Undetected and underserved: the untold story of patients who had a minor stroke

Finch, Emma; Foster, Michele; Fleming, Jennifer; Aitken, Philip; Williams, Ian; Cruwys, Tegan; Worrall, L.

doi:10.5694/mja16.01009

Cited by 8 publications

(16 citation statements)

References 12 publications

(28 reference statements)

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“…They recommend interventions to integrate into the health care system in a cost effective manner with staff trained in these techniques. Behaviour change techniques used successfully in health promotion activities including motivational interviewing, health coaching, and cognitive behavioural therapy can take longer to implement than is available during a busy and short admission (average shortest stay 4.2 days) after a transient ischaemic attack (TIA) or minor stroke . An approach is required that can address the complexity of adherence, cognitive change, and behavioural change, while being brief and able to be implemented immediately after diagnosis of a TIA or minor stroke.…”

Section: Introductionmentioning

confidence: 99%

Using a structured, patient‐centred, educational exchange to facilitate a shared conversation about stroke prevention medications

Coombes

Rowett

Whitty

et al. 2019

Evaluation Clinical Practice

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Objective The aim of this study was to investigate the feasibility of a structured patient‐centred educational exchange to facilitate a shared conversation about stroke prevention medications. Methods Participants (18 years or older) with a principal diagnosis of stroke or transient ischaemic attack were purposively sampled from the stroke unit of a 780‐bed teaching hospital in Australia and consented to participate in the study. A patient‐centred educational exchange was conducted face to face at the bedside before discharge and by telephone post discharge. The structure of these sessions was adapted from academic detailing, an educational strategy, which includes identifying experience, listening to the needs of the audience, and tailoring messages to influence behaviour. To facilitate sharing of needs, three questionnaires, validated as research tools, were used to identify participants' experience, perceptions, and beliefs. The identified perceptions were used to personalize educational messages. The outcomes of the study were to provide descriptions of patients' perceptions necessities and concerns about their condition and medications, provide examples of personalized responses to these, evaluate acceptability by patients, and determine the time taken to share the information. Results Sixteen participants completed both the bedside session (average duration 27 minutes) and the telephone follow‐up (average duration 23 minutes). The strongest patient concern identified was having another stroke. Personalized responses included emphasizing long‐term treatment in response to the perception that stroke will last for a short time, reinforcement of necessity for medications, and further exploration of concerns. Conclusion The questionnaires engaged the participants, allowing them to share perceptions and beliefs, facilitating a patient‐centred educational exchange in a timely manner.

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Section: Introductionmentioning

confidence: 99%

Using a structured, patient‐centred, educational exchange to facilitate a shared conversation about stroke prevention medications

Coombes

Rowett

Whitty

et al. 2019

Evaluation Clinical Practice

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show abstract

“…There is a growing interest worldwide in patients who have experienced a minor stroke. In the tertiary healthcare sector, the focus has been on rehabilitating people with more severe impairments following major stroke, resulting in people with minor stroke often being quickly discharged without rehabilitation (Finch et al, ). However, even when a stroke is minor, impairments can endure and have substantial impact on quality of life.…”

Section: Introductionmentioning

confidence: 99%

Exploring changing needs following minor stroke

Finch

Foster

Fleming

et al. 2019

Health Soc Care Community

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Medical advances have led to many of the severe consequences of stroke being averted. Consequently, more people are being discharged from hospital following treatment for what is classed as minor stroke. The needs of people with minor stroke have received little research attention. The aim of the current study was to conduct an exploratory prospective needs analysis to document the unmet health, rehabilitation and psychosocial needs of a recently hospitalised minor stroke cohort approximately 2 weeks (T1) and 2 months (T2) post‐hospital discharge. An exploratory cohort design was used to explore the unmet health, service and social needs of 20 patients with minor stroke. Participants completed questionnaires (Survey of Unmet Needs and Service Use, Mayo‐Portland Adaptability Inventory‐4, Exeter Identity Transition Scales, RAND 36‐Item Health Survey 1.0) at T1 and T2. Nine participants reported unmet needs at T1 and seven participants reported unmet needs at T2. Between T1 and T2, there was a significant improvement in perceived role limitations due to physical health. Participation in society was significantly better at T2. In conclusion, patients with minor stroke report health, service and social needs that are unmet by existing services. This patient cohort urgently requires co‐ordinated services to detect and manage these unmet needs.

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“…attentional neglect), physical risks and difficulties (e.g. limb weakness) and emotional disturbance (depression) (Finch et al, 2017;Hanney, 2012;Hu et al, 2017). Such limitations lead to difficulties performing activities of daily living and complex activities (Hanney, 2012;Hu et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Unveiling the complexities of mild stroke: An interpretative phenomenological analysis of the mild stroke experience

Hodson

Gustafsson

Cornwell

2019

Aus Occup Therapy J

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Introduction Limited research has been conducted from a longitudinal and qualitative perspective on the experience of life after mild stroke. This restricts the knowledge held in this area. This study aimed to answer the question: How do people with mild stroke understand their experiences in the first 6 months after hospital discharge? Methods Interpretative Phenomenological Analysis, involving five Australians with mild stroke, interviewed at 1‐, 3‐ and 6 months post‐hospital discharge. Results Two themes emerged about the transitional journeys post‐mild stroke: (i) Understanding and representation of stroke and (ii) Underlying relationship dynamics revealed. The first theme had two subthemes: (i) Society defines the stroke experience, and (ii) The past determines the present. The first of these reflected the impact that societal perceptions of ‘stroke’ had on participants’ views of their mild stroke, including feelings of being ‘lucky’ even when experiencing hidden difficulties that were viewed as liveable repercussions. The second explores how previous health conditions acted as a mediator for participants’ experiences of the mild stroke and how personal attributes assisted adaption to post‐mild stroke changes. The final theme highlights how participants’ relationships were either strengthened or weakened after the mild stroke, dependent on previous relationship dynamics. Conclusion Current societal perceptions of stroke are centred on ‘observable’ symptoms; however, more subtle symptoms common in the mild stroke population remain widely unknown by the general public impacting post‐mild stroke experiences. Previous health conditions and personal attributes have an impact on how people react to their mild stroke and help to explain the individualist nature of mild stroke outcomes. Relationship dynamics prior to mild stroke can impact on post‐mild stroke family functioning, and should be screened for, and supported by health professionals. All of these factors emphasise the need for a patient‐centred and multidisciplinary approach when determining interventions.

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Undetected and underserved: the untold story of patients who had a minor stroke

Cited by 8 publications

References 12 publications

Using a structured, patient‐centred, educational exchange to facilitate a shared conversation about stroke prevention medications

Using a structured, patient‐centred, educational exchange to facilitate a shared conversation about stroke prevention medications

Exploring changing needs following minor stroke

Unveiling the complexities of mild stroke: An interpretative phenomenological analysis of the mild stroke experience

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