Community Perceptions of Barriers to Stroke Recovery and Prevention in Greater Kampala, Uganda: Implications for Policy and Practice.
Community Perceptions of Barriers to Stroke Recovery and Prevention in Greater Kampala, Uganda: Implications for Policy and Practice.
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DOI：
10.5430/ijh.v3n2p8
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发表时间：
2017-11-01
期刊：
影响因子：
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通讯作者：
Sajatovic, Martha
中科院分区：
文献类型：
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作者：
Blixen, Carol;Nakibuuka, Jane;Sajatovic, Martha
目的：在撒哈拉以南非洲，卒中风险和卒中负担正在增加。定性分析被用来评估感知障碍，中风的恢复和预防在城市/郊区乌干达人口，以完善和实施一个有前途的护士和同行领导的自我管理干预以前进行在美国。方法：在深入访谈和焦点小组进行了48名参与者（中风幸存者，照顾者，和那些中风的风险。所有的访谈和焦点小组都被录音，逐字转录，并使用内容分析法进行分析，重点放在主导主题上。结果：从数据中可以看出三个主要领域的感知障碍：（1）个人障碍（创伤后应激障碍、压力、拒绝寻求护理、药物不依从性、不健康的生活方式、功能障碍和缺乏中风知识）;（2）家庭/社区障碍（缺乏家庭和社区支持以及照顾者负担）;以及（3）提供者和保健系统障碍（缺乏机会和后续行动不足）。重要的是，在这项研究中的参与者确定了一个迫切需要提高中风的意识，在社区的一部分，恢复和预防工作。结论：中风风险降低的努力，在病人，社区和医疗保健系统的水平是必要的。这些努力也许可以沿着以前非常成功的减少乌干达艾滋病毒负担的公共卫生倡议的路线进行。
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.