Exploring the challenges and experiences of stroke patients and their spouses in Blantyre, Malawi

Magister Scientiae (Physiotherapy) - MSc(Physio)Stroke is the second leading cause of disability worldwide. Up to 60% of the survivors remain severely disabled. These people experience various challenges in such areas as self-care, mobility, accessing medical and rehabilitation services, transportation and finance. These affect them psychologically, physically and socially predisposing them to complications. Hospital based stroke records report on critical cases, which are not a true reflection of after effects of stroke in a community setting. The impact of stroke on patients and spouses cannot be underestimated considering that it is often sudden, giving no chance to patients or spouse to adjust to the predicament. The aim of this study was, therefore, to explore the challenges stroke patients and their spouses experienced during the rehabilitation process, from diagnosis through to treatment and discharge. The study was based on a qualitative approach, utilising an exploratory design. Data was collected using semi-structured in-depth interviews and focus group discussions. All interviews were tape recorded and transcribed verbatim. A thematic content analysis was used to analyse data. Ethical approval was sought from the University of the Western Cape and the College of Medicine Research Ethics Committee, University of Malawi. Permission was obtained from the General Manager of Malawi Against Physical Disabilities. The results indicates a range of challenges including dependence on spouse for basic self-care activities and activities of daily living, stress due to fear of dependence on their spouses, loss of opportunity for regular interaction with friends and family, limited facilities and accessibility to rehabilitation. Spouses are also burdened by of caregiving responsibilities. In conclusion, this study highlights that the consequences of stroke affect both patients and spouses in the areas of health, finance and social. There is need for rehabilitation professionals to give equal attention to the challenges experienced by spouses when managing stroke patients. The study recommends that accessibility to rehabilitation should be improved by increasing patients’ space at the centre, construction of more centres and expand CBR services to cover all districts in the country