Community-based care of stroke patients in a rural african setting

dc.contributor.authorWasserman, Sean
dc.contributor.authorde Villiers, Linda
dc.contributor.authorBryer, Alan
dc.date.accessioned2016-09-19T06:58:32Z
dc.date.available2016-09-19T06:58:32Z
dc.date.issued2009
dc.date.updated2016-01-07T07:52:13Z
dc.description.abstractBackground: In order to develop a community based-model of stroke care we assessed discharge planning of stroke patients, available resources, and continuity of care between hospital and community in a remote rural setting in South Africa. We sought to determine outcomes, family participation and support needs, as well as implementation of secondary prevention strategies. Methods: Thirty consecutive stroke patients from the local hospital were assessed clinically (including Barthel Index and modified Rankin scores) at time of discharge. Patients were re-assessed three months after discharge in their homes by a trained field worker using a structured questionnaire. Results: Two thirds of all families received no stroke education before discharge. At discharge 27 (90%) were either bed or chair-bound. All the patients were discharged into family care as there was no stroke rehabilitation facility available to the community. Of 30 patients recruited, 20 (66.7%) were alive at 3 months, 9 (30%) were deceased, and 1 was lost to follow-up. At 3 months, 55% of survivors were independently mobile as compared with 10% at discharge. A total of 13 (65%) patients in our cohort were visited by home-based carers. Only 45% reported taking aspirin at 3 months. Conclusions: The 3 month mortality rate was high. Most survivors improved functionally but were left with significant disability. Measures to improve family education and the level of home-based care can be introduced in a model of stroke care attempting to reduce carer strain and improve functional disability in rural stroke patients.
dc.identifierhttp://dx.doi.org/10.7196/SAMJ.3284
dc.identifier.apacitationWasserman, S., de Villiers, L., & Bryer, A. (2009). Community-based care of stroke patients in a rural african setting. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/21791en_ZA
dc.identifier.chicagocitationWasserman, Sean, Linda de Villiers, and Alan Bryer "Community-based care of stroke patients in a rural african setting." <i>South African Medical Journal</i> (2009) http://hdl.handle.net/11427/21791en_ZA
dc.identifier.citationWasserman, S., de Villiers, L., & Bryer, A. (2009). Community-based care of stroke patients in a rural African setting. South African Medical Journal, 99(8), 579.
dc.identifier.ris TY - Journal Article AU - Wasserman, Sean AU - de Villiers, Linda AU - Bryer, Alan AB - Background: In order to develop a community based-model of stroke care we assessed discharge planning of stroke patients, available resources, and continuity of care between hospital and community in a remote rural setting in South Africa. We sought to determine outcomes, family participation and support needs, as well as implementation of secondary prevention strategies. Methods: Thirty consecutive stroke patients from the local hospital were assessed clinically (including Barthel Index and modified Rankin scores) at time of discharge. Patients were re-assessed three months after discharge in their homes by a trained field worker using a structured questionnaire. Results: Two thirds of all families received no stroke education before discharge. At discharge 27 (90%) were either bed or chair-bound. All the patients were discharged into family care as there was no stroke rehabilitation facility available to the community. Of 30 patients recruited, 20 (66.7%) were alive at 3 months, 9 (30%) were deceased, and 1 was lost to follow-up. At 3 months, 55% of survivors were independently mobile as compared with 10% at discharge. A total of 13 (65%) patients in our cohort were visited by home-based carers. Only 45% reported taking aspirin at 3 months. Conclusions: The 3 month mortality rate was high. Most survivors improved functionally but were left with significant disability. Measures to improve family education and the level of home-based care can be introduced in a model of stroke care attempting to reduce carer strain and improve functional disability in rural stroke patients. DA - 2009 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Community-based care of stroke patients in a rural african setting TI - Community-based care of stroke patients in a rural african setting UR - http://hdl.handle.net/11427/21791 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21791
dc.identifier.urihttp://www.samj.org.za/index.php/samj/article/view/3284
dc.identifier.vancouvercitationWasserman S, de Villiers L, Bryer A. Community-based care of stroke patients in a rural african setting. South African Medical Journal. 2009; http://hdl.handle.net/11427/21791.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleCommunity-based care of stroke patients in a rural african setting
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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