Perceived and experienced restrictions in participation and autonomy among adult survivors of stroke in Ghana.

BACKGROUND Many stroke survivors do not participate in everyday life activities. OBJECTIVE To assess the perceived and experienced restrictions in participation and autonomy among adult stroke survivors in Ghana. METHOD The "Impact on Participation and Autonomy Questionnaire" (IPAQ) instrument was administered in a survey of 200 adult stroke survivors to assess perceived restrictions in participation and autonomy, followed by in-depth interviews with a sub-sample on the restrictions they experienced in participation. RESULTS Perceived restrictions in participation were most prevalent in the domains of education and training (3.46±0.79), paid or voluntary work (2.68±0.89), helping and supporting other people (2.20±0.82), and mobility (2.12±0.79). There were significant differences in two domains between survivors who received physiotherapy and those who received traditional rehabilitation. Over half of the survivors also perceived they would encounter severe problems in participation in the domains of paid or voluntary work, mobility, and education and training. The sub-sample of stroke survivors (n=7) mostly experienced restrictions in participation and autonomy in going outside the house, working, and in fulfilling family roles. CONCLUSION If these perceptions and experiences are not addressed during rehabilitation, they could further inhibit the full participation and social integration of stroke survivors.