AbstractWorld wide, stroke is a leading cause of death and, for those who survive a stroke, the condition is a major cause of functional disablement. Although there is considerable information available from developed countries about the difficulties and challenges that stroke survivors face after they are discharged from hospital, in Jordan there is a paucity of information about stroke survivors and their life experiences after stroke, and there is no demographic data available to inform the development of health and community services for these individuals. At present the health and social services that are available to stroke survivors and other people with severe disability are highly under developed in Jordan.
All stroke survivors admitted to hospital in Jordan leave hospital as soon as their condition is stable. Therefore, the day-to-day responsibility of caring for these individuals remains largely with their families. Globally very few studies have looked at the family's involvement in stroke care in the community and to date there have been no studies in Jordan focusing on stroke survivors and the impact that the condition has on their families or indeed on the impact of culture on the care of stroke survivors.
The aim of this study was to identify, for the first time, the demographic characteristics of stroke patients in Jordan and to explore the perceptions of Jordanian therapists, stroke survivors and their family carers of the challenges faced by, and the care received, by stroke survivors in the community.
The study was carried out in several stages. Firstly, the World Health Organisation's MONICA protocol was used to collect retrospective demographic data about stroke patients from two hospitals in Jordan over a three-year period. This data provides the first comprehensive profile of stroke patients admitted to hospital in Jordan. Secondly, a focus group interview with Jordanian therapists was held to investigate their perceptions of the care of stroke survivors in the community. The therapists focused on issues surrounding the expectations of recovery, the level of support provided by carers, carers' feelings towards
their caring role, the impact of carers' gender on any care given and the impact of caring for a stroke survivor on family life.
Following pilot studies a series of semi-structured interviews was held with stroke survivors and their family carers. The Jordanian participants were interviewed in Arabic and the tape recorded information transcribed and analysed in Arabic. Measures were taken to ensure the accuracy of transcripts and the reliability and validity of the data analysis using forward and backward translation methods.
Though most Jordanian participants (stroke survivors and their family carers) received some limited support from therapists, the prohibitive cost of therapy together with difficulties in accessing the services made regular support difficult. Formal support by therapists and other members of the health services, and informal support from family members were complicated by issues of gender and culture. As a result stroke survivors in Jordan often faced anxiety, isolation and frustration in respect of the physical and social needs they identified.
This study presents a unique contribution to knowledge about the experiences of stroke survivors and their families in a developing country and also shows how care systems are very dependant on cultural contexts, cultural beliefs and practices.
The thesis concludes with recommendations for the development of community care policy and practice for people with disabilities.
|Date of Award||Jul 2002|
|Supervisor||Ann Moore (Supervisor), Dr Sue Ballcok (Supervisor) & Lesley Dawson (Supervisor)|