scholarly journals Development of a Digital Lifestyle Modification Intervention for Use after Transient Ischaemic Attack or Minor Stroke: A Person-Based Approach

2021 ◽  
Vol 18 (9) ◽  
pp. 4861
Author(s):  
Neil Heron ◽  
Seán R. O’Connor ◽  
Frank Kee ◽  
David R. Thompson ◽  
Neil Anderson ◽  
...  
Keyword(s):  
Focus Group ◽  
Scoping Review ◽  
Transient Ischaemic Attack ◽  
Lifestyle Modification ◽  
Data Entry ◽  
Personal Control ◽  
Minor Stroke ◽  
User Engagement ◽  
Self Confidence ◽  
Ischaemic Attack

This paper describes the development of the ‘Brain-Fit’ app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the theory- and evidence-informed person-based approach, initial planning included a scoping review of qualitative evidence to identify barriers and facilitators to use of digital interventions in people with cardiovascular conditions and two focus groups exploring experiences and support needs of people (N = 32) with a history of TIA or minor stroke. The scoping review and focus group data were analysed thematically and findings were used to produce guiding principles, a behavioural analysis and explanatory logic model for the intervention. Optimisation included an additional focus group (N = 12) and individual think-aloud interviews (N = 8) to explore perspectives on content and usability of a prototype app. Overall, thematic analysis highlighted uncertainty about increasing physical activity and concerns that fatigue might limit participation. Realistic goals and progressive increases in activity were seen as important to improving self-confidence and personal control. The app was seen as a useful and flexible resource. Participant feedback from the optimisation phase was used to make modifications to the app to maximise engagement, including simplification of the goal setting and daily data entry sections. Further studies are required to examine efficacy and cost-effectiveness of this novel digital intervention.

Abstract P208: Transient Ischaemic Attack: How the Patient Perceives it

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mary J MacLeod ◽  
Ali Abdullah
Keyword(s):  
Secondary Prevention ◽  
Transient Ischaemic Attack ◽  
Patient Adherence ◽  
Behavioural Change ◽  
Illness Perception ◽  
Personal Control ◽  
Self Report ◽  
Minor Stroke ◽  
Medical Attention ◽  
Ischaemic Attack

Background: The risk of stroke after Transient Ischaemic Attack (TIA) is 8-11 % within a month. Rapid assessment and early use of preventative therapies can reduce this risk by 80-90%. Many patients do not seek timely medical attention, and may minimise their symptoms. The purpose of this study was to assess patients' perception of the significance of TIA/ minor stroke, and their beliefs and attitudes to secondary prevention interventions. Methods: 120 patients with a recent TIA/minor stroke were given a questionnaire after clinic/ward review. This included the validated Brief Illness Perception Questionnaire (Brief-IPQ: scores 0-10), and Beliefs about Medicines Questionnaire (BMQ: scores 5-25). Patient adherence to secondary prevention medications was assessed by self-report. Results: There was a 56% return rate. Within the brief-IPQ, patients had a mid score for perceived consequences of their event (4.88 (sd2.67)). Only 22% took urgent action at the time of the event. 60% were persuaded to take action by family or friends. Patients scored the midpoint for emotional distress (4.9 (sd 3.4)) and felt they could not exert personal control (4.0(3.2)). They did believed treatment would control their condition (7.7(2.1)). The majority of patients (86.3%) believed in the necessity of medication, with mean necessity score of 18.36(3.5). 14% reported concerns about becoming dependent upon medications and the potential adverse consequences of taking medication. 78% of patients said they complied with their treatment. Conclusions: Patients may not regard TIA or minor stroke as having important implications for their future health. Many only seek medical advice as a result of external pressure. Patients do not feel they have personal control over the condition, but believe medication is necessary and beneficial. These findings will inform strategies for education and behavioural change interventions in people at risk of or who have had a TIA/minor stroke

scholarly journals Usability and Acceptability of a Novel Secondary Prevention Initiative Targeting Physical Activity for Individuals after a Transient Ischaemic Attack or “Minor” Stroke: A Qualitative Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8788
Author(s):  
Neil Heron ◽  
Sean R. O’Connor ◽  
Frank Kee ◽  
Jonathan Mant ◽  
Margaret E. Cupples ◽  
...  
Keyword(s):  
Physical Activity ◽  
Secondary Prevention ◽  
Transient Ischaemic Attack ◽  
Recurrence Risk ◽  
Relevant Information ◽  
Minor Stroke ◽  
Group Discussions ◽  
Self Evaluation ◽  
Ischaemic Attack ◽  
Optimal Approach

Behavioural interventions that address cardiovascular risk factors such as physical inactivity and hypertension help reduce recurrence risk following a transient ischaemic attack (TIA) or “minor” stroke, but an optimal approach for providing secondary prevention is unclear. After developing an initial draft of an innovative manual for patients, aiming to promote secondary prevention following TIA or minor stroke, we aimed to explore views about its usability and acceptability amongst relevant stakeholders. We held three focus group discussions with 18 participants (people who had experienced a TIA or minor stroke (4), carers (1), health professionals (9), and researchers (4). Reflexive thematic analysis identified the following three inter-related themes: (1) relevant information and content, (2) accessibility of format and helpful structure, and (3) strategies to optimise use and implementation in practice. Information about stroke, medication, diet, physical activity, and fatigue symptoms was valued. Easily accessed advice and practical tips were considered to provide support and reassurance and promote self-evaluation of lifestyle behaviours. Suggested refinements of the manual’s design highlighted the importance of simplifying information and providing reassurance for patients early after a TIA or minor stroke. Information about fatigue, physical activity, and supporting goal setting was viewed as a key component of this novel secondary prevention initiative.

