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Arch Phys Med Rehabil. 2016 Sep;97(9):1526-1532.e9. doi: 10.1016/j.apmr.2016.02.008. Epub 2016 Mar 2.

Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India.

Author information

1
International Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: suresh.kumar@lshtm.ac.uk.
2
International Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
3
Institute for Global Health, Faculty of Population Health Sciences, University College London, London, United Kingdom.
4
T.S. Srinivasan Institute of Neurological Sciences, Voluntary Health Services Hospital, Taramani, Chennai, India.
5
Indian Institute of Public Health Hyderabad, Amar Cooperative Society, Madhapur, Hyderabad, Telangana, India.
6
Institute of Public Health-Delhi, Institutional Area, Gurgaon, Haryana, India.

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

PMID:
26944710
PMCID:
PMC5813710
DOI:
10.1016/j.apmr.2016.02.008
[Indexed for MEDLINE]
Free PMC Article

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