Health-Related Quality of Life of Stroke Survivors Having Follow-Up at the Stroke Clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A qualitative study
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Date
2025-02-13
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Addis Ababa University
Abstract
Background: Stroke is the second leading cause of death and the third leading cause of
disability worldwide. Patients who survive the acute insult often suffer from multiple morbidities
including physical, psychological, cognitive and socio-economic burdens.Prior studies have
shown that most stroke survivors face a low health-related quality of life (HRQOL). Despite the
growing prevalence and incidence of stroke in Ethiopia, there is a dearth of information on the
health-related quality of life (HRQOL) of stroke survivors in the country. Our study aims to
bridge this knowledge gap and inform the responsible bodies to design mitigating strategies that
will improve stroke patients’ quality of life.
Objectives: This study aims to understand the health-related quality of life (HRQOL) of adult
stroke survivors who have follow-up at the stroke clinic of in Tikur Anbessa Specialized
Hospital, Addis Ababa, Ethiopia.
Methods: A qualitative study using a descriptive phenomenology approach was conducted. The
study used a non-probability purposive sampling method to find the maximum variation in
participants by age, gender, residence, type, and duration of stroke. After explaining the
objectives and importance of the study, consent in written form was taken from all
participants.Data was collected through an in-depth interview using a semi-structured
questionnaire and voice recorder. The audio recordings were transcribed and qualitative thematic
analysis was performed using the NVIVO 15 software.
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Result: A total of 16 participants were enrolled for an in-depth interview until saturation was
achieved. There were 10 male and 6 female participants. 13 Participants were from Addis Ababa.
Four themes emerged from the data. The first was physical and psychological disempowerment,
in which survivors reported severe motor deficits (e.g., limb weakness, speech impairments...),
dependency, and emotional struggles, including identity crises, anxiety, and depression.
The second theme was the socioeconomic burden from substantial personal spending on
medications, transportation, and physiotherapyservice which exacerbated the decrease in
activities of daily living (ADL). The third theme, which is work area challenges like job loss and
workplace discrimination, on the other hand, was a challenge for our stroke survivors. Social
stigma and isolation also had a major impact on performing their ADLs. According to the
findings, Spirituality as a resilience factor, on the other hand, had the most positive impact on
survivors.
Conclusions: Our findings showed that stroke survivors faced multidimensional challenges
spanning from their home to their environment that severely impair their HRQoL. The
challenges identified in this study were related to physical disability, psychological distress,
economic crisis, social isolation and stigma, and work place challenges. These findings
underscore the need for a comprehensive intervention that will address the physical, emotional,
and socioeconomic needs of stroke survivors. Notably, spirituality had a positive impact on
survivors' HRQOL, suggesting its potential integration into care plans.
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HRQOL, suggesting its potential integration into care plans.