What are the patient-held illness beliefs after a transient ischaemic attack, and do they determine secondary prevention activities: an exploratory study in a North London General Practice

Kamara, Stania; Singh, Surinder

doi:10.1017/s146342361100051x

Cited by 15 publications

(31 citation statements)

References 21 publications

(26 reference statements)

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“…Our response rate was similar to reported rates in other qualitative studies conducted with TIA patients [18]. Although, as in all research studies, it is possible that patients who choose to participate may differ from those that don't, participants in the current study did not differ in terms of gender and postcode index of multiple deprivation scores from those that did not take part.…”

Section: Discussionsupporting

confidence: 82%

“…As with previous qualitative studies in TIA populations (e.g. [18]) participation in this study was limited to patients who did eventually seek care and had received a TIA diagnosis. Consequently, participants' recall of symptoms and care-seeking decisions may have been affected by the subsequent attachment of a TIA label to their experiences.…”

Section: Discussionmentioning

confidence: 99%

“…Although TIA and stroke share similarities, TIA patients differentiate their experience on the basis of the temporary nature of TIA and the expectation of full recovery [18]. TIA patients also describe symptom experiences which differ from those typically associated with a traditional stroke presentation [19].…”

Section: Introductionmentioning

confidence: 99%

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Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

et al. 2014

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BackgroundPrompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay.MethodsTwenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category.ResultsDelay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions.ConclusionsThis study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over-ride or undermine the importance of patients' own identification of TIA.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

et al. 2014

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“…They found that the TIA changed participants’ perception of their health as they became aware of their stroke risk. Similarly Kamara & Singh also found a discrepancy between the medical definition of TIA as an acute event and the participant’s explanation of TIA which related to the ability to recover fully from the TIA in the long term [24]. We have identified the long term consequences of TIA for participants in our sample which included 13 people under 65 of whom seven were still in work and two were primary carers of young or disabled children.…”

Section: Discussionmentioning

confidence: 98%

Transient ischaemic attack: a qualitative study of the long term consequences for patients

et al. 2014

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BackgroundTransient ischaemic attack (TIA) is characterised by its transient nature with symptoms of neurological dysfunction resolving within 24 hours. The occurrence of TIA is a major risk factor for stroke with 10–15% of TIA patients going on to have ischaemic stroke. Internationally, recommendations for the management of TIA focus on the need for early diagnosis and medical management of the acute increased risk of ischaemic stroke. However there is a limited amount of evidence that some patients suffer enduring consequences as a result of this ‘transient’ event. This paper focusses on patients’ long term lived experience following a TIA.MethodsSemi structured interviews were carried out with patients who had a TIA between two and 24 months previously. Participants were asked about their TIA, the advice and management received and any changes made as a result of the TIA. Interviews were recorded and transcribed verbatim. Thematic content analysis involved scrutinising transcripts to look for links and associations within and between accounts in a process similar to the grounded theory approach of open coding. The category of transience emerged and was explored in more detail to examine the enduring consequences of TIA.ResultsThirty nine patients aged between 31 and 89 years were interviewed. Accounts detailed the long term impact of the TIA and the subsequent ‘at risk’ status, on the physical and psychosocial wellbeing of participants. Some participants sought to proactively manage the consequences of their TIA but found it difficult to obtain the information and support they needed, whereas others felt that no further action was needed to prevent future stroke.ConclusionCurrent definitions conceptualise TIA as a transient event however our study suggests that some patients experienced long term consequences as a result of their TIA. These included anxiety and uncertainty in the light of their increased stroke risk. TIA patients need access to detailed, evidence based stroke prevention information from a credible source, and support to help them understand and apply the information over time, if they are to effectively self-manage the long term consequences of TIA and reduce their risk of future stroke.

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“…It has been shown that those who perceive TIA as something minor or with no lasting impact may be reluctant to address risk factors for further cerebrovascular events. 34 Identifying balance and walking problems may be one way to overcome this barrier.…”

Section: Discussionmentioning

confidence: 99%

Balance and Gait Impairment in Transient Ischemic Attack and Minor Stroke

Batchelor

Williams

Wijeratne

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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What are the patient-held illness beliefs after a transient ischaemic attack, and do they determine secondary prevention activities: an exploratory study in a North London General Practice

Cited by 15 publications

References 21 publications

Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

Delay in Seeking Medical Help following Transient Ischemic Attack (TIA) or “Mini-Stroke”: A Qualitative Study

Transient ischaemic attack: a qualitative study of the long term consequences for patients

Balance and Gait Impairment in Transient Ischemic Attack and Minor Stroke

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