The psychological sequelae of transient ischaemic attack: the development of a preliminary screening tool

Spurgeon, Laura Claire (2013). The psychological sequelae of transient ischaemic attack: the development of a preliminary screening tool. University of Birmingham. M.Phil.

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Abstract

While much research has been conducted into the psychosocial impact of stroke, rather less attention has been directed to Transient Ischaemic Attack (TIA). Two points are of particular relevance to this thesis: firstly, both TIA and subjective distress are established precursors of secondary stroke; and secondly, treatment that incorporates the patient’s perspective is demonstrably more effective. Together, this suggests that early identification of patients’ psychological reactions to TIA could inform tailored intervention post-diagnosis, thus potentially reducing the adverse consequences of TIA. This study aimed to develop a psychometrically-robust preliminary screening tool to facilitate early recognition of dysfunctional psychological reactions to TIA. Consistent with orthodox psychometric theory, and to inform test construction, various data-types and methodologies were used to capture patients’ subjective experiences. Using three different epistemological approaches (combined qualitative/quantitative Q-methodology, qualitative repertory grid analysis, and quantitative factor analysis) remarkable thematic consistency in patient experiences emerged. These formed the basis of the preliminary screening instrument, which incorporates 21 questions in a forced-choice, paired-comparison format, permitting weighted responses that indicate the significance of each theme to the patient. Early small-scale use indicates its usability and reliability; further work is required to establish its psychometric and clinical value for a larger clinical sample.

Type of Work:

Thesis (Masters by Research > M.Phil.)

Award Type:

Masters by Research > M.Phil.

Supervisor(s):