scholarly journals Rehabilitation of patients after transient ischaemic attack or minor stroke: pilot feasibility randomised trial of a home-based prevention programme

2019 ◽  
Vol 69 (687) ◽  
pp. e706-e714 ◽  
Author(s):  
Neil Heron ◽  
Frank Kee ◽  
Jonathan Mant ◽  
Margaret E Cupples ◽  
Michael Donnelly
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Secondary Prevention ◽  
Cardiovascular Risk Factors ◽  
Transient Ischaemic Attack ◽  
Standard Care ◽  
Minor Stroke ◽  
Home Based ◽  
Ischaemic Attack

BackgroundAlthough the importance of secondary prevention after transient ischaemic attack (TIA) or minor stroke is recognised, research is sparse regarding novel, effective ways in which to intervene in a primary care context.AimTo pilot a randomised controlled trial (RCT) of a novel home-based prevention programme (The Healthy Brain Rehabilitation Manual) for patients with TIA or ‘minor’ stroke.Design and settingPilot RCT, home-based, undertaken in Northern Ireland between May 2017 and March 2018.MethodPatients within 4 weeks of a first TIA or ‘minor’ stroke received study information from clinicians in four hospitals. Participants were randomly allocated to one of three groups: standard care (control group) (n = 12); standard care with manual and GP follow-up (n = 14); or standard care with manual and stroke nurse follow-up (n = 14). Patients in all groups received telephone follow-up at 1, 4, and 9 weeks. Eligibility, recruitment, and retention were assessed; stroke/cardiovascular risk factors measured at baseline and 12 weeks; and participants’ views were elicited about the study via focus groups.ResultsOver a 32-week period, 28.2% of clinic attendees (125/443) were eligible; 35.2% of whom (44/125) consented to research contact; 90.9% of these patients (40/44) participated, of whom 97.5% (39/40) completed the study. After 12 weeks, stroke risk factors [cardiovascular risk factors, including blood pressure and measures of physical activity] improved in both intervention groups. The research methods and the programme were acceptable to patients and health professionals, who commented that the programme ‘filled a gap’ in current post-TIA management.ConclusionFindings indicate that implementation of this novel cardiac rehabilitation programme, and of a trial to evaluate its effectiveness, is feasible, with potential for clinically important benefits and improved secondary prevention after TIA or ‘minor’ stroke.

Risk of cardiac events in atypical transient ischaemic attack or minor stroke

The Lancet ◽  
1992 ◽  
Vol 340 (8820) ◽  
pp. 630-633 ◽  
Author(s):  
P.J. Koudstaal ◽  
J.C. van Latum ◽  
A. Algra ◽  
L.J. Kappelle ◽  
J. van Gijn ◽  
...  
Keyword(s):  
Transient Ischaemic Attack ◽  
Minor Stroke ◽  
Cardiac Events ◽  
Ischaemic Attack

scholarly journals Optimising Psychoeducation for Transient Ischaemic Attack and Minor Stroke Management (OPTIMISM): Protocol for a feasibility randomised controlled trial

2020 ◽  
Vol 2 ◽  
pp. 24
Author(s):  
Eirini Kontou ◽  
Marion Walker ◽  
Shirley Thomas ◽  
Caroline Watkins ◽  
Holly Griffiths ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Transient Ischaemic Attack ◽  
Controlled Trial ◽  
Intervention Group ◽  
Minor Stroke ◽  
Control Group ◽  
Warning Sign ◽  
Feasibility Randomised Controlled Trial ◽  
Ischaemic Attack ◽  
Randomised Controlled

Background: A transient ischaemic attack (TIA) and minor stroke are medical emergencies and often a warning sign of future strokes if remain untreated. Few studies have investigated the long-term psychosocial effects of TIA and minor stroke. Secondary prevention and medical management are often the primary focus with limited access offered for further psychosocial support. Psychoeducational interventions can provide education and advice to people with physical health conditions and, with suitable tailoring, could be appropriate for people after TIA and minor stroke. This study aims to develop a group psychoeducational intervention for people after TIA and minor stroke and to test whether it is acceptable and feasible. Methods: This mixed-methodology study involves two phases: Phase 1) A qualitative study to determine the content of a suitable intervention; Phase 2) A single-centre feasibility randomised controlled trial to evaluate the acceptability of this intervention. The overall study has ethical approval. Stroke survivors have been involved in designing and monitoring the trial. The aim is to recruit 30-40 participants from a Stroke/TIA Service, within 6 months following their diagnosis. Participants will be randomly allocated to either the usual care control group or the intervention group (psychoeducational programme). The programme will consist of six group sessions based on providing education, psychological and social support. The primary outcomes will relate to the feasibility aims of the study. Outcomes will be collected at 3 and 6 months to assess mood, quality of life, knowledge and satisfaction, and resource use. Discussion: There is a need to develop and evaluate effective interventions that enhance the education provided to people after TIA and minor stroke and to promote their psychosocial wellbeing. Findings will indicate the acceptability of the intervention and parameters needed to conduct a definitive trial. Registration: ClinicalTrials.gov ID NCT02550392; registered on 15 September 2015; status: completed.

Sign in / Sign up

Export Citation Format

Share Document