EVALUATION COMMITTEE

The Faculty Council has appointed the following adjudication committee to evaluate the thesis and the associated lecture: 

• Proffessor Anners Lerdal, University of Oslo, Norway 
• Proffessor Katharina Stibrant Sunnerhagen, Institute Neuroscience and Physiology, University of Gothenburg, Sweden 
• Professor Mette Grønkjær, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Denmark (Chairman)

Moderator: Professor Michael Skovdal Rathleff, HST, Aalborg University, Denmark

ABSTRACT

Patients following Transient Ischemic Attack (TIA) should not have any residual symptoms following 24 hours. This has however been challenged as some patients suffering a TIA report lasting challenges across multiple life domains. This includes reduced quality of life, cognitive impairments, depression and anxiety. These challenges can be so severe that some patients have difficulties with social participation and changed family dynamics. This Ph.D. thesis investigates what symptoms patients following TIA experience, when these arise, who are at risk of lasting challenges, how these impact on their everyday life and finally identify design principles for future intervention development to support return to everyday life.

Study I is a national register-based study investigating the use of sick leave benefits and homecare following TIA. Results showed that nearly one out of five patient following TIA are in need of sick leave benefits 5-12 weeks following diagnosis.

Study II is a prospective cohort study with 12 months following. The aim was to investigate fatigue and factors associated with fatigue at 12 months. Results show that more than half experience pathological fatigue at 12 months. Fatigue level and frequency was comparable to that reported within stroke. Prevalence of acute ischemic lesion was equally distributed between patients who report fatigue and the ones that do not. Patients who express fatigue already shortly after discharge seems to be more likely to develop fatigue at 12 months.

Study III is a qualitative study to gather in-depth knowledge on impacts of TIA for patients reporting lasting challenges and to identify what they believed facilitated return to everyday life. The participants experienced limitations impacting physical, psychological, and social domains, and they felt uninformed that lasting challenges could affect them. Different coping strategies were activated, and participants with close, supportive relations managed better. A pressure to return to work and a lack of trust in the general practitioner affected their recovery negatively. Overall, return to everyday life after TIA was considered stressful and appropriate support lacking.

Study IV aims to develop an evidence-based and patient-centered intervention through a co-creation process. This revealed a need for individualized interventions based on a needs-assessment, unlimited support from a specialized healthcare professional, who can also act as a bystander and a need for increase knowledge and improved communication between healthcare sectors.