Abstract
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.
Highlights
Transient Ischemic Attack (TIA), known as mini-stroke, warning stroke, or transient stroke, has traditionally been defined as a sudden neurological deficit with symptoms of less than 24 hours duration [1]
For 12 participants there was less than one hour delay in contacting medical services, four participants sought care within 24 hours and for four participants delays stretched to longer than a day
The themes identified in participants’ descriptions of care-seeking are summarised below under the categories of symptom recognition, care-seeker, type of care sought and secondary delays and discussed with reference to delay in contacting medical services
Summary
Transient Ischemic Attack (TIA), known as mini-stroke, warning stroke, or transient stroke, has traditionally been defined as a sudden neurological deficit with symptoms of less than 24 hours duration [1]. Studies have shown that urgent assessment and clinic treatment following TIA can decrease 6-month disability and result in an 80% reduction in subsequent stroke [7,8,9]. Despite the health benefits associated with early treatment, almost half of patients fail to seek medical attention within 24 hours of TIA [10]. Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. 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
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