Prevalence of Recurrent Stroke among a Rehabilitation Cohort in Nigeria.

OBJECTIVE: A recurrent stroke increases the rates of mortality and morbidity after an initial stroke. There is, however, a dearth of data on the prevalence of recurrent stroke in Nigeria. METHODS: A secondary analysis of the data obtained from 100 stroke survivors undergoing physiotherapy at 2 health facilities in Nigeria was carried out to document the prevalence of recurrent stroke. The association between recurrent stroke and selected socio-demographic and clinical factors of the participants was explored using logistic regression analysis. RESULTS: Thirty-two (32%) participants had had a recurrent stroke. Employment status and educational level were significantly associated with recurrent stroke. The outcome of the logistic regression analysis further showed that participants who were employed (OR = 0.08; P<0.001; 95% CI = 0.02-0.32) and who had no formal education (OR = 0.22; P = 0.03; 95% CI = 0.05-0.87) were significantly less likely to present with recurrent stroke compared to the unemployed participants and those who had tertiary educational qualification, respectively. CONCLUSION: Approximately 1 in 3 stroke survivors undergoing rehabilitation had experienced stroke recurrence. The finding of this study buttresses the urgent need to emphasize and aggressively pursue secondary stroke prevention. Further studies are, however, required to explore those potentially modifiable factors that are associated with recurrent stroke, and having more representative samples.

Attitudes toward interprofessional practice among healthcare students in a Nigerian University.

This study assessed attitudes of undergraduate healthcare students in Nigeria toward interprofessional practice. A cross-sectional survey of a convenience sample of 489 dental, medical, medical laboratory science, nursing, physiotherapy, and radiography students from a public university was conducted. The 14-item Attitudes Toward Healthcare Teamwork Scale was used to assess the students' attitudes. Data were summarized using descriptive statistics while differences in attitudes based on students' age, gender, year of study, and course of study were identified using inferential statistics. The findings showed that there were more (n= 281; 57.5%) male respondents and mean age was 25 years. Mean attitude score was 53.75 (±7.41) out of 70 depicting an overall positive attitude. Year and course of study resulted in statistically significant (p< .001) differences in attitudes with students in the sixth year of study, and medical students having more positive attitudes than their colleagues in junior years and other courses respectively. Most students agreed that interprofessional practice facilitates optimal patient care but also agreed with statements that portray interprofessional practice as unnecessarily time consuming. Integration of interprofessional education into existing undergraduate healthcare professions curricula in Nigeria could help address misconceptions and reinforce positive attitudes toward interprofessional practice.

Relationship between functional independence and psychosocial quality of life of stroke survivors undergoing outpatient rehabilitation in Maiduguri, Nigeria.

BACKGROUND: There are divergent findings on the impact of functional independence on psychosocial quality of life (QoL) of stroke survivors. AIM: To investigate the relationship between functional independence and psychosocial QoL among stroke survivors in Maiduguri, Nigeria. METHODS: A cross-sectional design was utilized, and functional independence and psychosocial QoL of consecutive stroke survivors undergoing rehabilitation were assessed with the motor subscale of the Functional Independence Measure (motor- FIM) and the psychosocial subscale of the Stroke-Specific Quality of Life Scale-12 (SS-QoL- 12) respectively. Relationships between the two variables were explored with Pearson's correlation coefficients and multivariable regression analysis. RESULTS: Fifty-nine stroke survivors participated in the study with a male majority (54.2%). Correlation between motor-FIM and the psychosocial subscale scores was not statistically significant (r = 0.24; p = 0.07) while correlation between motor-FIM and each item of the psychosocial subscale showed that a statistically significant correlation (r = 0.29; p = 0.02) was present for the 'mood' item only. Functional independence however did not statistically contribute to the multivariable regression model (R2 = 0.22; P < 0.01) for the 'mood' item after controlling for the effect of the participants' age and sex. CONCLUSION: Functional independence had no independent or statistically significant relationship with overall psychosocial QoL. Further studies are therefore needed to explore modifiable factors that influence psychosocial QoL of stroke survivors in our setting.

