Accessibility of physiotherapy services post-hospital discharge after stroke in Blantyre, Malawi: The patient’ perspectives

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Date
2021-12-16
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Kamuzu University of Health Sciences
Abstract
Stroke is the fourth leading cause of mortality and acquired disability in Malawi(1).Despite challenges faced by people with disability, studies shows that physiotherapy treatment improves the functional status of patients with stroke by minimising impairments hence increasing their quality of life (2). However, anecdotal evidence shows that most Malawian patients with stroke do not attend physiotherapy services after acute hospital discharge and the underlying reasons for such a trend are not empirically established. Therefore, this study aims at exploring the perspectives of people with stroke with regards to accessing and utilising physiotherapy services post-hospital discharge at Queen Elizabeth Central Hospital Blantyre Malawi. Type of the study This research will be a cross-sectional qualitative study Problem Statement The principal investigator has observed that there is an increase in the number of patients diagnosed with a stroke at Queen Elizabeth Central Hospital and these patients do not return for physiotherapy services after being discharged from the hospital after acute medical care. There is no documented evidence to show why patients with stroke do not attend physiotherapy treatment despite given an appointment date. This study aims at exploring the perspectives of people with stroke with regards to accessing and utilising physiotherapy services post-hospital discharge in Blantyre, Malawi. Objectives  To explore the patient's perspectives and experiences with accessing physiotherapy services post-hospital discharge.  To ascertain the patient's understanding of the benefits of utilising physiotherapy services post-hospital discharge.  To investigate challenges faced by patients with stroke on accessing and utilising physiotherapy services post-hospital discharge.  To obtain possible solutions from the patients with stroke for the challenges they face on accessing and utilising physiotherapy services post-hospital discharge. Methodology Study place The study will be conducted in patient’s homes residing in Blantyre within 70km of the discharging hospital Queen Elizabeth Central Hospital. Study population Discharged patients with stroke from Queen Elizabeth Central Hospital between 6 weeks to 12 months during the time of study Study period Three months from December 2021 to February 2022 Sample size In qualitative research, 15 interviews are recommended to reach saturation (19,20) Data collection In-depth interviews using a semi-structured questionnaire will be used to collect data from purposively recruited participants according to the inclusion criteria. Data Management The recorded interviews will be transcribed verbatim for analysis. All identifiable information for the individual participant will be removed and replaced by study code and saved in a password computer. The anonymised data will be analysed using a thematic content approach using both deductive and inductive methods. Expected Findings Financial challenges, lack of mobility aids and inadequate information as being some of the reasons for not accessing and utilising physiotherapy services. Dissemination A copy of the manuscript resulting from this study will be shared with COMREC Committee. The results will also be presented and submitted to the School of Therapeutic Sciences at The University of the Witwatersrand. Oral presentation to the QECH Research Committee and Physiotherapy department respectively.
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Accessibility of Physiotherapy session after hospitalization
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