Social participation in community dwelling Nigerian stroke survivors living in London

Purpose

This study seeks to answer the question “what are the factors that influence the social participation of indigenous Nigerian stroke survivors”?

Aim

The aim of the study is to explore the social participation experiences of community dwelling indigenous Nigerian stroke survivors living in London, and the factors that influence these.

Methods

Concept analysis of social participation and stroke was conducted to understand how the concept relates to stroke rehabilitation and recovery. A sequential exploratory mixed methods design was used for the research study. Data was collected from twelve (n=12) participants using semi-structured interviews and activity diaries in qualitative phase one, and from forty-two participants (n=42) using an online questionnaire in quantitative phase two. Data analysis was conducted using qualitative thematic analysis and quantitative statistical analysis. Qualitative and quantitative data were integrated using joint displays, to determine confirmation or disagreement of findings. The PEN-3 cultural model was used as a theoretical framework to determine the influence of culture on the social participation experiences of participants.

Findings

This first concept analysis of social participation and stroke enabled an operational definition of the concept in relation to stroke rehabilitation and recovery. The study demonstrated that the experiences of social participation among indigenous Nigerian stroke survivors is influenced by their cultural beliefs, cultural identity, spirituality, faith, misconceptions, and lack of awareness about stroke. Marginalization of some participants resulted in loss of status and exclusion from activities of the indigenous community to which they belong. There was no difference on experiences of social participation across gender for the male and female participants. However, experiences of social participation vary for participants born in Nigeria and the United Kingdom based on their personal factors (p=.027); relational factors (p=.001); independence and selfcare factors (p=.030), and education and work factors (p=.002). The Mann-Whitney exact significance for these factors is lower than the p value 0.05 (p<.05). This indicates that there is a significant difference at p<.05, for the country of birth of the indigenous Nigerian stroke survivor participants in respect of their experiences of social participation after stroke for these four factors.

Conclusion

This is the first research on social participation engaging indigenous Nigerian stroke survivors in the UK. Social participation is an essential outcome of successful rehabilitation and recovery from stroke and should be accessible to stroke survivors of various backgrounds. Health professionals working in stroke care will need to become culturally aware, and be mindful of the implications for rehabilitation practice, and recommendations for practice, education, research, service development and policy arising from this research study.