Preferred rehabilitation setting among stroke survivors in Nigeria and associated personal factors.

BACKGROUND: Incorporating patients' preferences in the care they receive is an important component of evidence-based practice and patient-centred care. OBJECTIVE: This study assessed stroke patients' preferences regarding rehabilitation settings. METHODS: A cross-sectional design was used to examine preferences of stroke patients receiving physiotherapy at three hospitals in Northern Nigeria. Personal factors and preferred rehabilitation setting data were obtained using the Modified Rankin Scale (to assess global disability) and a researcher-developed questionnaire. Associations between preferences and personal factors were explored using bivariate statistics. RESULTS: Sixty stroke patients whose mean age was 53.6 ± 14.8 years participated in the study. Most of the participants (38.3%) preferred an outpatient setting, 19 (31.7%) preferred rehabilitation in their homes, 14 chose inpatient rehabilitation (23.3%), while 4 (6.7%) preferred the community. Age and source of finance were significantly associated with preferences. The majority (66.7%) of those aged ≥ 65 years expressed a preference for rehabilitation in the home or community (X2 = 6.80; p = 0.03). Similarly, most of the participants (53.3%) who depended on family finances preferred home- or community-based rehabilitation, while most of those who depended on employment income for finances preferred an outpatient rehabilitation setting (X2 = 16.80; p = 0.01). CONCLUSION: A preference for rehabilitation in outpatient facilities predominated followed by home-based rehabilitation, and preferences varied based on age and source of finance. These variations in preferences have implications for making rehabilitation decisions.

Prevalence of Balance Impairment Among Stroke Survivors Undergoing Neurorehabilitation in Nigeria.

BACKGROUND: Poststroke balance impairment adversely affects stroke outcomes and addressing the impairment is expected to constitute an important focus of neurorehabilitation. AIMS: To examine the prevalence and factors associated with balance impairment after stroke. METHODS: Ninety-five stroke survivors undergoing neurorehabilitation at 2 government hospitals in Northern Nigeria participated in this cross-sectional study. Berg Balance Scale (BBS) was used to assess the presence of balance impairment (BBS score of 0-20). Prevalence of balance impairment was presented as frequency and percentage while demographic and stroke-related determinants of balance impairments were identified using logistic regression analysis. RESULTS: Thirty-five (36.8%) stroke survivors had balance impairment, and age, gender, and poststroke duration were statistically significant determinants. Stroke survivors aged less than 40 years (odds ratio [OR] = .14 [confidence interval [CI] = .20-.94]) and 40-59 years (OR = .23 [CI = .06-.81]) had a lower likelihood of having balance impairment compared to stroke survivors aged 60 years and above. Similarly, males had a lower likelihood of having balance impairment (OR = 1.60 [CI = .05-.55]) compared to females while those in the acute/subacute phase of stroke had a 7-fold likelihood of having balance impairment (OR = 7.74 [CI = 2.63-22.79]) compared to those with chronic stroke. CONCLUSIONS: Poststroke balance impairment appears to be significantly influenced by stroke survivors' age, gender, and poststroke duration. Hence, these variables should be considered when planning rehabilitation strategies for improving balance after stroke.

Musculoskeletal Symptoms among Family Caregivers of Community-Dwelling Stroke Survivors in Nigeria.

