Stigma among stroke survivors in Ethiopia: Experience from a tertiary hospital Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia.
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Date
2021-11
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Addis Abeba University
Abstract
Background:
Stigma among neurologic disease is a widely recognized global health issue. The negative
impact it has on different neurologic diseases has been described. Although stroke survivors
have different degree of stigma which may contributes to negative outcomes, there is
shortage of study on stigma among stroke survivors and its predictors, especially in low and
middle income countries.
Study title:
Stigma among stroke survivors: Experience from a tertiary hospital in Addis Ababa, Ethiopia
Objective:
To assess the prevalence of stigma and its associated factors among stroke survivors having
a follow up at the Neurologic Out-patient Clinic in Tikur Anbessa Specialized Hospital.
Methods:
Institution based quantitative cross sectional study was conducted among 123 stroke patients
having a follow up at Tikur Anbessa Specialized Hospital Neurology Out-patient Clinics.
Data were collected by interviewer administered questionnaire. Stigma was measured using
Stigma scale for chronic illness (SSCI-8) tool and included self, family, and community
perceived stigma. Depression was assessed using Patient Health related Questionnaire
(PHQ9), and functional status using modified Rankin Scale. Data were entered and analyzed
using Statistical Package for Social Sciences (SPSS V25) software package. Binary logistic
regression and multinomial logistic regression was used. Adjusted odds ratios with 95%
confidence interval were used to identify associated factors with perceived stigma.
Results:
Overall, the prevalence of perceived stigma was 55%. For the perceived family and
community, it was 17.9%, and 13.8% respectively. Functional disability [moderate to severe
disability (AOR=6.88, CI: 2.257, 22.46) P=.001.], Depression (AOR=19, CI: 2.24,
161.34)P=.007 and residual weakness (AOR=9.71, CI: 0.94, 94.95) P=.051were factors
associated with perceived stigma in stroke patients.
Conclusion and recommendation:
Around half of stroke survivors who participated in this study described some form of
perceived stigma. The personal perceived stigma was higher when compared to family or
community perceived stigma. Factors associated with perceived stigma were Depression,
residual weakness post stroke, and moderate to severe disability functional status. The
rehabilitation services for patients with stroke should be strengthened. These should include
physical, emotional, and social aspect of disabilities. In addition, establishing patient support
groups for stroke survivors, and educating the community about stroke may be important to
address stigma.
Description
Keywords
Stroke,Stigma,Neurologic disease