The Needs and Barriers of Medication-Taking Self-Efficacy Among Poststroke Patients: Qualitative Study

Abstract

Background Stroke is one of the top 10 leading diseases worldwide, with high mortality and morbidity rates. There is an incomplete understanding of the various types of self-efficacy involved in the prevention of recurrent stroke, and one of them is medication-taking self-efficacy. Objective This study aimed to explore the fundamental needs and barriers of medication-taking self-efficacy in poststroke patients in Malaysia. Methods We performed in-depth individual interviews with poststroke patients (N=10) from the Outpatient Neurology Clinic, Hospital Kuala Lumpur. All interviews were transcribed verbatim, and an inductive thematic analysis was performed on the data collected from the interviews. Results Two key themes were identified: (1) self-efficacy in taking the effort to understand stroke and its preventative treatment for recurrent stroke and (2) self-efficacy in taking prescribed medication to prevent stroke. Patients needed to be proactive in seeking reliable information about stroke and the perceived benefits of preventative treatment for stroke. The discussion was focused on eliciting the needs and barriers related to medication-taking self-efficacy. Patients needed to develop independence and self-reliance to overcome barriers such as dependency and low motivation. External factors such as limited information resources, low perceived severity, poor social environment, and poor communication add to the challenges of poststroke patients to improve their self-efficacy of managing their medications. Conclusions The study identified potential key findings related to the needs of patients in a localized setting, which are also related to several health behavioral concepts and constructs, indicating the importance of overcoming barriers to improve the quality of life in poststroke patients. We anticipate that the results will be taken into consideration for future personalized patient education interventions.

The Unmet Needs of Community-Dwelling Stroke Survivors: A Systematic Review of Qualitative Studies

“…The participants’ unmet need for stroke-related information seemed insatiable, they generated inexhaustible interest in it (e.g., stroke symptom, treatment, prevention and prognosis), and they did [ 19 , 43 , 45 , 47 , 49 ]. Patients usually want to know many faces and forms of stroke [ 47 ], which was due to being afraid of having another stroke or of possible medication side effects [ 49 ].…”

“…For instance, Abrahamson V [ 15 ] reported that stroke nurse specialists emphasized investigations, medication, and liaising with general practitioners or consultants, while the stroke association coordinator highlighted signposting to other services. Of note, some researchers [ 15 , 19 ] reported that clinicians may sometimes discover unmet needs; however, if the patient believes that further intervention will not alleviate the need, they will not find it, which means that the patient’s unmet need is irreplaceable and unique.…”

<p>An Evaluation of the Video Narrative Technique on the Self-Efficacy of Medication Understanding and Use Among Post-Stroke Patients: A Randomized-Controlled Trial</p>

“…Based on post-stroke patients’ needs in Malaysia, 21 two sets of video narratives (in English and the Malay language) were previously designed to enhance MUSE. 23 ( Video 1 , Video 2 , Video 3 and Video 4 ).…”

“…Thus, this trial focused on a behavioral modification approach to overcome major personal obstacles, eg, self-efficacy, motivation, and negative illness and its treatment perception. 21 Through the qualitative feedback, 23 the patients appreciated the healthcare professional who helped them increase the awareness of illness management and stroke prevention. They were receptive of the audio-visuals featuring their pain and challenges, moreover, towards their peer, who boldly stepped forward to share his success and strength in managing his stroke condition.…”

Video Narratives Intervention Among Stroke Survivors: Feasibility and Acceptability Study of a Randomized Controlled Trial

“…In Malaysia, the ischemic stroke incidence has shown an increase of approximately 30% annually, with an increase of approximately 19% for hemorrhagic stroke, which is a more prominent condition among the aging community [ 12 , 13 ]. The majority of poststroke patients experience physical disability, learning, and speech impairment, which also lead to emotional problems [ 14 , 15 ]. Hence, an individual who experienced stroke will benefit from resilience, which requires self-efficacy [ 16 , 17 ].…”