Barriers and Facilitators of Stroke Recovery: Perspectives From African Americans With Stroke, Caregivers and Healthcare Professionals

• Published in: Journal of stroke and cerebrovascular diseases Vol. 28; no. 9; pp. 2506 - 2516
• Main Authors: Magwood, Gayenell S., Ellis, Charles, Nichols, Michelle, Burns, Suzanne Perea, Jenkins, Carolyn, Woodbury, Michelle, Adams, Robert
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2019
• Subjects: Adult; Attitude of Health Personnel; Black or African American - psychology; caregivers; Caregivers - psychology; disparities; Female; Focus groups; Health Knowledge, Attitudes, Practice - ethnology; Health Resources; Health Services Research; Health Status Disparities; Healthcare Disparities - ethnology; Humans; Male; Middle Aged; outcomes; Qualitative Research; recovery; Recovery of Function; Risk Factors; Social Support; South Carolina - epidemiology; Stroke; Stroke - diagnosis; Stroke - ethnology; Stroke - parasitology; Stroke - physiopathology; Stroke Rehabilitation; Treatment Outcome; South Carolina; disparities; caregivers; Stroke; Focus groups; recovery; outcomes
• ISSN: 1052-3057; 1532-8511; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.012

Introduction and Goal: Stroke is a serious health condition that disproportionally affects African-Americans relative to non-Hispanic whites. In the absence of clearly defined reasons for racial disparities in stroke recovery and subsequent stroke outcomes, a critical first step in mitigating poor stroke outcomes is to explore potential barriers and facilitators of poststroke recovery in African-American adults with stroke. The purpose of this study was to qualitatively explore poststroke recovery across the care continuum from the perspective of African-American adults with stroke, caregivers of African-American adults with stroke, and health care professionals with expertise in stroke care.
Materials and Methods: This qualitative descriptive study included in-depth key informant interviews with health care providers (n = 10) and focus groups with persons with stroke (n = 20 persons) and their family members or caregivers (n = 19 persons). Data were analyzed using thematic analysis according to the Social Ecological Model, using both inductive and deductive approaches.
Findings: Persons with stroke and their caregivers identified social support, resources, and knowledge as the most salient factors associated with stroke recovery. Perceived barriers to recovery included: (1) physical and cognitive deficits, mood; (2) medication issues; (3) lack of support and resources; (4) stigma, culture, and faith. Health care providers identified knowledge/information, care coordination, and resources in the community as key to facilitating stroke recovery outcomes.
Conclusions: Key findings from this study can be incorporated into interventions designed to improve poststroke recovery outcomes and potentially reduce the current racial-ethnic disparity gap.