Documenting the impact of stroke in a middle-income country: a Malaysian case study

Abstract

Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC).

Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.

Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.

Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality.

Implications for rehabilitation

• The impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries.

• Support from the family and reinforcement of religious coping were judged to successfully aid recovery.

• Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.

Keywords:

• Stroke
• low and middle-income countries
• recovery
• coping strategies
• family support
• health services

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was funded through the Australian Research Council (Discovery Project Scheme, project number DP140101995). Data collection was undertaken at the Monash SEACO HDSS technology research platform. The authors would like to express their appreciation to the SEACO Field Team and members of the SEACO Scientific Advisory Group from the Malaysian Ministry of Health. SEACO is funded by the Monash University Malaysia Campus; the Office of the Vice Provost Research, Monash University Australia; the office of the Deputy Dean Research, Faculty of Medicine, Nursing and Health Sciences, Monash University Australia; The Faculty of Arts, Monash University Australia, and the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia. SEACO is an associate member of the INDEPTH Network.