Impact of culture on rehabilitation services for stroke patients in developing countries: Jordanian perspective

Abstract

The purpose of this study was to explore the perceptions of stroke survivors of the rehabilitation services received by them in the Jordanian community. A secondary aim was to explore the impact of culture on providing appropriate services for stroke survivors.

Eighteen stroke survivors were recruited from an outpatient stroke rehabilitation programme. All 18 participants had been discharged from hospital for between one and six months. Semi-structured interviews were performed either in the physiotherapy outpatient clinic where the stroke patient was attending a clinic or in their homes. Transcription of interviews carried out in Arabic and thematic analysis was also carried out in that language by transcribers who were fluent in Arabic and English, using a back-translation method. Necessary measures were taken to ensure the accuracy, reliability and validity of the data collection and analysis.

Following thematic analysis, themes arising out of the data included physiotherapy and occupational therapy support in the community, out-patient rehabilitation clinic services, community clinic services and support from families, friends and neighbours. Participants expressed satisfaction with their therapists but there were large areas of unmet rehabilitation need for stroke survivors in the Jordanian community such as a limited availability of occupational therapy services, insufficient amount of therapy services and poor medical support.

The current study was unique and elicited a new body of evidence about the life experiences of stroke survivors after they are discharged from hospitals in Jordan. The findings from this study will inform service providers and planners about the needs of stroke survivors and will contribute to the development of appropriate community care for these people.  This study presents a unique contribution to knowledge relating to the experiences of stroke survivors in a developing country and also shows how rehabilitation services are very dependent on cultural contexts, cultural beliefs and practices.