Nketia-Kyere Mercy, Aryeetey Genevieve Cecilia, Nonvignon Justice, Aikins Moses
Tema General Hospital, Tema, Ghana.
Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG13, Legon, Accra, Ghana.
Arch Physiother. 2017 Jul 6;7:8. doi: 10.1186/s40945-017-0037-5. eCollection 2017.
Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined.
A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert's scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents' adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at < 0.05.
The results showed that majority (76.3%) of the respondents had economic barrier as their main individual/personal barrier to physiotherapy services. For medication adherence level, patients with low medication adherence level were about 21 times the odds of defaulting on accessing physiotherapy services five times or more as compared to those with medium adherence level (OR 20.63, 95% CI 8.96, 42.97). It was concluded in the study that individual/personal barriers of stroke patients were the significant barriers to accessing physiotherapy services at Tema General Hospital.
物理治疗已被证明可降低中风患者的残疾风险。对物理治疗的依从性差会对治疗效果和医疗成本产生负面影响。然而，对于加纳物理治疗服务的障碍，尤其是这方面的情况，人们知之甚少。本研究的目的是评估特马总医院（TGH）中风患者接受物理治疗服务的障碍。确定了特马总医院物理治疗服务的个人/自身及卫生系统障碍。
采用横断面研究设计。使用简单随机抽样技术招募207名受访者进行面对面访谈。采用访谈者 administered问卷收集受访者接受物理治疗服务的个人/自身障碍数据，并使用李克特量表进行描述。使用自行构建的问卷评估卫生系统障碍，该问卷有以下标题下的部分：人为因素、物理治疗方式、物理障碍和材料/设备因素。测量的指标包括等待物理治疗的时间以及物理治疗师对患者的态度；电疗法、运动疗法和按摩疗法等物理治疗方式。使用莫利斯基8项药物依从性问卷评估受访者的药物依从性。数据使用Epi info 7和STATA 12.0录入并分析。使用卡方检验确定变量之间的关联，并使用逻辑回归模型检验自变量和因变量之间关联的强度。统计学显著性水平设定为<0.05。
结果显示，大多数（76.3%）受访者将经济障碍作为接受物理治疗服务的主要个人/自身障碍。对于药物依从性水平，与中等依从性水平的患者相比，药物依从性水平低的患者不接受物理治疗服务达五次或更多次的几率约为其21倍（OR 20.63，95%CI 8.96，42.97）。该研究得出结论，中风患者的个人/自身障碍是特马总医院接受物理治疗服务的重要障碍。