Introduction: Caring for stroke survivors may be burdensome with adverse consequences on caregivers' physical health. This study examined the prevalence of musculoskeletal symptoms and associated factors among family caregivers of stroke survivors in Nigeria. Methods: A hospital-based cross-sectional study involving 90 stroke caregiver and stroke survivor dyads was conducted. Data on the participants' demographics and post-stroke duration were obtained. Seven-day prevalence of musculoskeletal symptoms among the caregivers and level of stroke survivors' disability were respectively assessed using the Nordic Musculoskeletal Questionnaire and Modified Rankin Scale. Prevalence of musculoskeletal symptoms was presented as percentages while participants' characteristics associated with prevalence of musculoskeletal symptoms were examined using inferential statistics. Results: Mean (SD) age of caregivers and stroke survivors was 33.2 (10.7) years and 58.9 (9.7) years respectively. Majority of the caregivers were females (61.1%), and children of the stroke survivors (58.9%). Prevalence of musculoskeletal symptoms was 82.2%. The low back was the most affected body region (72.2%) followed by the upper back (40%) while musculoskeletal symptoms in the wrist was least prevalent (3.3%). Female caregivers, caregivers of female stroke survivors and spousal caregivers had significantly higher prevalence of musculoskeletal symptoms compared to other categories of caregivers. Only 5 (5.6%) caregivers had however received any training on safe care giving methods while only 21 (28.4%) caregivers with musculoskeletal symptoms had received treatment. Conclusion: With the high prevalence of musculoskeletal symptoms among family caregivers of stroke survivors, effective preventive strategies including training and education as well as timely access to treatment would be required.

Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria.

BACKGROUND: Functional independence is often compromised after stroke and its restoration is one of the goals of stroke rehabilitation. OBJECTIVE: This study assessed the impact of balance on functional independence after stroke. METHODS: Ninety-five stroke patients undergoing physical rehabilitation at two health institutions in Nigeria participated in the study. Balance and functional independence were respectively assessed with the Berg Balance Scale and the Barthel Index. Binary logistic regression analysis was conducted to examine the independent impact of balance on functional independence while controlling for participants' age, sex, side of hemiparesis and post-stroke duration. RESULTS: Mean±SD age of the participants was 58.4±13.1 years and females were more (f = 48; %  = 50.5). The regression model from the binary regression analysis explained 73.2% (Nagelkerke R2 = 0.732) of the variance in functional independence. Good balance function was found to independently and significantly (P <  0.01) increase the likelihood of being functionally independent after stroke (Odds ratio = 1.33; 95% CI = 1.11 to 1.58). CONCLUSION: The goal of attaining functional independence after stroke may depend to a significant extent on good balance function irrespective of the stroke survivor's age, sex and post-stroke duration.

Caregiving Appraisal by Family Caregivers of Stroke Survivors in Nigeria.

Introduction: Attending to caregiving experiences of family caregivers of stroke survivors is important in person-centered stroke rehabilitation. This study explored caregiving appraisals by family caregivers of stroke survivors in Nigeria. Methods: A cross-sectional survey of family caregivers' negative and positive appraisals of caregiving was conducted using the 24-item 4-domain revised Caregiving Appraisal Scale (rCAS). Mann Whitney U and Kruskal-Wallis tests were used to identify differences in caregiving appraisals based on specific caregiver and stroke survivor variables. Results: Seventy-three caregiver and care recipient dyads participated in the study. Mean age of the caregivers was 31.51 (9.82) years. From a score of 5, and higher scores depicting higher appraisal, mean (SD) score for caregiving satisfaction and caregiving mastery (positive appraisal domains) was 4.23 (0.97) and 4.04 (0.92) respectively while 2.29 (0.98) and 2.11 (0.93) were respectively recorded for caregiving burden and environmental impact (negative appraisal). Caregivers' gender, age, and employment status resulted in significantly different appraisals with female caregivers having higher caregiving mastery (U = 446, P<0.05), caregiving satisfaction (U = 384.5, P<0.01), and also caregiving burden (U = 382.5, P<0.01) compared to their male counterparts; while older (U = 330; P<0.05) and employed (U = 437.5, P<0.05) family caregivers reported higher caregiving satisfaction and burden respectively than younger and unemployed family caregivers. Conclusion: Given the comparatively higher positive caregiving appraisal, and the documented benefits of positive caregiving appraisal, efforts should be geared towards identifying effective means of reinforcing positive appraisal, and reducing negative stroke caregiving appraisal, especially for female, older and employed family caregivers.

Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria.

Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke-whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk factor) was assessed using open-ended questionnaire. Data were treated with descriptive statistics and logistic regression analysis. Results. Sixty-nine stroke survivors (male = 72.5%; mean ± SD age = 49.7 ± 10.6 years) participated in the study. Thirty-four (49.4%) participants had knowledge of stroke risk factors. Only educational level was significantly associated with knowledge and participants with tertiary educational qualification were about 48 times (odds ratio = 48.5; CI = 7.6-309.8; P < 0.0001) more likely to be knowledgeable than those with no education. Conclusion. Less than half of the participants had knowledge of stroke risk factors. Participants with tertiary education were significantly more knowledgeable than those with lower educational qualifications. Effective means of educating stroke survivors on stroke risk factors should be identified and adopted.

Impact of social support on participation after stroke in Nigeria.

BACKGROUND: Participation which entails involvement in life situations and represents a higher level of functioning can be severely restricted after a stroke. This study investigated the impact of social support on participation of stroke survivors in Nigeria. METHODS: Ninety-six community-residing stroke survivors were recruited from physiotherapy outpatient departments of two tertiary care hospitals in Northern Nigeria. Socio-demographic, clinical, participation (London Handicap Scale), and social support (Multidimensional Scale of Perceived Social Support) data were obtained. The impact of social support on global and domain-specific participation was examined using bivariate analyses and multiple regression analyses. RESULTS: Mean (SD) age of the stroke survivors was 56.6 (12.0) years. Social support was a significant (ß = 0.41, p < 0.0001) and independent determinant of the economic self-sufficiency domain of participation (p < 0.0001) in a regression model that accounted for 27% of the variance in the domain (R(2) = 0.27). Social support, however, had no independent effect on overall participation and the other participation domains namely mobility, physical independence, occupation, social integration, and orientation. CONCLUSION: The impact of social support was significant only in the economic self-sufficiency domain of participation with higher availability of social support related to better economic self-sufficiency. This finding provides additional information on the importance of social support post-stroke.

Prevalence of Low Back Pain among Undergraduate Physiotherapy Students in Nigeria.

Background. Low back pain (LBP) is a major cause of disability and the most common work-related musculoskeletal disorder among physiotherapists. This study examined the prevalence of low back pain among students undergoing training to become physiotherapists. Methods. Participants were 207 undergraduate clinical physiotherapy students at three universities in Nigeria. A modified version of a questionnaire used in a previous study was utilized to obtain demographic, educational activities, and LBP data. Prevalence of LBP was examined with descriptive statistics while factors associated with prevalence were explored using chi-square statistics. Results. More male students (53.1%) and those in the penultimate year of study (53.1%) participated in the study. Lifetime, 12-month, 1-month, and 7-day prevalence of LBP were 45.5%, 32.5%, 17.7%, and 11.5%, respectively. Prevalence of LBP was not significantly associated with any of the demographic variables. Educational activities, namely, "having techniques practiced on self for ≤10 hours" and "treating patients for ≥30 hours," a month prior to the study were significantly (P < 0.05) associated with higher 1-month and 7-day LBP prevalence, respectively. Conclusions. Although the prevalence of LBP was comparatively low, its association with educational activities emphasizes the need to incorporate effective LBP preventive strategies in the training of physiotherapy students.

Participation in leisure activities after stroke: A survey of community-residing stroke survivors in Nigeria.

BACKGROUND: Leisure provides pleasure and relaxation, and has health benefits even after a stressful and life-changing event such as a stroke. OBJECTIVE: This study examined leisure participation among a sample of community-residing stroke survivors in Nigeria. METHODS: Fifty-five stroke survivors undergoing rehabilitation were consecutively recruited from two government hospitals in Northern Nigeria. Data on pre- and post-stroke participation, and socio-demographic (age, sex, marital, employment, and educational status) and clinical (level of disability, post-stroke duration, stroke type and side of hemiplegia/hemiparesis) attributes of the stroke survivors were obtained. Leisure participation was assessed in four domains of recreational, social, cognitive, and productive/creative activities. Associations between leisure participation and the socio-demographic and clinical variables were examined using bivariate analysis. RESULTS: Mean (SD) age of the stroke survivors was 53.55 (14.39) years. Prevalence of leisure participation was 89.1%. Participation in specific leisure domains however varied thus: social (83.6%), cognitive (60%), recreational (41.8%), productive/creative activities (30.9%). Significant associations were observed between participation in cognitive, productive/creative, and recreational leisure activities, and specific socio-demographic and clinical attributes. CONCLUSIONS: Leisure participation was high in a general sense but marginal in recreational and productive/creative activities. The observed socio-demographic and clinical associations with post-stroke leisure participation may assist in providing effective leisure rehabilitation strategies.

