Factors influencing follow-up care post-TIA and minor stroke: a qualitative study using the theoretical domains framework.

Aftercare General Practitioners Humans Ischemic Attack, Transient / therapy Qualitative Research Stroke / therapy
Follow-up Minor stroke TIA Theoretical domains framework Transient ischaemic attack

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
21 Feb 2022
Historique:
received: 11 10 2021
accepted: 27 01 2022
entrez: 22 2 2022
pubmed: 23 2 2022
medline: 24 2 2022
Statut: epublish

Résumé

Follow-up care after transient ischaemic attack (TIA) and minor stroke has been found to be sub-optimal, with individuals often feeling abandoned. We aimed to explore factors influencing holistic follow-up care after TIA and minor stroke. Qualitative semi-structured interviews with 24 healthcare providers (HCPs): 5 stroke doctors, 4 nurses, 9 allied health professionals and 6 general practitioners. Participants were recruited from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Interview transcripts were deductively coded using the Theoretical Domains Framework and themes were generated from coded data. There was no clear pathway for supporting people with TIA or minor stroke after rapid specialist review in hospital; consequently, these patients had limited access to HCPs from all settings ('Environmental context and resources'). There was lack of understanding of potential needs post-TIA/minor stroke, in particular residual problems such as anxiety/fatigue ('Knowledge'). Identification and management of needs was largely influenced by HCPs' perceived role, professional training ('Social professional role and identity') and time constraints ('Environmental context and resources'). Follow-up was often passive - with onerous on patients to seek support - and predominantly focused on acute medical management ('Intentions'/'Goal'). Follow-up care post-TIA/minor stroke is currently sub-optimal. Through identifying factors which influence follow-up, we can inform guidelines and practical strategies to improve holistic healthcare.

Sections du résumé

BACKGROUND BACKGROUND
Follow-up care after transient ischaemic attack (TIA) and minor stroke has been found to be sub-optimal, with individuals often feeling abandoned. We aimed to explore factors influencing holistic follow-up care after TIA and minor stroke.
METHODS METHODS
Qualitative semi-structured interviews with 24 healthcare providers (HCPs): 5 stroke doctors, 4 nurses, 9 allied health professionals and 6 general practitioners. Participants were recruited from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Interview transcripts were deductively coded using the Theoretical Domains Framework and themes were generated from coded data.
RESULTS RESULTS
There was no clear pathway for supporting people with TIA or minor stroke after rapid specialist review in hospital; consequently, these patients had limited access to HCPs from all settings ('Environmental context and resources'). There was lack of understanding of potential needs post-TIA/minor stroke, in particular residual problems such as anxiety/fatigue ('Knowledge'). Identification and management of needs was largely influenced by HCPs' perceived role, professional training ('Social professional role and identity') and time constraints ('Environmental context and resources'). Follow-up was often passive - with onerous on patients to seek support - and predominantly focused on acute medical management ('Intentions'/'Goal').
CONCLUSIONS CONCLUSIONS
Follow-up care post-TIA/minor stroke is currently sub-optimal. Through identifying factors which influence follow-up, we can inform guidelines and practical strategies to improve holistic healthcare.

Identifiants

DOI: 10.1186/s12913-022-07607-0 PMID: 35189884 PMC: PMC8859903
pubmed: 35189884
doi: 10.1186/s12913-022-07607-0
pii: 10.1186/s12913-022-07607-0
pmc: PMC8859903
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

235

Informations de copyright

© 2022. The Author(s).

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Auteurs

Grace M Turner (GM)

Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK. G.Turner.1@bham.ac.uk.
Centre for Patient Reported Outcomes Research, University of Birmingham, B15 2TT, Birmingham, UK. G.Turner.1@bham.ac.uk.
NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, B15 2TH, Birmingham, UK. G.Turner.1@bham.ac.uk.

Maria Raisa Jessica V Aquino (MRJV)

Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.

Lou Atkins (L)

Centre for Behaviour Change, University College London, WC1E 6BT, London, UK.

Robbie Foy (R)

Leeds Institute for Health Sciences, University of Leeds, Leeds, LS2 9JT, UK.

Jonathan Mant (J)

Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB1 8RN, UK.

Melanie Calvert (M)

Institute of Applied Health Research, University of Birmingham, B15 2TT, Birmingham, UK.
Centre for Patient Reported Outcomes Research, University of Birmingham, B15 2TT, Birmingham, UK.
NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, B15 2TH, Birmingham, UK.
NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, B15 2TH, Birmingham, UK.
Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, B15 2TT, Birmingham, UK.
NIHR Applied Research Collaboration (ARC) West Midlands, University of Birmingham, B15 2TT, Birmingham, UK.

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Classifications MeSH

questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Continuité des soins › Post-cure › Factors influencing follow-up care post-TIA...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Médecins › Médecins généralistes › Factors influencing follow-up care post-TIA...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Factors influencing follow-up care post-TIA...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Accident ischémique transitoire › Factors influencing follow-up care post-TIA...
questionsmedicales.fr › Disciplines des sciences naturelles › Science › Recherche › Recherche empirique › Recherche qualitative › Factors influencing follow-up care post-TIA...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Factors influencing follow-up care post-TIA...