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

BMC Family Practice

Research Article

Fiona Campbell¹  Alicia O’Cathain²  Jennifer Read²  Elizabeth J Croot²  Graham Venables³  Tony W Ryan⁴ 

[1] Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK;Medical Care Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK;Neurology Department, Sheffield Teaching Hospitals NHS Foundation Trust, 12 Claremont Crescent, Sheffield, Neurosciences, UK;School of Nursing and Midwifery, University of Sheffield, Barber House Annex, 3a Clarkehouse Road, Sheffield, UK;

关键词: Transient ischaemic attack;    Qualitative;    Patient experience;    Self-management;    Secondary prevention;    Stroke;   

DOI  :  10.1186/s12875-014-0174-9

 received in 2014-05-22, accepted in 2014-10-10,  发布年份 2014

来源: Springer

【 摘 要 】

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-s15% 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.

【 授权许可】

CC BY   
© Croot et al.; licensee BioMed Central Ltd. 2014