Consistent determinants of health-related quality of life in the first 12 months after stroke: a prospective study in Nigeria.

BACKGROUND: Health-related quality of life (HRQoL) of stroke survivors can be described as an important and holistic index of stroke outcome. To enhance this all encompassing construct, information on its predictors at different phases of stroke is required. OBJECTIVE: This study sought to identify consistent determinants of HRQoL over the course of 1 year after stroke in Nigeria. METHODS: Information on socio-demographic, clinical, and functioning attributes of 55 consecutive individuals with first-ever stroke were obtained during acute admission and at 1, 3, 6, and 12 months post-stroke. Attributes of functioning namely, motor performance, functional activity, and participation were assessed using the Simplified Fugl-Meyer Assessment, the motor-Functional Independence Measure, and the London Handicap Scale, respectively. HRQoL was also assessed with the Health-Related Quality of Life in Stroke Patients-40 scale at 1, 3, 6, and 12 months. Attributes that were associated with HRQoL at these time points were identified using bivariate and multivariable regression analyses. RESULTS: Among the independent variables, concurrently assessed participation was the sole significant (P < 0.0001) determinant of HRQoL at 1, 3, and 6 months, respectively accounting for 70%, 64%, and 75% variance in HRQoL. At 12 months, participation (P < 0.0001), and functional activity (P < 0.05) accounted for 83% variance in HRQoL, with better functional activity and participation associated with better HRQoL. CONCLUSION: The outcome of this study indicates that optimizing post-stroke functional activity and participation through proven and effective rehabilitation strategies may result in better HRQoL in stroke survivors.

Attitude of physiotherapy students in Nigeria toward persons with disability.

BACKGROUND: Attitudes of students of health care professions, such as physiotherapy, toward persons with disability may influence their attitude and practice post-qualification. OBJECTIVE: To examine attitudes toward persons with disability among undergraduate physiotherapy students in Universities in Nigeria. METHODS: The 30-item Attitudes toward Disabled Persons--Form A (ATDP-A) scale was used to assess the attitudes of penultimate and final year physiotherapy students in 3 Nigerian universities. Overall and item-by-item analyzes of responses to the ATDP-A scale were carried out. Differences in attitude by sex, age, year and university of study were also examined using independent t-test and one-way ANOVA. RESULTS: One hundred and sixty-nine students with a male majority (56.2%) participated in the study. Mean score on the ATDP-A was 94.95 ± 17.50 with more students (60.4%) having a score >90 which depicts positive attitude. Item-by-item analysis of responses to the 30 items on the ATDP-A showed that negative attitudes were preponderant on items relating to the emotional component of the personality of persons with disability. Only age of students and their university of study however resulted in statistically significant differences in attitudes and older students reported better attitudes toward persons with disability. CONCLUSIONS: Although the overall attitude of the physiotherapy students was positive, negative stereotypes and discriminatory tendencies were observed in issues relating to the perceived emotional capacity of persons with disabilities. Educational strategies capable of effecting more positive attitudes in physiotherapy students in Nigeria toward persons with disability are urgently needed.

Impact of poststroke fatigue on health-related quality of life of nigerian stroke survivors.

