Date of Award

Winter 8-1-2018

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Medical Surgical Nursing

First Advisor

Dr. Jyothi Chakrabarthy

Second Advisor

Mr. Jomon C U

Abstract

Abstract Manipal College of Nursing Manipal iii ABSTRACT “A descriptive study to assess treatment non-adherence among people diagnosed with stroke and burden among their caregivers in Kasturba hospital Manipal.” was carried out at Manipal Academy of higher education by Ashwini for the award of M.Sc. Nursing degree. The objectives of the study were to determine the treatment non-adherence among people diagnosed with stroke, to explore barriers for treatment non-adherence among people diagnosed with stroke and to assess the burden of caregivers of people diagnosed with the stroke. The conceptual framework was based on stress appraisal model of Chappell and Reid(2002). The research approach was a quantitative approach and descriptive survey design was used. Non probability purposive sampling technique was used in the study Data was collected from people diagnosed with stroke using demographic proforma, treatment non-adherence tool and barrier questionnaire. Data was collected from caregivers of people diagnosed with stroke using demographic proforma and Zarit caregiver burden scale. The content validity of the tools was established by giving the tools to five experts and modifications were made based on their suggestions. All the tools were pretested and reliability of the tools was established by using Cronbach's alpha. Reliability of Zarit caregiver burden scale was 0.848. Reliability of tool to Abstract Manipal College of Nursing Manipal iv assess treatment non-adherence was 0.748. Reliability of tool to assess barriers to treatment non-adherence was 0.786. The pilot study was conducted which revealed the feasibility of the study. Administrative permission was obtained from Dean, MCON Manipal, IRC MCON Manipal, Medical Superintendent Kasturba Hospital Manipal and IEC (IEC:783/2017). Informed consent was obtained from the study participants. The study comprised of 300 sample. The data gathered was coded and analysed using SPSS 16.0. Descriptive statistics were used for data analysis. The study finding related to people diagnosed with stroke revealed that most of the participants 167 (55.7%) were older than 55 years. With respect to gender majority of the participants 180(60%) were males. With respect to marital status, 241(80.3%) were married. Majority of the participants 221(73.7) belonged to the nuclear family. Majority of the participants 148(49.3%) were diagnosed with stroke within the age group of 36-55 years. Recurrence of stroke was present in 80(26.7%) participants. Majority of the participants 252(84%) did not have a family history of stroke. Data regarding clinical parameters of people diagnosed with stroke revealed that 293(97.7%) participants were having a GCS score of 12-15 on follow up. With regard to bladder function, most of the participants 287(95.7%) were continent. Majority of the participants 203(67.7%) were independent for activities of daily living. Most of the participants 293(97.6%) had normal speech comprehension. Majority of the participants 287(94.71%) had normal verbal output. Abstract Manipal College of Nursing Manipal v With regard to treatment non-adherence majority of the participants, 232 (76.56%) were having non-adherence to health habits. Most of the participants 207 (68.31%) were non-adherent to stroke rehabilitation. Most of the participants 151(49.83%) were non-adherent to regular follow up visits. Few of the participants 111(36.63%) were non-adherent to medications. According to the rank order of identified barriers for treatment non-adherence, long waiting hours in the OPD (80%) and the financial problem (49%) were ranked as higher barriers. Data regarding caregivers of people diagnosed with stroke revealed that most of the participants 215 (71.7%) were between the age group of 36-55 years. With respect to marital status, 232(77.3%) were married. Majority of the participants 220(96.7%) did not have previous experience of caring stroke patients. Most of the participants 224(74.7%) did not have any health problems. Majority of the participants 121(40.3%) were spouses of people diagnosed eith stroke. Most of the participants 115(38.3%) have given the care for less than or equal to five months. Data regarding caregiver burden revealed that most of the study participants 162 (54%) had moderate to the severe burden. This study recommends that the people diagnosed with stroke and their caregivers must campaign regarding the importance of treatment adherence for the better treatment outcome as well as regarding available health insurance facility in the Kasturba Hospital.

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