Barriers to reintegration experienced by stroke clients post discharge from a rehabilitation center in Malawi
Chimatiro, George Lameck
MetadataShow full item record
Stroke is a worldwide medical emergency, and the trend in its incidence is rising. Stroke leads to activity limitation and participation restriction among stroke clients. However rehabilitation of stroke disability has been found as lacking emphasis on reintegration issues, resulting into stroke clients facing different barriers to reintegration in the community after discharge. There is limited information about experiences of stroke clients in the communities after discharge from rehabilitation centers in Malawi. The current study was conducted to explore the barriers to reintegration experienced by the clients post discharge from a rehabilitation center in Malawi. A qualitative research was adopted to explore the perceived barriers to reintegration at Malawi Against Physical Disabilities (MAP) Kachere rehabilitation centre in Blantyre. In-depth interviews were utilized to capture data from perspectives of eight stroke clients, eight caregivers and seven service providers. The data was analyzed by means of content analysis. The findings of this study show key barriers that challenge community reintegration at two levels: individual and environmental. At individual level the barriers include impairments mainly depression and anxiety and physical weakness; and personal characteristics such as denial, gender and comorbidity. At the environmental level stroke clients experience attitudinal barriers by people in different settings of the community, poor terrain, long distance to places of interest, inaccessible structures and poverty. From the findings, therefore, stroke client experience wide range of barriers in both the activity and participation domains of community reintegration.Based on the key findings, recommendations have been made along three broad lines. To decrease barriers to reintegration, service providers could use the findings to consider equally addressing the potential negative contextual factors to reintegration when managing stroke clients, a shift from purely medical model approach to management of stroke. To increase rehabilitation services the government of Malawi could address the problem of limited funding to rehabilitation organizations and put measures to increase number of rehabilitation personnel at community, district and national levels. Further research in the area of community reintegration and development of a model of stroke care and rehabilitation in the country has also been recommended with view to improving stroke care and enhanced community reintegration post stroke in the country.