A study of perceived factors affecting patients' participation in outpatient stroke physiotherapy exercise in Nigeria

Abstract

Background/Aims: Stroke results in a range of disabilities, activities and restrictions which have been shown to benefit from physiotherapy rehabilitation and exercise. However there are numerous factors that prevent stroke patients from participating in their exercise programmes. The aim of this study was to explore the factors that were perceived to affect people with stroke in Nigeria in participating in their outpatient physiotherapy exercise. Methods: Semi-structured interviews were used to explore the topic. The interviews were transcribed and analyzed using thematic analysis. Eight male participants with stroke who were attending outpatient stroke physiotherapy in Nigeria were recruited in December 2009. Findings: The factors that were perceived to affect the participants' participation in their outpatient physiotherapy programme encompassed three dimensions: the internal and personal, the relational and experiential, and external factors. These dimensions were interconnected with the internal and personal factors being central to the participants' participation. Conclusions: This study has provided an insight into the factors that were important for a small group of Nigerian men post-stroke who were receiving out-patient stroke physiotherapy. This can lead to further research that could assist in informing the development of clinical practice and services.

Uncovering Treatment Burden as a Key Concept for Stroke Care: A Systematic Review of Qualitative Research

“…Country of study: Sweden (n=19) [52]–[70]; UK (n=12) [7],[71]–[81]; Canada (n=11) [82]–[92]; Australia (n=10) [93]–[102]; US (n=5) [103]–[107]; Norway (n=3) [108]–[110]; Netherlands (n=3) [111]–[113]; New Zealand (n=2) [114],[115]; Iran (n=1) [116]; Republic of Ireland (n=1) [117]; Nigeria (n=1) [118]; and China (n=1) [119]. Participant numbers ranged from 1 to 113.…”

“…Settings of studies: community (n=34) [7],[52],[55]–[58],[60],[61],[63],[69],[71],[73],[75],[80],[83],[85]–[88],[90]–[94],[96],[99]–[101],[106],[110],[115]–[117],[119]; outpatient (n=5) [54],[62],[65],[74],[118]; care homes (n=3) [111]–[113]; hospital (n=6) [59],[68],[72],[81],[104],[107]; stroke units (n=8) [64],[66],[67],[76],[78],[79],[89],[95]; stroke medical centre (n=1) [108]; and mixed setting such as hospital and community (n=12) [53],[70],[77],[82],[84],[97],[98],[102],[103],[105],[109],[114]. Gender of participants: males and females (n=56) [7],[52],[53],[55]–[57],…”

“…Ages of participants ranged from 22 to 100 years; this was unreported in a few studies (n=7) [53],[54],[72],[105],[106],[110],[114]. Time since stroke (n=41) [7],[52],[55]–[58],[63]–[65],[68]–[71],[74],[78]–[80],[83]–[85],[87]–[89],[91]–[95],[97],[99]–[104],[107],[108],[110],[116]–[118] ranged from under 2 weeks to 16 years. Disability since stroke (n=39) [7],[54]–[56],[58],[61],[63],[65],[67]–[69],[71],[76],[77],[79]–[83],[85],[89]–[92],[95],[96],[99],[100],[102]–[104],[106],[108]–[110],[115],[117]–[119] was very variable.…”

“…Co-morbidities were seldom mentioned (n=11) [53],[67],[73],[77],[80],[86],[90],[93],[99],[100],[112] nor were medications (n=3) [7],[77],[86]. Qualitative data gathering methods: interviews (n=63)[7],[52]–[74],[76]–[91],[94]–[102],[105],[107]–[119]; focus groups (n=4) [93],[103],[104],[106]; interviews and focus groups (n=2) [75],[92]; additional field notes (n=5) [69],[87],[88],[111],[118]; additional patient observation (n=1) [95]. Data analysis: a variety of qualitative methods were used, and all sought to identify common themes raised by participants (details are described in Table S4).…”

“…Patients develop expectations of themselves and their health care providers and work at maintaining motivation during the long recovery process [76],[91],[93],[99],[104],[118]. They slowly learn to cope with uncertainty during recovery [75],[93] and problem solve as the need arises [79],[92].…”