{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:25:06Z","timestamp":1791563106416,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015509","name":"National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast","doi-asserted-by":"publisher","award":["NIHR200182"],"award-info":[{"award-number":["NIHR200182"]}],"id":[{"id":"10.13039\/501100015509","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To explore healthcare staff's experiences of how dehydration is identified and managed in hospitalised patients after acute stroke, and facilitators and challenges to optimising hydration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Optimal hydration post\u2010stroke reduces the risk of neurological deterioration and other complications. Patients are at risk of dehydration in acute stroke, particularly those with dysphagia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A descriptive qualitative study reported following the COREQ guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Semi\u2010structured interviews, utilising patient vignettes, were conducted in 2018 (Apr\u2013Oct) with a purposive sample of 30\u00a0multidisciplinary staff members from two UK stroke units. Interviews were digitally recorded and transcribed verbatim. Content analysis identified common themes which were mapped to the Theoretical Domains Framework and the Behaviour Change Wheel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The themes were mapped to twelve of the fourteen domains in the Theoretical Domains Framework. Participants believed that inadequate hydration management had potentially serious consequences, and described complex knowledge, skills and cognitive elements to effective hydration care. Participants felt that maintaining hydration was a multidisciplinary responsibility requiring good communication. Although the performance of initial dysphagia screening was reinforced by external audit, other areas of post\u2010stroke hydration management were not; notably, there was no established method of assessing hydration. Barriers to maintaining good hydration included lack of staff, out\u2010of\u2010hours working patterns, low priority given to hydration, patients\u2019 comorbidities and complex post\u2010stroke disabilities such as dysphagia, aphasia, inattention and hemiparesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings highlighted the importance of assessing and maintaining hydration but identified barriers to, and variation in, clinical practice. To provide optimal care, barriers to the prevention and treatment of dehydration after stroke must be further understood and addressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Multidisciplinary teamwork is important in hydration care after stroke, but clarity is required about the specific contributions of each team member. Without this, hydration care becomes \u2018everybody's and nobody's job\u2019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.16332","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T04:09:35Z","timestamp":1650341375000},"page":"1089-1102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["How is hydration assessed and managed in acute stroke? A qualitative study of healthcare staff\u2019s knowledge, attitudes and experiences"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0620-6029","authenticated-orcid":false,"given":"Colette","family":"Miller","sequence":"first","affiliation":[{"name":"Stroke Research Team University of Central Lancashire  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3051-1237","authenticated-orcid":false,"given":"Josephine M. E.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Stroke Research Team University of Central Lancashire  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9149-8606","authenticated-orcid":false,"given":"Stephanie","family":"Jones","sequence":"additional","affiliation":[{"name":"Stroke Research Team University of Central Lancashire  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Marie","family":"Timoroska","sequence":"additional","affiliation":[{"name":"Lancashire Teaching Hospitals NHS Foundation Trust Royal Preston Hospital  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Maley","sequence":"additional","affiliation":[{"name":"Blackpool Teaching Hospitals NHS Foundation Trust Blackpool Victoria Hospital  Blackpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Blackpool Teaching Hospitals NHS Foundation Trust Blackpool Victoria Hospital  Blackpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7936-5536","authenticated-orcid":false,"given":"Brigit M.","family":"Chesworth","sequence":"additional","affiliation":[{"name":"Stroke Research Team University of Central Lancashire  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-3772","authenticated-orcid":false,"given":"Caroline L.","family":"Watkins","sequence":"additional","affiliation":[{"name":"Stroke Research Team University of Central Lancashire  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010017\u20100605\u20109"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010018\u20108799\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.9.2043"},{"issue":"40","key":"e_1_2_11_5_1","first-page":"12","article-title":"Using subcutaneous fluids in end\u2010of\u2010life care","volume":"110","author":"Bowen P.","year":"2014","journal-title":"Nursing Times"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2012.73.5.262"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20107\u201037"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010012\u20109414\u20100"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1744987119880234"},{"key":"e_1_2_11_11_1","volume-title":"Clinical guidelines for stroke management","author":"Stroke Foundation","year":"2021"},{"key":"e_1_2_11_12_1","volume-title":"Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive summary","author":"Francis R.","year":"2013"},{"key":"e_1_2_11_13_1","article-title":"Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances","volume":"5","author":"Gomes C. 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