Mlambo Ntombifuthi, Hlongwana Khumbulani
Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
S Afr J Physiother. 2020 Oct 7;76(1):1475. doi: 10.4102/sajp.v76i1.1475. eCollection 2020.
Stroke is one of the major causes of physical disability worldwide. Whilst physiotherapy interventions are important for the recovery of stroke survivors, the uptake remains inconsistent and factors contributing to these inconsistencies are not well documented, especially in South Africa.
The overall objective was to determine the intrinsic and extrinsic factors associated with adult stroke survivors' inconsistent uptake of physiotherapy interventions at Turton Community Health Centre, Ugu District, KwaZulu-Natal, South Africa.
This was a cross-sectional study involving 50 stroke survivors who missed one or more of their physiotherapy appointments and 25 who attended all their appointments (comparison group) within a 2-year period. A researcher-administered semi-structured questionnaire was used to collect data, which was captured and analysed using SPSS v25. Results were summarised using descriptive statistics. Pearson's chi-square test was used for bivariate analysis.
Only two intrinsic factors were significantly associated with the outcome variable, namely: believed in exercises recommended by physiotherapists (χ = 3.86, = 0.049) and improvements noted from the start of recommended exercises (χ = 9.439, = 0.007). Transportation, including hiring of private cars (74%) and being far away from the health facility (48%), were key extrinsic challenges affecting access to health facilities.
Personal reasons and the difficulty in accessing health facilities were main factors affecting stroke survivors' uptake of physiotherapy interventions.
Design of patient-tracking and family support systems may potentially improve the stroke survivors' uptake of physiotherapy interventions.
中风是全球身体残疾的主要原因之一。虽然物理治疗干预对中风幸存者的康复很重要，但接受情况仍然不一致，导致这些不一致的因素没有得到很好的记录，特别是在南非。
总体目标是确定与南非夸祖鲁-纳塔尔省乌古区图尔顿社区卫生中心成年中风幸存者物理治疗干预接受不一致相关的内在和外在因素。
这是一项横断面研究，涉及50名在两年内错过一次或多次物理治疗预约的中风幸存者以及25名参加了所有预约的幸存者（对照组）。使用研究人员管理的半结构化问卷收集数据，数据使用SPSS v25进行录入和分析。结果使用描述性统计进行总结。使用Pearson卡方检验进行双变量分析。
只有两个内在因素与结果变量显著相关，即：相信物理治疗师推荐的锻炼（χ = 3.86，P = 0.049）以及从推荐锻炼开始就注意到有改善（χ = 9.439，P = 0.007）。交通，包括租用私家车（74%）和距离医疗机构较远（48%），是影响获得医疗设施的关键外在挑战。
个人原因和获得医疗设施的困难是影响中风幸存者接受物理治疗干预的主要因素。
设计患者跟踪和家庭支持系统可能会提高中风幸存者接受物理治疗干预的程度。
