ABSTRACT

Purpose: As part of the burden of stroke, survivors often find it difficult returning to an active community life after discharge from either acute hospitalization or a rehabilitation programme. This study aimed at determining the level of community reintegration and related factors among a Nigerian sample of stroke survivors.

Relevance: It revealed areas of community reintegration requiring special focus by attending clinicians and also the subset of survivors with need for special attention.

Participants:   Seventy-one community-dwelling stroke survivors (mean age=  64.14±10.26 years) comprising 50.7% females recruited by volunteer sampling ( in response to adverts placed in churches’ magazine and through community town criers) and snowball sampling techniques. They were recruited from 3 randomly-selected communities each from Nnewi North and South Local Government areas of Anambra State, Nigeria.

Methods: The study was a survey. The Reintegration to Normal living Index (RINL) instrument was used to assess participants’ level of community reintegration while a brief questionnaire was used to obtain information on the their socio-demographic variables like marital status, pre and post-employment status, employment types, type of assistive mobility device being used and presence of co-morbidities.

Analysis: Obtained data was analysed and presented as frequency and percentages, mean and standard deviation and with Spearman rank-order correlation statistics. Level of significance was set at 0.05.

Result: About 94% of study participants were yet to be fully integrated into the community. Distance mobility (34.10%), performance of daily activities (39.30%), recreational activities (40.10%), family roles (40.80%), social activities (48.50%) and community mobility (49.40%) were areas that were more severely affected  when mean participants’ scores were computed as percentages of maximum possible scores. Age (r=-0.351), pre-stroke (r=-0.295) and post-stroke (r=-0.513) employment status and the type of mobility assistive device being used (r=0.343) were the survivors’ variables which significantly correlated with their level of community reintegration.

Conclusions: Majority of study participants had problems fully integrating into the community.  Problems were more obvious in areas of mobility, daily activities, family and social roles. Community reintegration is worse for older survivors and those who could not return to gainful employment poststroke.

Implications: Physiotherapists should regularly screen for the level of reintegration among community-dwelling stroke survivors. Those identified as not fully-reintegrated should be referred for continual rehabilitation which should target particularly the enhancement of mobility functions and vocational rehabilitation.

Keywords: Stroke, Community reintegration, Nigeria