The optimal timing of supporting patients in health-related behavior change after TIA or ischemic stroke: a prospective cohort study to determinants of health-related intention to change over time.
Dorien Brouwer-Goossensen, Hester F Lingsma, Peter J Koudstaal and 1 others
PMID 33208689WHAT IT FOUND
Fear after stroke or TIA decreased by 3 months, while confidence to change health behavior stayed high.
For physical therapists, early activity conversations may build on confidence rather than fear.
Key findings
01Fear after stroke or TIA was higher at baseline than at 3 months, and the paper reported that fear started to decrease after 6 weeks.
02Self-efficacy and response-efficacy did not change over follow-up.
03The decrease in fear remained after adjustment for age, sex, baseline self-efficacy, and response-efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study followed patients for only 3 months, so changes during longer rehabilitation were not captured. Not all patients completed the 6-week questionnaires, and the authors mainly drew conclusions from baseline compared with 3 months. The study did not test a behavior-change intervention, so it cannot show that timing changes actual behavior or clinical outcomes. Patients with severe aphasia, non-Dutch speakers, and those discharged to a nursing home were excluded, so the results may not apply to them. The authors note possible social desirability bias and an intention-behavior gap, meaning high confidence may not have translated into actual behavior change.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that starting behavior change support directly after stroke or TIA improves outcomes. This was an observational study of determinants, not a tested intervention, and the decrease in fear was not shown to change actual behavior.