Self-Care Following Transient Ischemic Attack: Module Development and Validation

Abstract

Background and Objectives: Residual impairments frequently persist after a Transient Ischaemic Attack (TIA). In Malaysia, limited local data and the absence of a locally suited post-TIA care module hinder effective stroke prevention. This study was intended to develop a self-care module for post-TIA individuals and assess its content validity, understandability and actionability level. Methods: Guided by the Design, Development and Research (DDR) framework, this study was conducted in 2 phases. In Phase 1, 78 medical records were analysed, followed by interviews with TIA patients diagnosed between 2019–2023 to determine profiles and patients’ needs. In Phase 2, a scoping review of 16 studies were conducted to analyse existing care programs. A module was then drafted and underwent validation by a group of experts. Results: TIA patients were predominantly Malay (56.4%) and male (64.1%), with median age 67 years, and hypertension (85.9%) and diabetes (80.8%) as two common comorbidities. Frequently reported impairments were fatigue (66.7%), weakness (54.2%), and balance issues (41.7%). All respondents expressed a need for accessible, TIA prevention-focused information. The developed module comprises (1) knowledge addressing TIA recurrent risks, residual impairments, and lifestyle changes, and (2) a structured 12-week progressive home-based exercises. Expert validation (n=12) yielded Item-Content Validity Index (I-CVI) scores of 0.83–1.00, with Patient Education Materials Assessment Tool (PEMAT) understandability and actionability scores of 86.35% and 91.67% respectively. Conclusions: Post-TIA, individuals do not fully recover as commonly assumed, demonstrating the need for post-onset care. The locally developed self-care module is valid and has good understandability and actionability level.