Community reintegration and satisfaction of survivors of stroke receiving physiotherapy services in the community health centres within the Johannesburg area

• Main Author: Kusambiza-Kiingi, Adrian
• Format: Others
• Language: en
• Published: 2017
• Online Access: http://hdl.handle.net/10539/22303

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