Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India

Kamalakannan, Sureshkumar, Gudlavalleti Venkata, Murthy, Prost, Audrey, Natarajan, Subbulakshmy, Pant, Hira, Chitalurri, Naveen, Goenka, Shifalika and Kuper, Hannah (2016) Rehabilitation Needs of Stroke Survivors After Discharge From Hospital in India. Archives of Physical Medicine and Rehabilitation, 97 (9). 1526-1532.e9. ISSN 0003-9993

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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.

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