Assessing Post-stroke Outpatients’ Rehabilitation Service Quality Gaps in Bangladesh

Abstract

Objectives: The majority (80%) of stroke survivors in Bangladesh have lived with either minor or major physical, emotional, and cognitive disabilities. Due to patients’ poor perceived experience in healthcare services, participation in rehabilitation care has become a significant challenge for them. Consequently, it increases the burden of stroke disability. Therefore, this study aimed to measure the gaps in post-stroke outpatients’ rehabilitation Service Quality (SQ) and factors related to these gaps. Methods: A cross-sectional descriptive study was administered on 311 post-stroke outpatients who were selected by stratified sampling method from 5 divisional centers of a rehabilitation hospital. Data collection tools consisted of the following: a demographic information form and a modified Service Quality (SERVQUAL) questionnaire. Cronbach’s alpha coefficient was applied to analyze the internal consistency. Besides, Pearson’s (r) correlation test was applied to examine the correlation coefficient between the explored items. The obtained data were analyzed by descriptive statistics, Paired Samples t-test, and Eta-statistic (δ) of the Analysis of Variance (ANOVA). Results: Patients’ expectations were rated higher than the perceptions in all dimensions of rehabilitation SQ and indicated a significant gap (t=-29.604, P<0.001). Patients’ occupation (δ=0.189), family status (δ=0.289), pre-stroke daily activities (δ=0.235), and post-stroke disability (δ=0.286) indicated a significant relationship with the gaps in rehabilitation SQ. Discussion: Post-stroke rehabilitation SQ gaps are required to be addressed by considering the factors related to these gaps. Most importantly, the rehabilitation hospital must integrate the continuous quality improvement monitoring systems to enhance SQ as well as patients’ participation in rehabilitation care programs.