Struck by stroke - experiences of living with stroke in a rural area in Uganda.

Activities of Daily Living Africa Caregiver support. Family Non-communicable diseases Occupational therapy Rehabilitation Rural

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
05 06 2023
Historique:
received: 05 02 2023
accepted: 06 05 2023
medline: 7 6 2023
pubmed: 6 6 2023
entrez: 5 6 2023
Statut: epublish

Résumé

The global burden of stroke is increasing and persons with low socioeconomic status are among those worst affected. In Uganda, stroke is estimated to be the sixth highest ranking cause of death. The Ugandan healthcare system is reported to be inequitable, where poorer populations often live in rural areas with long distances to health care. Stroke rehabilitation is often scarce, with less financial and human resources. The aim of this study was to explore and describe the consequences of stroke in daily activities in everyday life for people in a rural part of Masaka in Uganda. Qualitative study design. Fourteen persons who had had stroke and were living in their home environment were interviewed about their experiences of having a stroke and managing their lives after the stroke incident. The interviews were analysed using thematic analysis. In addition, sociodemographic data and level of independence (Barthel Index and Stroke Impact Scale 3.0) was collected to describe participant characteristics. Most of the participants had major consequences of stroke and described that they were dependent on support for managing their daily activities. Five themes were identified in the analysis: (1) Accepting and adapting to new ways of managing everyday life, (2) Changing roles and hierarchical positions, (3) Depending on caregiver support, (4) Interrupted care due to economic constraints, (5) Stroke leading to losses and losses leading to stroke. The consequences of stroke on the persons' daily lives clearly reached beyond the person with stroke, affecting the whole family and their proximate social networks. These consequences included increased burdens on caregivers and a worsened economic situation for all persons affected. Therefore, interventions for stroke management should preferably not only target the individual affected by stroke, but also support the caregivers in the caring and rehabilitation process. Home rehabilitation approaches with a focus on improving health literacy are suggested.

Sections du résumé

BACKGROUND
The global burden of stroke is increasing and persons with low socioeconomic status are among those worst affected. In Uganda, stroke is estimated to be the sixth highest ranking cause of death. The Ugandan healthcare system is reported to be inequitable, where poorer populations often live in rural areas with long distances to health care. Stroke rehabilitation is often scarce, with less financial and human resources. The aim of this study was to explore and describe the consequences of stroke in daily activities in everyday life for people in a rural part of Masaka in Uganda.
METHODS
Qualitative study design. Fourteen persons who had had stroke and were living in their home environment were interviewed about their experiences of having a stroke and managing their lives after the stroke incident. The interviews were analysed using thematic analysis. In addition, sociodemographic data and level of independence (Barthel Index and Stroke Impact Scale 3.0) was collected to describe participant characteristics.
RESULTS
Most of the participants had major consequences of stroke and described that they were dependent on support for managing their daily activities. Five themes were identified in the analysis: (1) Accepting and adapting to new ways of managing everyday life, (2) Changing roles and hierarchical positions, (3) Depending on caregiver support, (4) Interrupted care due to economic constraints, (5) Stroke leading to losses and losses leading to stroke.
CONCLUSIONS
The consequences of stroke on the persons' daily lives clearly reached beyond the person with stroke, affecting the whole family and their proximate social networks. These consequences included increased burdens on caregivers and a worsened economic situation for all persons affected. Therefore, interventions for stroke management should preferably not only target the individual affected by stroke, but also support the caregivers in the caring and rehabilitation process. Home rehabilitation approaches with a focus on improving health literacy are suggested.

Identifiants

pubmed: 37277865
doi: 10.1186/s12889-023-15832-3
pii: 10.1186/s12889-023-15832-3
pmc: PMC10240678
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1063

Informations de copyright

© 2023. The Author(s).

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Auteurs

Linda Timm (L)

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. linda.timm@ki.se.

Julius Kamwesiga (J)

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Uganda Allied Health Examinations Board, Kampala, Uganda.

Sulaiman Kigozi (S)

Butabika National Referral Mental Hospital, Kampala, Uganda.
Uganda Institute of Allied Health and Management Sciences - Mulago, Kampala, Uganda.

Charlotte Ytterberg (C)

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.

Gunilla Eriksson (G)

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Susanne Guidetti (S)

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.

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