Carol Blixen1, Jane Nakibuuka2, Mark Kaddumukasa2, Haddy Nalubwama3, Mathew Amollo3, Elly Katabira2, Martha Sajatovic1. 1. Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA. 2. Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda. 3. School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
Abstract
OBJECTIVE: Stroke risk and stroke burden are increasing in Sub Saharan Africa. Qualitative analysis was used to assess perceived barriers to stroke recovery and prevention in an urban/suburban Ugandan population in order to refine and implement a promising nurse and peer-led self-management intervention previously conducted in the United States. METHODS: In depth interviews and focus groups were conducted with 48 participants (stroke survivors, caretakers, and those at risk for stroke. All interviews and focus groups were audiotaped, transcribed verbatim, and analyzed using content analysis, with an emphasis on dominant themes. RESULTS: Three major domains of perceived barriers to stroke recovery and prevention emerged from the data: (1) Individual barriers (PTSD, stress, resistance to seeking care, medication non-adherence, unhealthy lifestyles, functional impairment, and a paucity of stroke knowledge); (2) Family/community barriers (lack of family and community support and caretaker burden); and (3) Provider and healthcare system barriers (lack of access and inadequate follow-up). Importantly, participants in this study identified a pressing need for increasing stroke awareness in the community as part of recovery and prevention efforts. CONCLUSIONS: Stroke risk reduction efforts implemented at the patient, community, and healthcare system levels are needed. These efforts could, perhaps, be modeled along the lines of a previous very successful public health initiative to reduce HIV burden in Uganda.
OBJECTIVE: Stroke risk and stroke burden are increasing in Sub Saharan Africa. Qualitative analysis was used to assess perceived barriers to stroke recovery and prevention in an urban/suburban Ugandan population in order to refine and implement a promising nurse and peer-led self-management intervention previously conducted in the United States. METHODS: In depth interviews and focus groups were conducted with 48 participants (stroke survivors, caretakers, and those at risk for stroke. All interviews and focus groups were audiotaped, transcribed verbatim, and analyzed using content analysis, with an emphasis on dominant themes. RESULTS: Three major domains of perceived barriers to stroke recovery and prevention emerged from the data: (1) Individual barriers (PTSD, stress, resistance to seeking care, medication non-adherence, unhealthy lifestyles, functional impairment, and a paucity of stroke knowledge); (2) Family/community barriers (lack of family and community support and caretaker burden); and (3) Provider and healthcare system barriers (lack of access and inadequate follow-up). Importantly, participants in this study identified a pressing need for increasing stroke awareness in the community as part of recovery and prevention efforts. CONCLUSIONS: Stroke risk reduction efforts implemented at the patient, community, and healthcare system levels are needed. These efforts could, perhaps, be modeled along the lines of a previous very successful public health initiative to reduce HIV burden in Uganda.
Authors: Gary Slutkin; Sam Okware; Warren Naamara; Don Sutherland; Donna Flanagan; Michel Carael; Erik Blas; Paul Delay; Daniel Tarantola Journal: AIDS Behav Date: 2006-07