Stroke patients and caregivers’ experiences and satisfaction with post-discharge self-management support in Ghana: A qualitative study

Abstract

Self-management support (SMS) is essential for improving stroke recovery and quality of life, yet Ghana faces significant challenges in post-discharge care delivery. Despite high stroke mortality rates after hospital discharge in sub-Saharan Africa, limited research has examined the experiences of stroke survivors and caregivers with healthcare provider support during the transition to home-based management. Understanding these experiences is crucial for identifying gaps and developing targeted interventions. Therefore, this study aimed to explore stroke survivors' and caregivers' experiences with post-discharge self-management support from healthcare providers in Ghana, including the adequacy, perceived impact, and satisfaction with existing support systems. Using Thorne's Interpretive Description approach, data were collected through fifteen dyadic interviews with stroke survivors and their primary caregivers. Data collection and analysis occurred concurrently, guided by Thorne's three-phase thematic analysis framework and informed by the Chronic Care Model to contextualize findings within evidence-based chronic care principles. Two main themes emerged: (1) unmet educational and support needs for home-based self-management, and (2) perceived impact and satisfaction with support system. Participants reported insufficient pre-discharge education, inadequate caregiver training, lack of structured follow-up, overlooked psychosocial and sexual health needs, and limited collaborative goal-setting. These gaps undermined survivors' confidence in self-management and satisfaction with care, leading some to seek alternative or unqualified guidance. The findings reveal a disconnect between current post-discharge practices in Ghana and established chronic care principles. Addressing these gaps requires targeted structural and policy reforms, enhanced provider training in SMS strategies, and the development of culturally appropriate interventions to meet the complex needs of stroke survivors and their caregivers.