An evaluation of the structure and process of stroke rehabilitation in primary, secondary and tertiary hospitals in Ghana

Abstract

Background: Evidence shows that quality indicators such as the structure and process of stroke rehabilitation can influence patient outcomes. However, not much attention has been paid to the study of these issues in low- and middle-income countries such as Ghana.Objectives: Our study evaluated the structure and process of stroke rehabilitation in primary, secondary and tertiary hospitals in the Greater Accra Region of Ghana.Method: A cross-sectional survey was conducted involving 111 healthcare professionals. The World Health Organization (WHO) situational analysis and Measure of Processes of Care for Service Providers for Adults (MPOC-SP[A]) questionnaires were administered to gather information on the structure and process of stroke rehabilitation. Descriptive statistics were used to summarise data, and chi-square and Kruskal–Wallis tests were used to establish associations and comparisons, respectively.Results: A stroke unit was only available in the tertiary hospital. Although all three hospitals had a multidisciplinary team approach to care, the constituents differed. Length of hospital-stay, duration of treatment and basis for discharge from acute care were not associated with the hospitals. Therapy sessions, access to computed tomography (CT) and magnetic resonance imaging (MRI) scanning were dependent on the hospitals.Conclusion: The structure and process of stroke rehabilitation across the three hospitals were similar in some constructs and different in others.Clinical implications: Data gathered will help to provide information on the available structure and processes of stroke rehabilitation, which could help assess the quality of care provided.

Perceptions of health professionals on structure and process of stroke rehabilitation in Ghana

“…Stroke patients in Ghana were reported in this study to be discharged from inpatient rehabilitation within 14 days of admission showing a shorter length of hospital stay. A study conducted in Ghana also reported that stroke patients in Ghana have shorter length of hospital stay (Mohammed, Nyante & Mothabeng 2022). One possible reason for the early discharge could be because of the limitation in bed capacity for stroke rehabilitation.…”

“…This study aims to provide data to help in better understanding of the structure and process of stroke rehabilitation in Ghana to help in facilitating interventions to improve the quality of stroke rehabilitation, which in turn can improve the outcome of stroke patients. A preliminary study carried out in Ghana to assess the structure and process of stroke rehabilitation in Ghana was conducted by the authors of this study (Mohammed, Nyante & Mothabeng 2022 ) using quantitative methods. In order to have a better understanding of the structure and process of stroke rehabilitation that was recorded in the previous quantitative study, a qualitative study needed to be carried out.…”