Understanding the cultural meanings of stroke in the Ghanaian setting: A qualitative study exploring the perspectives of local community residents

Abstract

Stroke has undergone different medical constructions over the Background: years. While the medical profession posits that disease is a biological condition, universal and unchanging, social constructionists perceive illness as the social meaning of the biological condition. Even though the medical notion of stroke is monolithic and sometimes contradicts the representations by local community residents, little attention has been paid to understanding the cultural meanings of stroke. This study explores the cultural meanings of stroke in five different cultural settings in Ghana.30 focus group discussions (FGDs) were conducted with local Methods: community members in five communities (Ga Mashie, Tafo, Gyegyeano, Chanshegu and Agorve) located in five regions in Ghana. The FGDs were conducted in Ga, Twi, Fante, Ewe and Dagbani, and were transcribed verbatim into English. The transcripts were analysed thematically.The local words used for stroke in all the five cultural settings focused Results: on physical disability associated with stroke after its onset, and this formed the dominant source of fear about the condition. Participants mentioned that spiritual and left-side stroke have the most debilitating impact on the sufferer. Although there was a general consensus that anyone can be at risk of stroke, there was a gender dynamics in the explanation of risk relativity. Participants believed that stroke can be cured through early detection and treatment, use of herbal medicines, and availability of financial resources. Compared to other disabling conditions, the community residents perceived stroke to be more severe due to its multifaceted disabilities.This study showed that the social meanings of stroke in the five Conclusions: communities are multifaceted, and reflected co-existence of biomedical and cultural frameworks. The findings showed the need to pay good attention to the sociocultural context when developing interventions strategies on stroke prevention and control.

Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives

“…Consistent with the findings from this study, the need for stroke awareness campaigns in LMICs is increasingly being advocated by recent studies . Even among health‐care providers in Africa, identifying early stroke symptoms can sometimes be a challenge at the population level .…”

“…42 Consistent with the findings from this study, the need for stroke awareness campaigns in LMICs is increasingly being advocated by recent studies. 43,44 Even among health-care providers in Africa, identifying early stroke symptoms can sometimes be a challenge at the population level. 45 Improving the public's knowledge of stroke risk factors, signs and symptoms of stroke is critical to improving the quality of stroke care.…”

The structure, processes, and outcomes of stroke rehabilitation in Ghana: A study protocol

“…In the Ghanaian context, the coordination of stroke care after discharge from acute care is fragmented ( 34 ), with further rehabilitation after acute care poorly addressed due to accessibility of care issues such as inadequate medical facilities and financial constraints ( 34 , 35 ). For this reason, some patients and/or their caregivers choose to use rehabilitation in a complementary or conventional setting as a treatment for stroke based on availability in the community and acceptability to their health beliefs or religious faith ( 7 , 36 ), and sometimes as a substitute for the absence of conventional rehabilitation ( 7 , 37 ). However, there is a paucity of information on the outcomes of stroke patients who use complementary medicine and rehabilitation in Ghana.…”

Improving stroke care in Ghana: a roundtable discussion with communities, healthcare providers, policymakers and civil society organisations

“…Although well-established evidence of an increasing stroke burden in Ghana is evident in high mortality and disability rates, 1,2 management of stroke in the healthcare settings is challenging and complex due to the pluralistic healthcare-seeking behaviours 3,4 and a host of factors, including poor healthcare accessibility. [4][5][6] Existing discrepancies between explanatory models of stroke by laypeople and pluralistic healthcare providers contribute to poor stroke prognosis in Ghana.…”

“…4,7 Studies have particularly shown that stroke survivors seek biomedical treatment, in addition to treatments from faith healers and herbal/traditional healers, either concurrently or sequentially. 3,4 Despite this, no previous scholarly attempt has been made to report evidence of stroke care, treatment and strategies for improvement from the perspectives of policymakers, health advocates/activists, healthcare professionals as well as faith healers and herbal healers.…”