Patient perspectives on health‐related behavior change after transient ischemic attack or ischemic stroke

Abstract

Objective Unhealthy lifestyle is common among patients with ischemic stroke or TIA. Hence, health‐related behavior change may be an effective way to reduce stroke recurrence. However, this is often difficult to carry out successfully. We aimed to explore patients' perspectives on health‐related behavior change, support in this change, and sustain healthy behavior. Methods We conducted a descriptive qualitative study with in‐depth, semistructured interviews in eighteen patients with recent TIA or ischemic stroke. Interviews addressed barriers, facilitators, knowledge, and support of health‐related behavior change framed by the protection motivation theory. All interviews were transcribed and thematically analyzed. Results Patients seem unable to adequately appraise their own health‐related behavior. More than half of the patients were satisfied with their lifestyle and felt no urgency to change. Self‐efficacy as coping factor was the most important determinant (both barrier and facilitator). Fear as threat factor was named as facilitator for health‐related behavior change by half of the patients. Most of the patients did not need support or already received support in changing health behavior. Patients indicated knowledge, guidelines, and social support as most needed to support and preserve a healthy lifestyle. Conclusion This study suggests that patients with recent TIA or ischemic stroke often do not have a high intention to change health‐related behavior. The results fit well within the framework of the protection motivation theory. As many patients seem unable to adequately appraise their health behaviors, interventions should focus on increasing knowledge of healthy behavior and improving self‐efficacy and social support.

Physical Activity After Transient Ischemic Attack or Mild Stroke Is Business as Usual

“…Therefore, people who believe their TIA to be serious are more likely to engage in secondary preventative measures, which highlights the importance of identifying people's health beliefs in response to exercise barriers and benefits when developing effective secondary prevention 41–43. A return to the business as usual attitude suggests little change in the individual's health belief and echoes recent evidence that shows people with TIA and mild stroke tend to have low intention to make changes to their health behaviors 44. Study participants who made positive changes or had physical activity levels in line with guideline recommendations used strategies and support to overcome or manage challenges, reflecting the individual's ability to self-direct physical activity engagement, which indicates high self-efficacy.…”

“…[41][42][43] A return to the business as usual attitude suggests little change in the individual's health belief and echoes recent evidence that shows people with TIA and mild stroke tend to have low intention to make changes to their health behaviors. 44 Study participants who made positive changes or had physical activity levels in line with guideline recommendations used strategies and support to overcome or manage challenges, reflecting the individual's ability to self-direct physical activity engagement, which indicates high self-efficacy.…”

Participants’ Perspective of Engaging in a Gym-Based Health Service Delivered Secondary Stroke Prevention Program after TIA or Mild Stroke

“…Participants, most of whom had little to no significant physical impairments limiting their ability to engage in the recommended level of physical activity, expressed a strong desire for health professional support. This desire suggests that factors other than physical ability may influence physical activity behaviour changes (e.g., anxiety, lack of awareness) among people with TIA and mild stroke [ 34 , 35 , 36 ]. Previous evaluations of secondary stroke interventions suggest that people with TIA and mild stroke want inclusion in the development of—and prescription of—physical activity [ 37 ]; regular health professional follow up [ 37 ]; simplified written information for self-directed physical activity [ 20 ]; and signposting for community-based physical activity [ 20 ].…”

A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke

“…Use of statins after IS is also associated with lower rates of mortality and decreased stroke recurrence [98]. Despite established treatment and secondary prevention strategies remaining effective for younger populations, young patients are more likely to experience delays in contacting emergency services, seeking appropriate care, and receiving accurate diagnosis, which hinders treatment and jeopardizes recovery [92,94,99]. The interplay of socioeconomic factors with delay or suboptimal care also requires special consideration.…”