Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions

BMC Health Services Research

Syed Mohamed Aljunid¹  Saperi Sulong³  Nor Aishah Omar Othman⁴  Devinder Kaur Ajit Singh⁴  Aznida Firzah Abdul Aziz⁵  Noor Azah Abd Aziz²  Nor Azlin Mohd Nordin⁵ 

[1] International Centre of Casemix and Clinical Coding, Universiti Kebangsaaan Malaysia, Kuala Lumpur, Malaysia;Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia;Department of Health Information, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia;School of Rehabilitation Sciences, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;United Nations, University-International Institute for Global Health, Kuala Lumpur, Malaysia

关键词: Family-assisted therapy;    Focus groups;    Rehabilitation;    Stroke;   

Others  :  1133457
DOI  :  10.1186/1472-6963-14-118

 received in 2013-04-06, accepted in 2014-02-28,  发布年份 2014

【 摘 要 】

Background

The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable.

Methods

Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research.

Results

Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues.

Conclusions

Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors.

【 授权许可】

   
2014 Mohd Nordin et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Mant J, Wade DT, Winner S: Health care needs assessment: stroke. In Health Care Needs Assessment: The Epidemiologically Based Needs Assessment Reviews. 2nd edition. Edited by Stevens A, Raftery J, Mant J, Simpson S. Oxford: Radcliffe Medical Press; 2004:141-244.
• [2]Lee AH, Somerford PJ, Yau KKW: Risk factors for ischaemic stroke recurrence after hospitalization. Med J Aust 2004, 181(5):244-246.
• [3]Dhamoon MS, Park Moon Y, Paik MC, Boden-Albala B, Rundek T, Sacco RL, Elkin MSV: Long term functional recovery after Ischemic Stroke. The Northern Manhattan Study. Stroke 2009, 40:2805-2811.
• [4]National Stroke Foundation (Aus): Clinical Guidelines for Stroke Management. Melbourne Australia; 2010. [http://www.nhmrc.gov.au/ webcite]
• [5]National Institute of Health and Clinical Excellence (UK) 2008. [Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA)] [http://www.nice.org.uk webcite]
• [6]Canadian Stroke Strategy 2006. [Canadian Best Practice Recommendations for Stroke Care] [http://www.canadianstrokestrategy.ca/ webcite]
• [7]Paolucci S, Grasso MG, Antonucci G, Troisi E, Morelli D, Cairo P, Bragoni M: One year follow-up in stroke patients discharged from rehabilitation hospital. Cerebrovasc Dis 2000, 10(1):25-32.
• [8]Turmusani M, Vreede A, Wirz SL: Some ethical issues in community-based rehabilitation initiatives in developing countries. Disabil Rehabil 2002, 24(10):558-564.
• [9]McLafferty I: Focus group interviews as a data collecting strategy. J Adv Nurs 2004, 48:187-194.
• [10]Woo J, Chan SY, Sum MWC, Wong E, Chui YPM: In patient stroke rehabilitation efficiency: influence of organization of service delivery and staff Numbers. BMC Health Serv Res 2008, 8:86-92. BioMed Central Full Text
• [11]McNaughton H, DeJong G, Smout RJ, Melvin JL, Brandstater M: A comparison of stroke rehabilitation practices and outcomes between New Zealand and United States facilities. Arch Phys Med Rehabil 2005, 86(12 Suppl 2):S115-S120.
• [12]The World Health Organisation[http://www.who.int/disabilities/ webcite]
• [13]Ministry of Health (Malaysia) Statistics on human resources 2010. [Allied health professionals] [http://www.moh.gov.my/index.php/pages/view/272 webcite]
• [14]Abdul Rahim AR, Sufean H, Abdul Jalil O: Hala Tuju Pengurusan – Sumber Manusia dan Kerjaya. Kuala Lumpur: Utusan Publications; 2006.
• [15]The Stroke Association (UK) 2006. [Stroke Statistics] [http://www.stroke.org.uk/ webcite]
• [16]Molesworth K 2006. [Mobility and health: the impact of transport provision on direct and indirect determinants of access to health services] [http://mobilityandhealth.org/fr/about/KateMolesworthMobilityandHealthPaperfinal.pdf webcite]
• [17]Belza B, Walwick J, Shiu-Thornton S, Schwartz S, Taylor M, LoGerfo J: Older adult perspectives on physical activity and exercise: Voices from multiple cultures. Prev Chronic Dis 2004, 1(4):A09. [http://www.cdc.gov.ezproxyhhs.nihlibrary.nih.gov/ webcite]
• [18]Legg L, Langhorne P, Drummond AE, Gladman JR, Logan PA, Walker MF: Rehabilitation therapy services for stroke patients living at home: systematic review of randomised controlled trials. Lancet 2004, 363:352-356.
• [19]Baskett JJ, Broad JB, Reekie G, Hocking C, Green G: Shared responsibility for ongoing therapy: a new approach to home-based therapy after stroke. Clin Rehabil 1999, 13:23-33.
• [20]Galvin R, Cusack T, Stokes E: To what extent are family members and friends involved in physiotherapy and the delivery of exercises to people with stroke? Disabil Rehabil 2009, 31(11):898-905.
• [21]Galvin R, Cusack T, O’Grady E, Murphy TB, Stokes E: Family-mediated exercise intervention (FAME): evaluation of a novel form of exercise delivery after stroke. Stroke 2011, 42(3):681-686.
• [22]Teasell R, Bayona N, Bitensky J: Background concepts in stroke rehabilitation. [http://www.ebrsr.com webcite]