title: Patients' responses to transient ischaemic attack symptoms: a cross-sectional questionnaire study in Australian general practices.
abstract: BACKGROUND
  Consensus guidelines for transient ischaemic attack (TIA) recommend urgent investigation and management, but delays in management occur and are attributable to patient and health system factors.
  
  
  OBJECTIVE
  To establish general practice patients' anticipated responses to TIA symptoms, and associations of appropriate responses.
  
  
  METHODS
  A cross-sectional questionnaire-based study in Australian general practices.
  
  
  METHODS
  Consecutive patients attending general practices completed questionnaires that contained the Stroke Action Test (STAT) adapted for TIA about demographic, health system use, and stroke risk factors. STAT elicits appropriate or inappropriate anticipated responses to 28 symptom complexes. Anticipated actions in-hours and out-of-hours were elicited. Associations of independent variables with adapted-STAT scores were tested with multiple linear regression.
  
  
  RESULTS
  There were 854 participants (response rate 76.9%). Urgent healthcare-seeking responses to transient neurological symptoms ranged from 96.8% for right-sided weakness with dysphasia to 59.1% for sudden dizziness. Associations of higher adapted-STAT scores were older age, Indigenous status, previous after-hours services use, self-perception of health as poor, and familiarity with a stroke public awareness campaign. A personal or family history of stroke, smoking status, and time of event (in-hours/out-of-hours) were not significantly associated with adapted-STAT scores.
  
  
  CONCLUSIONS
  Most general practice attendees expressed intentions to seek health care urgently for most symptoms suggestive of TIA, with highest levels of urgency observed in high stroke-risk scenarios. Intentions were not associated with a number of major risk factors for TIA and might be improved by further educational interventions, either targeted or at population level.
authors.affiliation: Discipline of General Practice, University of Newcastle, Australia.
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Dunbabin
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Goode
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Valderas
authors.affiliation: Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Levi
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Australia.
authors.forename: Mario
authors.initials: M
authors.lastname: D'Souza
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Australia.
authors.forename: Melanie
authors.initials: M
authors.lastname: Marshall
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Barker
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lasserson
mesh_terms: D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: attitudes; education; family practice; general practice; health knowledge; stroke; transient ischaemic attack