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印度脑卒中幸存者出院后的康复需求

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

作者信息

Kamalakannan Sureshkumar, Gudlavalleti Venkata Murthy, Prost Audrey, Natarajan Subbulakshmy, Pant Hira, Chitalurri Naveen, Goenka Shifalika, Kuper Hannah

机构信息

International Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.

International Center for Evidence in Disability, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.

出版信息

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

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.

摘要

目的

评估印度金奈中风幸存者出院后的康复需求。

设计

混合方法研究设计。

设置

居家。

参与者

中风幸存者(n = 50;平均年龄±标准差,58.9±10.5岁)及其主要照顾者(n = 50;平均年龄±标准差,43.1±11.8岁)参与了定量调查。中风幸存者(n = 12)、主要照顾者(n = 10)和医疗保健专业人员(n = 8)的一个子样本参与了定性深入访谈。

干预措施

不适用。

主要结局指标

出院后的康复需求。

结果

中风幸存者表达的需求中约82%以及照顾者表达的需求中92%表明他们对信息有很大需求。中风幸存者和照顾者报告的经济需求比例分别为70%和75%。定性数据揭示了中风康复服务获取方面的主要差距。服务提供者将服务的可获得性和可承受性确定为关键问题。中风幸存者及其照顾者将缺乏中风相关信息确定为中风康复服务可及性的主要障碍。照顾者表示非常需要支持来处理家庭关系。

结论

该研究突出了中风后康复服务存在大量未满足的需求。鉴于印度缺乏康复资源,开发一种可及、创新、以患者为中心且对文化敏感的康复干预措施具有公共卫生重要性。对于像印度这样的低收入和中等收入国家来说,制定技术驱动的中风康复策略以满足中风幸存者不断增长的康复需求至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c4/5813710/cad8cfe73b7e/gr1.jpg

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