Masters Degrees (Centre for Disability and Rehabilitation Studies)

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Browsing Masters Degrees (Centre for Disability and Rehabilitation Studies) by Author "Cook, Petri Johan"

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    Participatory outcomes, quality of life and barriers faced by stroke survivors in the rural Eastern Free State
    (Stellenbosch : Stellenbosch University, 2016-12) Cook, Petri Johan; Visagie, Surona; Ned, Lieketseng; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies
    ENGLISH SUMMARY : Introduction: It is widely recognised that rehabilitation forms an integral part of the process to enable stroke survivors to achieve functional independence, community integration and quality of life. Environmental barriers may however negatively influence achievement of these goals. Aim of the study: To describe functional, participation and quality of life outcomes as well as barriers experienced by stroke survivors in the catchment area of the Thebe District Hospital Complex. Methods: A quantitative, descriptive study was conducted. Data was obtained from 38 participants who suffered a stroke and received care between 1 January 2012 and 31 December 2014 at the Thebe/Phumelela District Hospital Complex. In total 176 names where obtained from the data base. Lack of or incorrect contact details and high mortality rates left 43 participants of whom 38 consented to participate. The ICF core set for stroke was utilized to develop tools to collect data on activities, participation and environmental barriers. Quality of life was determined with the WHO QOL Bref. Descriptive analysis of data was done using an Excel spreadsheet. Results: Functional and participatory outcomes were mostly limited to residential activities. Family relationships were good, but 66% of participants struggled to maintain intimate relationships. Community integration was limited with most participants unable to independently walk outside (55%), use public transport (55%) and drive (84%). Participation in social activities (66%), religious activities (63%), accessing services (71%), playing sport (89%), engaging in politics (66%), managing personal finances (61%), and accessing employment (74%) was difficult to impossible for many participants. The majority (82%) of participants reported a quality of life ranging between neutral and very poor. Recurring depressive affect was found to influence 58% of participants on a regular basis. Social health had the lowest mean score (46.3) of the four quality of life domains. The most severe environmental barriers perceived by participants included climate (82%), a lack of finances and assets (61%), mobility products (61%), as well as inability to access public buildings (76%) and, transport- (61%), education- (79%), housing- (66%), and labour (82%) services, systems and policies. The majority of participants (63%) received therapy for less than a month. Twenty one participants (55%) received follow up therapy at a local clinic. Few participants (11%) received vocational rehabilitation and no skills assessments, employer education or reasonable work accommodations were done. Conclusion: Poor functional-, participatory- and quality of life outcomes were achieved by stroke survivors in the rural Eastern Free State. Environmental barriers and impairments impacted negatively on functional-, participatory-, and other outcomes of stroke survivors. Rehabilitation service provision requirements, as stipulated by the National Policy, were not met. Recommendations: Establishing a stroke rehabilitation protocol is essential, ensuring a holistic approach by core disciplines from hospital discharge to community integration and productive activity through a model of multi sectoral collaboration. Accessibility of services to stroke survivors needs to be ensured through infrastructure development and sustainable transport solutions. Patient data systems must be optimised to allow accurate and efficient data retrieval.