Date Presented 03/23/24

Highlights the need to engage in legislative efforts to inform health policies and tailor interventions that influence provision and access to health education and resources among poststroke individuals experiencing health care disparities.

Primary Author and Speaker: Jennifer Decker

Additional Authors and Speakers: Barbara Nadeau

Given the increasing prevalence of strokes and consequent occupational disruption, it has become imperative that occupational therapists delve into the experiential domain of individuals living with healthcare disparities to uncover inequity gaps in health management and continuity of care (Dickens et al., 2022). The purpose of this study was to gain insight into the lived reality of the individual to increase understanding of the contextual factors that influence post-stroke health management. The question explored through this study: How do individuals experiencing healthcare disparities describe the impact of stroke on health management? A qualitative, phenomenological approach informed recruitment strategies through purposeful snowball sampling, targeting individuals with stroke onset of 3 months to 2 years, uninsured, and receiving health services through community or charity clinics. Data was collected via semi-structured interviews that were audio-recorded and transcribed verbatim. The interview transcripts were analyzed for meaning to identify patterns, generate codes, categorize codes, and cluster categories into themes. Six themes were identified to capture the participants’ experiences and describe the impact of stroke on health management: belief the system is unfair, biggest obstacle to recovery, loss of my previous self, didn’t have any other choice, cause-and-effect, and insightful outlook. Findings suggest that post-stroke health management is an intersectional process influenced by financial and insurance status, personal beliefs, accessibility and knowledge of resources, sources of social and emotional support, timing and understanding of health information, and communication with the healthcare system. Findings warrant the need and role of occupational therapy in community-engaged and community-based research to improve health outcomes through intervention implementation that aligns with areas of need identified by community-dwelling individuals.

References

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process fourth edition. American Journal of Occupational Therapy, 74(2), 1–87. https://doi.org/10.5014/ajot.2020.74S2001

Centers for Disease Control and Prevention. (2023). Stroke Facts. Retrieved from: https://www.cdc.gov/stroke/facts.html

Dickens, R. R., Gyang, T., Sanders, S., Ellis, J., Charles, & Simpkins, A. N. (2022). The importance of incorporating stroke survivors’ health perceptions in addressing health care disparities. Ethnicity & Disease, 32(2), 145–148. https://doi.org/10.18865/ed.32.2.145