Perceptions of stroke patients on physiotherapy services at Queen Elizabeth Central Hospital in Blantyre district, Malawi
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Date
2009-12-04
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Kamuzu University of Health Sciences
Abstract
Physiotherapy which is all services to people and populations that help to develop maintain, restore maximum movement and functional ability throughout their life span is
critical in organized stroke care and it is perceived as a key discipline. Malawi as a developing country in Africa is under pressure in achieving the quality care for stroke patients due to a number of problems which include; the increasing prevalence and incidents of stroke cases for the last century due to, changes in the environmental determinants and risk factors against limited health facilities to support the increasing demand for physiotherapy services. This is evidenced by presence of only four
Government central hospitals; Queen Elizabeth Central hospital, Zomba Central Hospital, Kamuzu Central Hospital and Mzuzu Central Hospital providing physiotherapy services.
There is also inadequate number of qualified personal against the increasing cases of stroke which has resulted in congestion and low standard care which is likely to cause more disability after stroke. The situation can only be reversed for the better, if physiotherapy services are improved by increasing health facilities for provision of physiotherapy services to stroke patients, training more staff in the field and providing adequate resources in the department because functional outcome after stroke is improved by more intensive or sustained physiotherapy. This framework and study, entitled perceptions of stroke patients on physiotherapy services aims to explore how stroke patients perceive the services being provided at Queen Elizabeth Central Hospital specifically the physiotherapy Department.
Fifteen participants with stroke attending physiotherapy services at QECH were purposively selected to participate in the study. The major constraints in the study were the increasing prevalence of stroke against inadequate personal. At the same time, because QECH was one the only four hospitals providing physiotherapy in the district, many patients were forced to travel long distances Respondents in the study also pointed
out that, even resources were inadequate for example physiotherapy equipment which
they perceived as having an effect on their progress and it was likely to contribute to disability after stroke. According to the study, the following were the results; A significant proportion of the participants, (80% percent) said that they heard about
physiotherapy from either friends or relatives. It was communicated to them that physiotherapy services involve doing exercises in order to regain and maintain muscle strength specifically for individuals with mobility problems due to accidents or stroke. However, twenty percent of the participants indicated that the information was given by a health provider at the Outpatient Department (OPD) after being diagnosed with stroke. Initially they did not have any idea as to what physiotherapy is all about. Participants
highlighted that the health personal did not explain well or address the issue in details on what is involved in physiotherapy for example; the duration of treatment that it takes a long period of time and the possible outcome after treatment. This was challenging for some patients because it contributed to stress due to frustration when the prognosis was poor for the first days. The interviews revealed that despite the participants having inadequate information from the health personal about physiotherapy as treatment for stroke, 93.3 percent perceived it as the best treatment because physiotherapy had a positive impact on their lives and were satisfied in terms of treatment although they fäced challenges like transport costs. Most of them highlighted the importance of physiotherapy which include the following improvements; being able to walk, perform activities of daily living and speech these were likely to be prevented disability in stroke patients. The participants identified long distance, inadequate staff and equipment to be major
challenges in accessing physiotherapy services. In general, the respondents had positive perception towards physiotherapy services. The report proposes a new framework that is based on perceptions of stroke patients on physiotherapy services in response to the identified constraints and challenges in accessing physiotherapy services.