BACKGROUND AND PURPOSE: A stroke event is often characterized by a number of debilitating consequences that may impact negatively on the health-related quality of life (HRQL) of survivors. This study examined the impact of poststroke fatigue (PSF), a persistent and prevalent stroke consequence, on HRQL of Nigerian stroke survivors. METHODS: One hundred stroke survivors were recruited from the physiotherapy outpatient departments of two tertiary hospitals in Northern Nigeria. The Fatigue Severity Scale and Health-Related Quality of Life in Stroke Patients-26 were respectively used to assess PSF and HRQL. The independent impact of PSF on overall and domain-specific HRQL was examined using hierarchical regression analyses. RESULTS: Mean age of the stroke survivors was 55.32 years (SD 13.9 years). The majority were males (66%), had suffered ischemic stroke (70%) and presented with moderately severe disability (42%). After controlling for demographic and stroke-related variables, PSF was found to be significantly and independently associated with all the domains of HRQL albeit at varying degrees. While the influence of PSF on the emotional domain was the most pronounced and uniquely contributed to 15% of the variance in the domain, its influence on the cognitive domain was the least prominent. PSF also solely accounted for 9% of the variation in overall HRQL with higher levels of PSF related with lower HRQL. CONCLUSIONS: Being a potentially treatable condition, PSF's significant impact on HRQL has implications for successful stroke care and rehabilitation. For instance, addressing PSF through appropriate interventions may assist in enhancing HRQL of stroke survivors.

Are there gender differences in longitudinal patterns of functioning in Nigerian stroke survivors during the first year after stroke?

BACKGROUND: Several studies have examined gender differences in various stroke outcomes. There is however little information on the influence of gender on post-stroke functioning in the context of the International Classification of Functioning, Disability and Health (ICF). OBJECTIVE: Gender differences in selected components of functioning, namely motor performance (body function), activity and participation, were examined in a sample of Nigerian stroke survivors. METHODS: This longitudinal study involved consenting first-incidence stroke survivors who were consecutively recruited from in-patient wards of a University teaching hospital in northern Nigeria. Demographic and clinical data were obtained at recruitment while motor performance, activity and participation were assessed at the 1st, 3rd, 6th, 9th and 12th months using the Simplified Fugl Meyer scale, the Functional Independence Measure Motor Sub-scale and the London Handicap Scale respectively. RESULTS: Participants were thirty-three male (60%) and 22 female (40%) stroke survivors who did not significantly differ in age, stroke sub-type, laterality and initial severity (P > 0.05). There were also no significant differences in motor performance, activity and participation between the male and female stroke survivors across the time points. CONCLUSION: Gender differences were not observed in the components of functioning over the first 12 months post-stroke.

Medical students' awareness of the role of physiotherapists in multidisciplinary healthcare.

BACKGROUND: Successful implementation of multidisciplinary healthcare approach may among other things depend on students' education and knowledge of the roles of healthcare professions other than their own. This study investigated medical students' awareness of the role of physiotherapists in multidisciplinary healthcare teams. METHODS: One hundred and ninety-eight medical students of the University of Maiduguri, Nigeria, participated in this study. Each student completed a self-administered questionnaire that obtained information on demographics, awareness of role of physiotherapists and educational sources of information as well as suggestions about other sources of information about physiotherapy. Chi-square test was used to analyze differences in awareness by gender and year of study. RESULTS: Although rates of awareness regarding some physiotherapy roles were high, many of the medical students were unaware that physiotherapists can practice on first-contact basis and autonomously. About 60% of the students also viewed the role of physiotherapists in the health team as one of providing assistance for medical work. Clinical ward round was the most common source of information on physiotherapy although many of the students suggested classroom lecture as a preferred means of obtaining information. Year of study resulted in significantly different level of awareness (p < 0.05) with a higher proportion of final year students exhibiting awareness of physiotherapists' roles. CONCLUSION: Clinical ward rounds facilitated the students' awareness of the role of physiotherapists. Interprofessional education involving lectures and clinical ward rounds may assist in building medical students' level of awareness and appreciation of the physiotherapy profession.

Sensitivity and responsiveness of the health-related quality of life in stroke patients-40 (HRQOLISP-40) scale.

