The profile and outcomes of stroke patients discharged from a hospital In the Eastern Cape
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Date
2012
Authors
Journal Title
Journal ISSN
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Publisher
University of Western Cape
Abstract
Stroke is the third leading cause of death and disability worldwide. The Uitenhage
Provincial Hospital admits many stroke patients. To date, no in-depth study has been
conducted on stroke patients admitted to the Hospital. This study identified the
profile of stroke patients admitted to the Uitenhage Provincial Hospital and explored
the challenges that these patients experienced post stroke. A concurrent mixed
model design was used to collect the data. Firstly retrospective data was obtained by
means of a quantitative data gathering instrument designed by the researcher. The
information obtained, included data relating to demographic characteristics, reported
risk factors relating to stroke, stroke onset-admission interval and length of hospital
stay, as well as information relating to the process of physiotherapy. Secondly
quantitative prospective information was collected by means of the Barthel Index, the
Modified Rankin Scale and the Facilitators And Barriers Survey. The sample for the
quantitative phase was drawn from medical records of 168 stroke patients admitted
to the Uitenhage Provincial Hospital from the 1 of January 2008 up to and including
the 31 of December 2009. For the second prospective quantitative part of the study,
participants were selected conveniently from the admitted patients. In the qualitative
phase, nine participants taken of the sampled participants were selected. The
Microsoft Excel 2007 Package and the SPSS 18 for social sciences were used to
analyse the quantitative data. Means, standard deviations, frequencies and
percentages were calculated for descriptive purposes and the Chi-square test was
used to test for associations between variables. Qualitative analysis began with the
transcription of voice recordings and the translation of relevant Afrikaans
transcription into English. Emerging categories were identified within the pre-determined themes. Permission and ethical clearance was obtained from the Higher
Degrees Committee and the Senate Research and Grants and Study Leave
Committee of the University of the Western Cape and permission to conduct this
study was also obtained from the Medical Superintendent of the Uitenhage
Provincial Hospital. Altogether 461 patients had been admitted with stroke during the
relevant period, but only 168 could be included in the retrospective quantitative
study. The mean age of the participants was 61,54 years; 59% were females and
41% males. The majority of the participants (86,9%) were admitted on the same day
of stroke onset, and the mean length of hospital stay was 7,38 days. Hypertension
was the most common reported risk factor, at 79%. Only 165 of the participants
received physiotherapy while hospitalised, with the mean total physiotherapy
sessions being 2,56 sessions. In 90% of the cases, physiotherapy sessions were
discontinued due to the patient being discharged from the Hospital. The mean
Barthel Index score was 81,46 and the family care domain of the Modified Rankin
Scale was the most affected. Participants experienced participation restrictions and
activity limitations due to stairs, gravel surfaces and kerb cuts. During the qualitative
interviews participants reported activity limitations related to walking and activities of
daily living. The participants also experienced participation restrictions, which
included dependency on others, decreased social support and an array of emotions
experienced post stroke. The current study’s findings suggest that the discharge of
patients from the hospital post stroke should follow a mulitidisciplinary approach.
Rehabilitation professionals should play an active role in the discharge process in
providing patient and caregiver education.
Description
Magister Scientiae (Physiotherapy) - MSc(Physio)
Keywords
Activity limitations, Environmental barriers, Environmental facilitators, Impairments, Participation restrictions, Physiotherapy, Profile, Rehabilitation, Stroke, Uitenhage Provincial Hospital