‘It burdens me’: the impact of stroke in central Aceh, Indonesia

Abstract

The complex primary and secondary consequences of stroke have often been equated with the concept of biographical disruption, although a number of mediating factors have been identified. However, the research to date is almost exclusively based in western contexts, despite the fact that stroke is increasing most rapidly in low-income and middle-income countries. This research explores the experience of stroke in the rural community of central Aceh, Indonesia. The participants included 11 stroke survivors and 18 carers, with data collected through in-depth interviews and photographic facilitated interviews, supported with participant observation over a nine month period. The participants discussed and illustrated the disruptive result of their stroke, but for most, their ability to maintain religious duties and contribute to their family resulted in a form of biographical continuity. Their strategies and challenges are discussed alongside the implications for care in this context.

How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis

“…However, while there has been a steady increase in citations using quantitative methods since 2000, it is only in recent years (2010 onwards) that qualitative studies on NCDs have emerged. Of the 130 included citations, nine used qualitative research designs [52, 59, 74, 77, 88, 92, 93, 100, 117], two utilized mixed methodologies [47, 113], and seven focused on the project design or evaluation of risk factor interventions or NCD prevention [30, 51, 57, 61, 65, 78, 86]. Ten of the citations were based on gray reports [134–143].…”

“…The majority used community-based or population-based secondary data sets such as from the Purworejo Health and Demographic Surveillance Site (HDSS), Indonesian Family Life Surveys (IFLS), National Basic Health Research Studies (Riskesdas), National Socio-Economic Household Surveys (Susenas), or the WHO STEPwise approach to Surveillance (STEPS). Sample sizes ranged from 18 stroke survivors in a qualitative study in Central Aceh [59, 77] to a sample of 664,196 people participating in the 2007 Riskesdas study [127]. The majority of studies included both women and men; a few focused on sex- or gender-specific issues and included only one group.…”

“…Through our review we identified 27 citations that dealt with NCD management at the structural policy level [25, 61, 88], clinical level [23, 54, 63, 72, 75, 83, 90–92, 95, 106, 108, 110, 113], community [16, 38, 52, 73, 74, 100], family [105, 107], and individual level [59, 77]. At the structural level, we recognized three issues: health insurance services for NCD patients [88], the need for a better collaboration between health and registration sectors [61], and the need to address the double burden of NCDs and infectious diseases such as tuberculosis and diabetes [25], which might be aggravated by smoking [39].…”

“…Only Effendy and colleagues provide insights into the involvement of family caregivers in cancer care [105, 107]. At the individual level, there has been some research on the individual perception and impact of stroke [59, 77]. …”

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

“…As suggested by Aamodt (1991), "the context of a culturally constituted environment provides the meaning, and makes ethnographic knowledge different from every other form of knowledge generated" (p. 52) in healthcare research. The combination of interpretive phenomenology and ethnography has previously been used in stroke research (Doolittle, 1994;Norris, Allotey, & Barrett, 2012) and nursing (Rapport & Maggs, 1997).…”