Background: Stroke is one of the top leading causes of death worldwide but the largest burden related to this condition occurs in low- and middle-income countries. In 2013, stroke accounted for 82.4% of all deaths in South Africa. The most effective management for stroke remains rehabilitation. The use of clinical evidence-based practice helps to ensure a uniform level of care across all health sectors. Studies report that the use of clinical practice guidelines among healthcare practitioners is very low and the reason is not well understood.
Aim: To explore rehabilitation practitioners’ perceptions of clinical practice guidelines for stroke management when working in rural primary care hospitals in the Bushbuckridge local municipality, Mpumalanga province.
Methods:A qualitative study using purposive sampling was undertaken at three primary care hospitals in Bushbuckridge. Face to face in-depth interviews were conducted with study participants.Recorded data were transcribed verbatim by an independent transcriber and verified by the researcher. An inductive approach to qualitative data analysis was used to generate common themes and sub-themes from the transcribed data. Data were analysed manually by the researcher.
Results: Sixteen rehabilitation practitioners (physiotherapists [n= 7], occupational therapists [n= 5], speech therapists & audiologists [n= 4]) employed at the hospitals consented to participate in the study. Analysis of the data revealed a total of seven themes: 1) Familiarity and application, 2) Guideline functions, 3) Value of guidelines, 4) Patient management conducts, 5) Barriers affecting guideline utilisation, 6) Communication, content and design improvements, 7) Evaluations and staff training.
Conclusions:Rehabilitation practitioners in rural Bushbuckridge have little knowledge about clinical practice guidelines for stroke management. The study also revealed that although therapists reported the use of clinical practice guidelines beneficial for patient rehabilitation, the uptake was very low. This study also revealed that most therapists did not know the difference between a clinical practice guideline and a clinical protocol.