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

Cawood, Judy; Visagie, Surona

doi:10.17159/2310-3833/2016/v46n3a5

Cited by 9 publications

(14 citation statements)

References 22 publications

(49 reference statements)

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“…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 . Other rehabilitation interventions included physiotherapy and speech therapy and patients typically attend a minimum of three occupational therapy sessions per week as inpatients.…”

Section: Introductionmentioning

confidence: 99%

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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Section: Introductionmentioning

confidence: 99%

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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“…36 Despite free healthcare, contextual factors, such as poverty, lack of transport or inaccessible public transport, further limit access to these facilities. 37,38,39,40,41 Home-and community-based care (HCBC) services are delivered by teams of community health workers (CHWs) 42,43 led by nurses (home-based care coordinators) who are responsible for conducting assessments and determining treatment plans. The CHWs are lay workers with mostly informal training, specific to the context they work in, and who focus on health promotion, prevention, curative and palliative services.…”

Section: Figuring It Out By Yourself: Perceptions Of Home-based Care Of Stroke Survivors Family Caregivers and Community Health Workers Imentioning

confidence: 99%

“… 36 Despite free healthcare, contextual factors, such as poverty, lack of transport or inaccessible public transport, further limit access to these facilities. 37 , 38 , 39 , 40 , 41 …”

Section: Introductionmentioning

confidence: 99%

Figuring it out by yourself: Perceptions of home-based care of stroke survivors, family caregivers and community health workers in a low-resourced setting, South Africa

Scheffler¹,

Mash²

2020

African Journal of Primary Health Care & Family Medicine

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Background In less resourced settings, formal rehabilitation services for stroke survivors were often absent. Stroke survivors were referred to community health workers (CHWs) who were untrained in rehabilitation. Aim To describe the experience and perceived needs of stroke survivors, their caregivers and CHWs in a context with limited access to and support from formal rehabilitation services. Setting The Breede Valley subdistrict, Western Cape, South Africa, a rural, less resourced setting. Methods A descriptive exploratory qualitative study. Four focus group interviews were held with purposively selected stroke survivors and caregivers and four with CHWs. A thematic approach and the framework method were used to analyse the transcripts. Findings A total of 41 CHWs, 21 caregivers and 26 stroke survivors participated. Four main themes and 11 sub-themes were identified. Because of the lack of knowledge, training and rehabilitation services, the main theme for all groups was having to ‘figure things out’ independently, with incontinence management being particularly challenging. Secondly was the need for emotional support for stroke survivors and caregivers. Thirdly, contextual factors such as architectural barriers and lack of assistive products negatively impacted care and function. Lastly, the organisation of health and rehabilitation services negatively impacted home-based services and professional support. Conclusions With appropriate training, the CHWs can be pivotal in the training and support of family caregivers and stroke survivors. Care pathways and the role and scope of both CHWs and therapists in home-based stroke rehabilitation should be defined and restructured, including the links with formal services.

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“…Comprehensive early intervention by an inter-professional team can assist patients to reach their maximum potential by decreasing the effect of disability. Rehabilitation thus plays a vital role in the transition between medical management and patients' return to independent participation in daily activities, community integration and their return to meaningful and productive work activities 5,6 .…”

Section: Introductionmentioning

confidence: 99%

The perceived burden of care among caregivers of survivors of cerebrovascular accident following discharge from a private rehabilitation unit

Serfontein¹,

Visser²,

Schalkwyk³

et al. 2019

S. Afr. j. occup. ther.

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Introduction: The transition between inpatient rehabilitation and discharge of survivors of stroke from private rehabilitation services in South Africa is often challenging. After the stroke survivor is discharged, caregivers have an important role as an extension of rehabilitation, although the occupation of caregiving is often unplanned. This study investigated the factors associated with the burden of care experienced by patients' caregivers. Methods: A quantitative descriptive study was conducted with 63 patients and 63 caregivers, using a consecutive, non-randomised sampling method. Patients' Functional Independence Measure (FIM) scores upon discharge were obtained. Telephonic interviews were conducted with the caregivers two months after the patients' discharge, using the Modified Caregiver Strain Index (MCSI) and a demographic data questionnaire to obtain their perceived burden of care. Results: Patients' median FIM score at discharge was 86, indicating that they needed minimal assistance. After discharge, caregivers experienced minimal to moderate strain (burden of care) according to the MCSI score. The associated factors that were identified included financial, physical, psychological and social aspects, of which financial strain was encountered most regularly. Caregivers also seemed to have unbalanced occupational profiles. Conclusions: Better caregiver training and support should be provided by private rehabilitation services for better integration of stroke survivors into the community.

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

Cited by 9 publications

References 22 publications

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

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

Figuring it out by yourself: Perceptions of home-based care of stroke survivors, family caregivers and community health workers in a low-resourced setting, South Africa

The perceived burden of care among caregivers of survivors of cerebrovascular accident following discharge from a private rehabilitation unit

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