Why the research is needed?
Stroke is a leading cause of disability and death worldwide. Transient Ischaemic Attack (TIA) begins just like a stroke; the difference is that a TIA is characterised by temporary short-lasting symptoms that typically last less than 24 hours. Even though TIA symptoms resolve, it is a medical emergency and often a warning sign of a major stroke. Minor stroke is a term used to refer to a confirmed stroke that results in mild impairments, however there is considerable variation in the criteria used as to what qualifies as a minor stroke.
Two-thirds of all patients experience minor or no physical deficits, however, there is a risk of a recurrent stroke in the week after a TIA or a minor stroke. Understandably, clinical management following a TIA/minor stroke diagnosis has a strong emphasis on secondary prevention. Full recovery is often assumed, so patients are often discharged without further rehabilitation or follow-up support. However, previous studies in TIA and minor stroke found high prevalence of emotional and cognitive problems.
What is already known about the subject?
It is well established within national clinical guidelines that people after stroke should be assessed and treated for neuropsychological difficulties (mood and cognition), although there is no specific reference to this for TIA.
Despite this recommendation, the provision of psychological care after stroke varies significantly across the UK and there is limited access to clinical psychology, which contrasts with the high levels of emotional distress and cognitive impairments reported by patients and their carers.
Who we are working with?
We will be working with stroke professionals working in NHS services, people who have experienced a TIA or minor stroke and their family members.
How are patients and the public involved?
We have a patients and public involvement group that includes people who have experienced TIA or minor stroke and their family members. The group informs all stages of the project and is consulted in regular intervals to ensure we stay on track to address needs, expectations and concerns.
What we will do?
We will use a mixed method design to evaluate examples of clinical care in TIA/minor stroke services in the NHS regarding psychological support for mood and cognition. We will conduct a UK-wide survey for stroke professionals, and then we will conduct interviews with stroke professionals and service users to learn what support is usually considered in terms of psychological care needs of people affected by less severe strokes who will not routinely access further stroke rehabilitation services.
What the benefits will be?
This research will benefit people affected by less severe strokes because it will identify potential gaps in psychological care provision and explore how to improve the pathways of support following a diagnosis of TIA or minor stroke. This will be important for creating recommendations or designing a new psychological care pathway for people with TIA/minor stroke in the future.
When the findings will be available?
The research project will end in May 2026. Results from different stages of this research project will be published regularly. The final report will be published after the study ends.
How we are planning for implementation?
We are planning to use data from this research to co-design a psychological care pathway for TIA/minor stroke survivors that could be implemented across UK.
Contact
Dr Eirini Kontou, Chief Investigator, eirini.kontou@nottingham.ac.uk.
Sandra Wydera, Research Support Officer, sandra.wydera@nottshc.nhs.uk.