Enhancing stroke care in Ghana: A systematic review of stroke rehabilitation services.

OBJECTIVE: In Ghana, the shifting demographics of stroke incidence towards young adults have prompted the expansion of stroke care and rehabilitation efforts. Nevertheless, the precise impact of stroke rehabilitation remains unclear. We conducted a systematic review to explore the landscape and effects of stroke rehabilitation in Ghana. METHOD: We identified articles on stroke rehabilitation services in Ghana through searches of PubMed, Scopus, Embase, and Web of Science from inception until February 2024. The Critical Appraisal Skills Programme (CASP) Qualitative Checklist was employed to assess the risk of bias in the included studies, supplemented by qualitative synthesis. RESULTS: Among the 213 articles screened, 8 were deemed suitable for review. These studies primarily focused on two groups: stroke survivors (n = 335) and healthcare professionals (HCPs) (n = 257). Many stroke survivors reported significant benefits from telerehabilitation, with increased participation in rehabilitation activities correlating with improved physical and cognitive outcomes. The findings also underscored a lack of knowledge about stroke rehabilitation among HCPs, alongside variations in the availability of protocols and guidelines for stroke management across different hospital levels. CONCLUSIONS: The review reveals several challenges in stroke rehabilitation in Ghana, including disparities in HCPs' perceptions and utilization of rehabilitation services. The findings emphasize the need for comprehensive, patient-centered approaches, standardized training for HCPs, improved resource allocation, and the integration of telehealth to overcome barriers and enhance stroke rehabilitation in Ghana. These insights hold significance not only for Ghana but also for guiding strategies in similar contexts worldwide, aiming to improve stroke rehabilitation outcomes.

Sociodemographic Determinants of Psychological Distress Among Adult Informal Caregivers.

Background and objective Providing care for a loved one with a chronic illness or disability can be mentally and emotionally challenging. Determining the factors that contribute to psychological distress among informal caregivers can be important in developing effective interventions to support this vulnerable population. This study aimed to examine the sociodemographic determinants of psychological distress among adult informal caregivers in the United States. Research design and method Secondary data analysis using the 2022 Health Information National Trends Survey was conducted. A total of 807 informal caregivers were included in the study. Sociodemographic characteristics, caregiving conditions, and caregivers' relationship to care recipients were assessed. Psychological distress was measured using Patient Health Questionnaire 4. Weighted multivariate logistic regression analysis was conducted to determine the associations between sociodemographic factors and psychological distress. Results The prevalence of psychological distress was 40%. The average age of the sample was 56 years with most caregivers being female and non-Hispanic White. Older age was associated with lower odds of distress (OR=0.974, 95% CI: 0.949-0.999). Female caregivers had higher odds of distress compared to males (OR=1.922, 95% CI: 1.023-3.612), and caregivers with household incomes of $75,000 or more had significantly lower odds of distress compared to those with incomes below $35,000 (OR=0.266, 95% CI: 0.119-0.595). Race/ethnicity and educational level did not show significant associations with caregiver distress. Conclusion Younger age, female birth gender, and lower household income were associated with higher odds of distress among informal caregivers. These findings can inform the development of targeted interventions to support caregivers' mental health.