title: Delay in seeking medical help following Transient Ischemic Attack (TIA) or "mini-stroke": a qualitative study.
abstract: BACKGROUND
  Prompt 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.
  
  
  METHODS
  Twenty 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.
  
  
  RESULTS
  Delay 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mc Sharry
authors.affiliation: Applied Research Centre in Health & Lifestyle Interventions, Coventry University, Coventry, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Baxter
authors.affiliation: Applied Research Centre in Health & Lifestyle Interventions, Coventry University, Coventry, United Kingdom.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Wallace
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust, Coventry, West Midlands, United Kingdom.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kenton
authors.affiliation: Applied Research Centre in Health & Lifestyle Interventions, Coventry University, Coventry, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Turner
authors.affiliation: Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom.
authors.forename: David P
authors.initials: DP
authors.lastname: French
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D057210:Delayed Diagnosis; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D012306:Risk; D013997:Time Factors