Primary Health Care Research & Development


What are the patient-held illness beliefs after a transient ischaemic attack, and do they determine secondary prevention activities: an exploratory study in a North London General Practice

Stania Kamaraa1 c1 and Surinder Singha2

a1 Primary Health Care BSc, University College London, Westminster, London, UK

a2 Senior Lecturer in General Practice, Research Department of Primary Care and Population Health, University College London, Westminster, London, UK


Background A transient ischaemic attack (TIA) is a strong predictor of future stroke. Stroke is the most common cause of mortality in the United Kingdom. Management of risk factors can reduce the possibility of future strokes; however, these are often difficult to achieve optimally. Current evidence suggests that beliefs about causal attributions, severity and perceived risk of stroke may influence uptake of secondary prevention activities amongst this patient group.

Aim To explore the illness beliefs of patients about TIAs and future risk of stroke, and to determine whether these beliefs determine secondary stroke prevention activities.

Method A qualitative study comprising face-to-face, semi-structured interviews conducted in the homes of participants. Sampling was purposive and drawn from a single North London General Practice. A thematic framework analysis method was followed.

Findings Eleven participants took part in the study (aged 46–86 years, three female participants and eight male participants). Time since diagnosis ranged from 2 to 25 years. There was a commonly held belief that TIAs are ‘short-lived events’ associated with full recovery, whereas strokes always lead to permanent ‘disability’. Only those who believed their TIAs to be ‘serious’ undertook activities to prevent further recurrence. Concordance with medication was the most popular prevention activity.

Conclusion The traditional medical definition of TIA and stroke do not reflect the views of patients who have had TIAs. One's perception of the severity of the initial TIA event and the risk of future stroke episodes may influence the uptake of secondary stroke prevention activities. Post TIA stroke prevention interventions should include tailored discussions focussing on the importance of the acute event and its implications for long-term health and future stroke risk.

(Received January 31 2011)

(Accepted September 30 2011)

(Online publication November 24 2011)


c1 Correspondence to: Dr Stania Kamara, Foundation Year 2 Doctor, Medway NHS Foundation Trust, Medway Maritime Hospital, Windmill Road, Gillingham, Kent ME7 5NY, UK. Email:

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