Participatory outcomes, quality of life and barriers faced by stroke survivors in the rural Eastern Free State
| dc.contributor.advisor | Visagie, Surona | en_ZA |
| dc.contributor.advisor | Ned, Lieketseng | en_ZA |
| dc.contributor.author | Cook, Petri Johan | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies | en_ZA |
| dc.date.accessioned | 2017-02-15T20:41:51Z | |
| dc.date.accessioned | 2017-03-29T11:52:30Z | |
| dc.date.available | 2017-02-15T20:41:51Z | |
| dc.date.available | 2017-03-29T11:52:30Z | |
| dc.date.issued | 2016-12 | |
| dc.description | Thesis (MHumanRehabSt)--Stellenbosch University, 2016. | |
| dc.description.abstract | 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. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING : Inleiding: Dit word algemeen aanvaar dat rehabilitasie ’n geintegreerde deel vorm van die proses om individue wat ’n beroerte oorleef het te help om funksionele onafhanklikheid, integrasie in die gemeenskap en kwaliteit lewe te bereik. Omgewingsstruikelblokke kan moontlik n negatiewe impak op die verwerkliking van bogenoemde uitkomste he. Doel van die projek: Om funksionele- en gemeenskapsintegrasie uikomste asook lewenskwaliteit van beroerte lyers, woonagtig in die Thebe Distriks Hospitaal Kompleks, te beskryf. Voorts is omgewingsstruikelblokke wat deur deelnemers ervaar word beskryf. Metode: ’n Kwantitatiewe, beskrywende studie is uitgevoer. Data is verkry van 38 deelnemers wat beroertes oorleef het en gesondheidssorg ontvang het by Thebe/Phumelela Distriks Hospitaal Kompleks tussen 1 Januarie 2012 en 31 Desember 2014. ’n Totaal van 176 name is verkry vanaf die data basis. Beperkte- sowel as onakkurate kontak besonderhede asook ’n hoë vlak van mortaliteit het veroorsaak dat 43 deelnemers opgespoor kon word. Van hulle het 38 ingestem om aan die studie deel te neem. ’n Vraelys is ontwikkel gegrond op die “ICF core set for stroke”, en is gebruik om data in te win rakende aktiwiteite, deelname en omgewingsstruikelblokke. Die WHO QOL Bref is gebruik om data in te win rakende kwaliteit lewe. Beskrywende analise van data is gedoen met Excel program. Resultate: Funksionele- en deelname uitkomste was meestal beperk to binneshuise aktiviteite. Alhoewel familie verhoudings goed was het 66% van deelnemers probleme ervaar met intieme verhoudings. Integrasie in die gemeenskap was beperk. Deelnemers het probleme ervaar om onafhanklik buite te loop (55%), publieke vervoer te gebruik (55%) en te bestuur (84%). Deelname in sosiale aktiwiteite (66%), godsdiens aktiwiteite (63%), bereikbaarheid van dienste (71%), sport beoefening (89%), politieke aktiwiteite (66%) asook bestuur van persoonkike finansies (61%) en werk (74%) was moeilik of onmoontlik vir baie deelnemers. Meeste deelnemers (82%) se lewenskwaliteit het gewissel van neutraal tot baie swak. Depressiewe affek het 58% van deelnemers op ’n gereelde basis geaffekteer. Sosiale gesondheid het die laagste gemiddelde waarde (64.3) van die vier areas van lewenskwaliteit getoon. Omgewingsstruikelblokke wat die meeste probleme veroorsaak het vir deelnemers was klimaat (82%), ’n gebrek aan bates (61%) en mobiliteits produkte (61%), ontoeganklikheid van publieke geboue (76%), asook vervoer- (61%), onderwys- (79%), behuising- (66%), en arbeid (82%) dienste, sisteme en beleide. Die meerderheid deelnemers (63%) het vir minder as n maand terapie ontvang. Een en twintig deelnemers (55%) het terapie ontvang by hul naaste kliniek. Min deelnemers (11%) het werks rehabilitasie ontvang terwyl geen deelnemers vaardigheids asseserings, werkgerers opleiding of redelike werks aanpassings ontvang het nie. Gevolgtrekking: Swak funksionele-, deelname- en lewenskwaliteit uitkomste is bereik deur beroerte oorlewendes in die afgeleë gedeelte van die Oos Vrystaat. Omgewingsstruikelblokke sowel as fiesiese beperkings het ’n negatiewe impak gehad op funksionele-, deelname-, en ander uitkomste van beroerte oorlewendes. Rehabilitasie dienste voldoen nie aan voogestede beleid stupilasies nie. Aanbevelings: Dit is noodsaklik om ’n beroerte rehabilitasie protokol te ontwikkel wat kan lei tot ’n holistiese benadering vanaf verskeie disiplines. ’n Model van samewerking deur verskeie sektore word benodig om integrasie in die gemeenskap en produktiwiteit te verseker na ontslag vanaf die hospital. Bereikbaarheid van basiese dienste moet verseker word deur ontwikkeling van infrastuktuur asook ontwikkeling van volhoubare vervoer oplossings. Optimalisering van pasiënt data sisteme is noodsaaklik om akkurate en doeltreffende inwinning van data te verseker. | af_ZA |
| dc.format.extent | xv, 117 pages ; illustrations, includes annexures | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/100970 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | |
| dc.rights.holder | Stellenbosch University | |
| dc.subject | Cerebrovascular disease | en_ZA |
| dc.subject | Cerebrovascular disease -- Patients -- Rehabilitation | en_ZA |
| dc.subject | Free State (South Africa) -- Environmental conditions | en_ZA |
| dc.subject | Quality of life | en_ZA |
| dc.subject | UCTD | |
| dc.title | Participatory outcomes, quality of life and barriers faced by stroke survivors in the rural Eastern Free State | en_ZA |
| dc.type | Thesis | en_ZA |