Community reintegration and related factors in a Nigerian stroke sample.

Christopher Akosile, Chioma Nworah, Emmanuel Okoye, Babatunde Adegoke, Joseph Umunnah, Ayodeji Fabunmi
1. Nnamdi Azikiwe University, Medical Rehabilitation
2. University of Ibadan, Department of Physiotherapy

Abstract
Background: The goal of stroke rehabilitation has shifted from mere survival of a victim to how well a survivor can be effectively reintegrated back into the community.

Objectives: The present study determined the level of satisfaction with community reintegration (CR) and related factors
among Nigerian community-dwelling stroke survivors (CDSS).

Methods: This was a cross-sectional survey of 71 volunteering CDSS (35 males, 36 females) from selected South-Eastern Nigerian communities. Reintegration to Normal Living Index was used to assess participants’ CR. Data was analysed using Spearman  rank-order correlation, Kruskal-Wallis and Mann-Whitney U tests at p≤0.05.

Results: Participants generally had deficits in CR which was either mild/moderate (52.1%) or severe (47.9%). Scores in the CR  domains of distance mobility, performance of daily activities, recreational activities and family roles were particularly low (median scores ≤ 4). CR was significantly correlated with and influenced by age (r=-0.35; p=0.00) and presence/absence of diabetes  mellitus (u=3.56.50; p=0.01), pre- (k=6.13; p=0.05) and post-stroke employment (k=18.26; p=0.00) status, type of assistive  mobility device being used (AMD) (k=25.39; p=0.00) and support from the community (k=7.15; p=0.03) respectively.

Conclusion:CR was generally poor for this CDSS sample. Survivors who are older, having diabetes as co-morbidity, using  AMD (particularly wheel-chair) and without employment pre- and/or post-stroke may require keener attention. Rehabilitation  focus may be targeted at enhancing mobility functions, vocational and social skills.

Keywords: Community reintegration, associated factors, post-stroke.