Secondary TIA Outpatient Prevention Program
“Mini stroke” education:
1. On a scale of “not at all” to “very much”, how well do you understand what a transient ischemic attack or mini stroke is?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
2. On a scale of “not at all” to “very much”, how well do you understand the chance of having a stroke after a transient ischemic attack or mini stroke?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
Self-Management:
3. On a scale of “not at all” to “very much”, how well are you watching your health needs?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
4. On a scale of “not at all” to “very much”, how often is it hard to follow your daily routine?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
Healthy Routine:
5. On a scale of “not at all” to “very much”, how well are you in charge of your stress levels?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
6. On a scale of “not at all” to “very much”, how likely are to follow a healthy routine?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
Social and Community Supports:
7. On a scale of “not at all” to “very much”, how important do you think it is to reach out to people who support you?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
8. On a scale of “not at all” to “very much”, how comfortable are you reaching out to others for support?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
Wellness:
9. On a scale of “not at all (0 days)” to “very much (5-7 days)”, how often are you active during the week?
Not at all (1)
0 days Somewhat/Very Little (2) 1-3 days Very Much (3) 4-7 days
10. On a scale of “not at all” to “very much”, how important do you think it is to do physical activity after a transient ischemic attack?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
Other:
11. How do you feel this education course helped you to understand how you can help prevent a stroke from happening?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
12. On a scale of “not at all” to “very much”, how likely are you to use the information that was given during this course in your everyday life?
Not at all (1) Somewhat/Very Little (2) Very Much (3)
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