Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India
Authors
Sureshkumar PhD
aInternational Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
Murthy MD
aInternational Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
Audrey PhD
bInstitute for Global Health, Faculty of Population Health Sciences, University College London, London, United Kingdom
Subbulakshmy PhD
cT.S. Srinivasan Institute of Neurological Sciences, Voluntary Health Services Hospital, Taramani, Chennai, India
Hira MA
dIndian Institute of Public Health Hyderabad, Amar Cooperative Society, Madhapur, Hyderabad, Telangana, India
Naveen MSc
dIndian Institute of Public Health Hyderabad, Amar Cooperative Society, Madhapur, Hyderabad, Telangana, India
Shifalika PhD
eInstitute of Public Health–Delhi, Institutional Area, Gurgaon, Haryana, India
Hannah PhD
aInternational Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
Keywords:
Health services research, India, Needs assessment, Rehabilitation, Stroke
Abstract
Objective
To assess the rehabilitation needs of stroke survivors in Chennai, India, after discharge from the hospital.
Design
Mixed-methods research design.
Setting
Home-based.
Participants
Stroke survivors (n=50; mean age ± SD, 58.9±10.5y) and primary caregivers of these stroke survivors (n=50; mean age ± SD, 43.1±11.8y) took part in the quantitative survey. A subsample of stroke survivors (n=12), primary caregivers (n=10), and health care professionals (n=8) took part in the qualitative in-depth interviews.
Interventions
Not applicable.
Main Outcome Measure
Rehabilitation needs after hospital discharge.
Results
About 82% of the needs expressed by stroke survivors and 92% of the needs expressed by caregivers indicated that they had a substantial need for information. The proportion of financial needs reported by the stroke survivors and the caregivers was 70% and 75%, respectively. The qualitative data revealed major gaps in access to stroke rehabilitation services. Service providers identified availability and affordability of services as key problems. Stroke survivors and their caregivers identified lack of information about stroke as major barriers to accessibility of stroke rehabilitation services. Caregivers expressed a tremendous need for support to manage family dynamics.
Conclusions
The study highlights a considerable unmet need for poststroke rehabilitation services. Given the lack of rehabilitation resources in India, developing an accessible, innovative, patient-centered, culturally sensitive rehabilitation intervention is of public health importance. It is crucial for low- and middle-income countries like India to develop technology-driven stroke rehabilitation strategies to meet the growing rehabilitation needs of stroke survivors.
Keywords: Health services research, India, Needs assessment, Rehabilitation, Stroke
List of abbreviations: NIH, National Institutes of Health
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