Assessment of Barriers to Physiotherapy Services for Stroke Patients at Tema General Hospital

Abstract

Background: Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about the barriers to physiotherapy services in Ghana. Objective: The objective of this study was to assess the barriers to physiotherapy services for stroke patients at TGH. The individual / personal and health system barriers to physiotherapy services at TGH were determined. Methods: A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers and health system barriers of respondents to physiotherapy services and were described using the Likert’s scale. Respondents’ adherences to Medication were assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance were set at p<0.05. Results: Majority (76.3%) of the respondents indicated economic barrier as their main individual barrier to physiotherapy services. Most (72.0%) respondents indicated exercise therapy as most difficult modality. For medication adherence level, patients with low medication adherence level were about 21 times the odds of defaulting on accessing physiotherapy services five times or more as compared to those with medium adherence level (OR 20.63, 95% CI 8.96, 42.97).

Conclusion: Personal barriers of stroke patients were found to be the most significant barriers to accessing physiotherapy services at Tema General Hospital.