Factors affecting poor attendance for outpatient physiotherapy by Patients discharged from Mthatha General Hospital with a stroke

Background: Stroke is a major cause of disability in the world and its long term effects require adherence to physiotherapy protocols for optimal rehabilitation. Clinical impression of data from Mthatha General Hospital (MGH) Physiotherapy Department revealed that there was poor attendance of outpatient physiotherapy by stroke patients discharged from MGH and this had negative effects on outcomes and health care costs. Objective: To determine the extent and the socio-demographic reasons for poor attendance for outpatient physiotherapy by stroke patients. Methods: An observational descriptive study was conducted using a randomly selected sample of 103 stroke patients from a population of 139 who attended physiotherapy in MGH in 2007. Structured interviews were conducted and SPSS was used for data analysis. Results: The majority (86%) of patients did not attend physiotherapy until discharge from the Physiotherapy Department. The major reasons for poor attendance were lack of finances (95%), migration to other areas (36%), and living a long distance from MGH (38%). Conclusion: Almost 9 out of 10 stroke patients fail to attend for outpatient physiotherapy because of lack of finances. recommendation: Development of a Provincial Rehabilitation Policy with specific reference to decentralization of rehabilitation services to address unavailability of physiotherapy services at clinics and health care centers which are proximal to the patients' residential areas is recommended. KEY words: STROKE, REHABILITATION, ADHERENCE, POVERTY, EASTERN CAPE.