PURPOSE: To investigate the sensitivity and responsiveness of the Health-Related Quality of Life in Stroke Patients-40 (HRQOLISP-40) scale in evaluating stroke patients from onset to 12 months. METHODS: Fifty-five patients with first-incidence stroke were followed-up for 12 months. The HRQOLISP-40 scale was used to assess health-related quality of life (HRQOL) while stroke severity was assessed with the Stroke Levity Scale. Sensitivity to change was assessed by analyzing changes in the HRQOLISP-40 scores between pairs of months with paired samples t-test. Standardized effect size (SES) and standardized response mean (SRM) were used to express responsiveness. RESULTS: Overall HRQOL and domains in the physical sphere of the HRQOLISP-40 were sensitive to change at different time intervals in the first 12 months post-stroke. Marked responsiveness (SES and SRM >0.7) was demonstrated by the overall scale, and the physical, psycho-emotional and cognitive domains at varying time intervals. For instance, SRM was greater than 0.7 between 1 and 6, 3 and 12, 1 and 9, and 1 and 12 months for both the physical and psycho-emotional domains. CONCLUSION: The HRQOLISP-40 is a sensitive and responsive stroke-specific quality of life measure that can be used to evaluate the outcome of stroke rehabilitation. IMPLICATIONS FOR REHABILITATION: Enhancing the health-related quality of life (HRQOL) of stroke survivors can be regarded as the ultimate goal of stroke rehabilitation. Sensitive and responsive stroke-specific HRQOL measures are required for use in evaluative studies, and clinical trials and practice. The Health-Related Quality of Life in Stroke Patients-40 (HRQOLISP-40) is a sensitive and responsive stroke-specific scale.

Quality of life of Nigerian informal caregivers of community-dwelling stroke survivors.

BACKGROUND: Caregivers play important roles in the collaborative efforts that characterize successful stroke rehabilitation, and their quality of life (QoL) may have implications for outcome of care. AIM: This study explored the QoL of caregivers of community-dwelling stroke survivors in north-eastern Nigeria. METHODS: Fifty-nine caregivers of community-dwelling stroke survivors attending physiotherapy out-patients departments of two government hospitals in the city of Maiduguri participated in the study. Information on participants' age, gender, employment status, educational background, relationship with the stroke patient, and time after onset of stroke were obtained through interview, while their QoL was assessed with WHOQoLBREF questionnaire. Demographic and QoL data were summarized with descriptive statistics, and influence of caregivers and care recipients' factors on QoL was analysed using Kruskal-Wallis test. RESULTS: Majority of caregivers were males (55.9%) and provided care for their parents (69.5%) who had suffered stroke within 1 year prior to study (72.9%). Mean scores on all QoL domains were above average with the physical domain recording the lowest scores. Caregivers' factors of age, educational background and employment, and duration poststroke onset were significantly associated with domains of QoL. CONCLUSION: Although QoL of stroke caregivers was fair across domains, the physical domain recorded the lowest mean scores. Older age, lack of formal education, unemployment and caring for stroke patients within the second year poststroke were associated with lower QoL scores. Information from this study may aid in identifying those caregivers who require support programmes and care the most.

Functional self-efficacy and its determinants in Nigerian stroke survivors.

BACKGROUND: Self-efficacy enhances functional recovery and the overall outcome of rehabilitation after stroke. OBJECTIVE: The objective of this study was to identify factors influencing functional self-efficacy in stroke survivors in a regional medical center in northeastern Nigeria. METHODS: A cross-sectional study of 50 stroke survivors attending the physiotherapy clinic of the University of Maiduguri, Nigeria, was conducted. Information on the sociodemographic and clinical characteristics of participants was obtained. Functional ability and self-efficacy were assessed using the modified Rankin Scale and Functional Ability Confidence Scale, respectively. RESULTS: The mean functional self-efficacy score of stroke survivors in this study was below average. Marital status and functional ability influenced functional self-efficacy. Very high functional efficacy scores were observed among those who reported no functional disability. CONCLUSION: The study shows a reciprocal relationship between functional ability and functional self-efficacy. It is expected that enhancement of functional ability in stroke rehabilitation will help boost functional self-efficacy of stroke survivors and vice versa.