Functional Outcomes of Stroke Patients Admitted to a Tertiary Hospital in the Western Cape, South Africa

Parekh, Ishita; Rhoda, Anthea

doi:10.4102/sajp.v69i2.23

Cited by 9 publications

(17 citation statements)

References 7 publications

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“…While mean and median length of stay could not be determined from the data (answer options did not reflect precise numbers of days), it seems from Figure 1 as if length of stay might be in line with findings from two studies in the Western Cape Province, published in 2013 and 2011 respectively: mean inpatient length of stay of 10.4 days in a tertiary hospital 8 and median length of stay of 8 days in a district hospital 2 with a six bed stroke unit. A 2009 study in rural KwaZuluNatal 7 found an average inpatient length of stay of 6 days.…”

Section: Discussionsupporting

confidence: 56%

“…Comprehensive assessments, skilled nursing care, early mobilisation, initiation of strategies to prevent secondary complications, early discharge planning and an early start to rehabilitation, are recommended 5 . These guidelines are not achieved in South Africa: Management of persons with stroke is more common in general medical wards instead of dedicated stroke care wards and stroke survivors are not always referred to therapy 6,7,8 . Stroke can cause multiple impairments which might necessitate a variety of rehabilitation interventions.…”

Section: Literature Reviewmentioning

confidence: 99%

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Stroke management and functional outcomes of stroke survivors in an urban Western Cape Province setting

Cawood¹,

Visagie

2016

S. Afr. j. occup. ther

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Section: Discussionsupporting

confidence: 56%

Section: Literature Reviewmentioning

confidence: 99%

Stroke management and functional outcomes of stroke survivors in an urban Western Cape Province setting

Cawood¹,

Visagie

2016

S. Afr. j. occup. ther

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“…The high annual incidence for stroke in South Africa is 75 000 new cases per year, which creates an economic burden of care on an overburdened public health sector 1 . Consequently, the length of hospital stay for patients with stroke in South African public hospitals has been found to be shorter than in other countries 2,3 . This is the context in which occupational therapy services are provided at a large public hospital in Soweto, South Africa, where an average of 80 stroke survivors are referred for rehabilitation every month.…”

Section: Introductionmentioning

confidence: 94%

“…The stroke survivors are initially seen as inpatients for the duration of their short hospitalisation, reported to be between six and ten days in public hospitals in South Africa 2,3 . During this short stay limited time is available for occupational therapy to address impairments, teach compensatory ADL techniques and educate patients as well as their families and carers about managing after discharge from hospital 6,7 .…”

Section: Introductionmentioning

confidence: 99%

“…This was confirmed by Teasell et al 9 who found that even with infrequent outpatient therapy sessions on a monthly basis, there is high level evidence that these sessions in conjunction with home-based stroke rehabilitation programmes are effective in achieving modest gains in ADL following inpatient rehabilitation. However, the lack of home-based rehabilitation services in Soweto and the poor return of patients with stroke for outpatient care is of great concern 3 . Both of these factors affect the duration and intensity of the post discharge rehabilitation programme.…”

Section: Introductionmentioning

confidence: 99%

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Upper limb mobility and personal management in patients with stroke attending occupational therapy at a tertiary hospital in Gauteng

Msengana

Witt

Owen

et al. 2019

S. Afr. j. occup. ther.

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Key words: stroke; upper limb motor recovery; personal management Zukiswa Msengana, BSc OT (UWC); MSc OT (Wits) http://orcid.org/0000-0001-7302-8088 Senior Occupational Therapist, Baragwanath Hospital, Johannesburg Postgraduate student. Department of Occupational Therapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand Patricia De Witt, Nat. Dip. OT (Pretoria); MSc OT (Wits); PhD (Wits) http://orcid.org/Antonette Owen, BOT (UP), MSc OT (Wits) http://orcid.org/0000-0002-4573-4185Introduction: This study described the outcomes for upper limb motor function after stroke and personal management of patients attending occupational therapy at a tertiary hospital in Gauteng, up to two months' post-discharge.Methodology: A quantitative, descriptive correlation design used assessments of upper limb motor function and independence in personal management to collect the data. Forty-five participants received routine rehabilitation including occupational therapy at the hospital. The same measurements were administered on discharge and during out-patient follow up at one and two months.Results: Results indicated that of 45 participants only 33 were available for reassessment at discharge. These participants had significant improvement in upper limb motor function and personal management. At discharge 48% of participants had >80% recovery of upper limb function and 59% had achieved independence or modified independence in personal management. The correlation between upper limb function and 73% personal management at discharge was strong, indicating an association between return of upper limb function and independence in personal management. By two months post discharge the correlation between the variables was low, as while only 20% of the 15 participants who returned for therapy at month 2 were dependent for personal management and over 50% presented with no or poor upper limb function.Discussion and Conclusion: Rehabilitation including occupational therapy intervention contributed to participant's improved performance in personal management tasks, even when upper limb motor function recovery was suboptimal. The intervention for personal management and compensatory techniques taught to participants resulted in independent or modified independence two months after discharge.

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Towards universal health coverage for people with stroke in South Africa: a scoping review

et al. 2021

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ObjectivesTo explore the opportunities and challenges within the health system to facilitate the achievement of universal health coverage (UHC) for people with stroke (PWS) in South Africa (SA).SettingSA.DesignScoping review.Search methodsWe conducted a scoping review of opportunities and challenges to achieve UHC for PWS in SA. Global and Africa-specific databases and grey literature were searched in July 2020. We included studies of all designs that described the healthcare system for PWS. Two frameworks, the Health Systems Dynamics Framework and WHO Framework, were used to map data on governance and regulation, resources, service delivery, context, reorientation of care and community engagement. A narrative approach was used to synthesise results.ResultsFifty-nine articles were included in the review. Over half (n=31, 52.5%) were conducted in Western Cape province and most (n=41, 69.4%) were conducted in urban areas. Studies evaluated a diverse range of health system categories and various outcomes. The most common reported component was service delivery (n=46, 77.9%), and only four studies (6.7%) evaluated governance and regulation. Service delivery factors for stroke care were frequently reported as poor and compounded by context-related limiting factors. Governance and regulations for stroke care in terms of government support, investment in policy, treatment guidelines, resource distribution and commitment to evidence-based solutions were limited. Promising supporting factors included adequately equipped and staffed urban tertiary facilities, the emergence of Stroke units, prompt assessment by health professionals, positive staff attitudes and care, two clinical care guidelines and educational and information resources being available.ConclusionThis review fills a gap in the literature by providing the range of opportunities and challenges to achieve health for all PWS in SA. It highlights some health system areas that show encouraging trends to improve service delivery including comprehensiveness, quality and perceptions of care.

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Functional Outcomes of Stroke Patients Admitted to a Tertiary Hospital in the Western Cape, South Africa

Cited by 9 publications

References 7 publications

Stroke management and functional outcomes of stroke survivors in an urban Western Cape Province setting

Stroke management and functional outcomes of stroke survivors in an urban Western Cape Province setting

Upper limb mobility and personal management in patients with stroke attending occupational therapy at a tertiary hospital in Gauteng

Towards universal health coverage for people with stroke in South Africa: a scoping review

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