| Summary: | A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand,
Johannesburg, in fulfilment of the requirements for the degree of Master of Science in
Physiotherapy (dissertation)
Johannesburg, 2016 === Background and aim of the study
The prevalence of stroke is high in South Africa. The average length of stay in hospital for
stroke survivors in a tertiary hospital in Johannesburg is twelve days. Despite the benefits of
early discharge from hospital for stroke survivors, early discharge from hospitals may lead to
inadequate physiotherapy intervention for functional independence. This lack of independence
would therefore lead to increased dependence on caregivers and lower levels of perceived and
real community integration for survivors of stroke. When patients return to their homes, they
require high levels of care. This care is often provided by family members or designated
caregivers. These caregivers undergo high levels of strain that often lead to exhaustion and
isolation. Patients at community health centres receive physiotherapy services on an outpatient
basis and home visits are done when necessary. Literature on levels of community reintegration
among stroke survivors within health centres in the Johannesburg area and their satisfaction
with the physiotherapy services received is lacking. The aim of this study was to determine
levels of community reintegration and satisfaction levels with physiotherapy of survivors of
stroke in community healthcare centres in the Johannesburg area as well as to determine if
there were any relationships between community reintegration and caregiver strain, quality of
life and patient satisfaction with physiotherapy.
Method and procedures
This was a quantitative, cross-sectional study with questionnaires administered to stroke
survivors and their caregivers at the community health centres in the Johannesburg area.
Community reintegration was measured using the Maleka Stroke Community Reintegration
Measure (M-SCRIM) and represented as frequencies and percentages as well as means and
standard deviations. Caregiver strain was measured using the Caregiver Strain Index (CSI) and
represented as frequencies and percentages. Quality of life was measured using the Stroke-
Specific Quality of Life measure (SSQOL) represented as frequencies and percentages and
satisfaction with physiotherapy services was measured using the Physical Therapy Patient
Satisfaction Questionnaire (PTPSQ) and represented as medians and interquartile ranges.
Correlations between M-SCRIM and CSI, M-SCRIM and SSQOL and M-SCRIM and PTPSQ
were determined using Spearman’s rank correlation coefficient.
Results
This study was conducted on 108 participants and 45 caregivers. The average age of the
participants was 54 years (SD=12.73). Eighty five of the participants (78%) had achieved some
form of community reintegration according to the M-SCRIM. Participants’ lowest scores on
the PTPSQ were for accuracy of bills, availability of parking and cost of physiotherapy. All
the other questions scored a median of 100%. The mean score for SSQOL was 157 out of 245
(64%) with the highest score recorded at 235 out of 245 (96%) and the lowest score measured
was 54 out of 245. Participants had some problems with each of the SSQOL domains. Forty
five of the participants had caregivers. Twenty five (55%) of the 45 caregivers were strained
according to the CSI. A positive correlation was found between the M-SCRIM and PTPSQ (r
= 0.27, p <0.0001) and the M-SCRIM and SSQOL (r = 0.51, p < 0.0001). A negative correlation
was found between the M-SCRIM and CSI (r = -0.37, p < 0.0001).
Conclusion
Eighty five per cent of the stroke survivors in this study had some form of community
reintegration and were generally satisfied with physiotherapy services. Their quality of life
SSQOL was relatively low with the participants experiencing problems in every SSQOL
domain. The majority of the caregivers were strained and survivors of stroke with higher
community reintegration had less caregiver strain. === MT2017
|
|---|
