27 item questionnaire tool, that measures the perceived impact of cognitive problems from the unique perspective of stroke survivors. Stroke survivors have been involved in all stages of the development of PRECiS, making it a patient-centred outcome measure. There are ‘easy access’ versions available for people who have difficulty with the standard version and an administration guide for when people need support to complete.

It was originally developed to measure outcomes within research trials, but the process of asking these questions may itself have therapeutic value and be useful for informing rehabilitation approaches.

The development of the PRECiS tool has been funded through a Stroke Association Postgraduate Fellowship awarded to Dr Emma Patchick.

What does the new research study into PRECiS show?

Published open access in the journal Clinical Rehabilitation, the new study suggests that the PRECiS tool is practical, valid and reliable to use.

Dr Emma Patchick who led the study said,

“Stroke survivors will have very different experiences of the impact of cognitive difficulties, depending on their life situation. That’s why including patient’s perspectives is so important for understanding if a treatment has ‘worked’. PRECiS provides a way of doing this for cognitive rehabilitation. It asks not just whether you have a cognitive problem, but whether that problem is bothering you and affecting your life. Our study demonstrated some positive findings related to PRECiS’ measurement properties and there are lots of exciting future avenues to explore: we want to understand more about how PRECiS works when used with different people; its clinical value; and perhaps look at how we might reduce the length to make it even more accessible. I’d be very happy to speak with researchers and clinicians interested in using PRECiS in their work.”

How can I access PRECiS and learn how to use it?

PRECiS and associated documents (including administration and scoring guide) are available to use free of a charge and can be accessed from the University of Manchester website. A free account will be required to download the PRECiS tool itself.

Dr Patchick is Research Associate for the Stroke Programme within the NIHR CLAHRC (Collaboration for Leadership in Applied Health Research and Care) Greater Manchester.  To find out more about her wider research, visit her webpage.