Life satisfaction and self-efficacy in patients affected by a first stroke living in Kuwait: A two-phase study

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa Healthcare USA, Inc.Life satisfaction and self-efficacy are important aspects of stroke rehabilitation. Previous research focuses on Western stroke survivors, neglecting the stroke experience in the Middle East. This research was conducted in Kuwait and entailed both quantitative and qualitative phases to obtain a more comprehensive, clinically relevant understanding of self-efficacy and life satisfaction during stroke rehabilitation in this culture. The aims were to: 1) investigate the relationships between self-efficacy and life satisfaction in female patients affected by stroke (Phase 1); and 2) explore health professionals' views regarding the importance of self-efficacy and possible strategies for enhancing self-efficacy during rehabilitation, through semi-structured interviews (Phase 2). Significant correlations were found between patients' general self-efficacy, and psychosocial adaptation self-efficacy following stroke. Self-efficacy (both general and psychosocial adaptation) showed significant correlations with life satisfaction post-stroke. Health professionals (more than half of whom were physiotherapists) recognised the importance of self-efficacy within stroke rehabilitation and identified five main ways to increase self-efficacy during stroke rehabilitation. These were to: 1) motivate and encourage patients; 2) provide more education about stroke and rehabilitation; 3) identify change; 4) offer a high-quality environment and therapy; and 5) set goals. In conclusion, psychosocial self-efficacy was identified as having a stronger relationship to life satisfaction compared with general self-efficacy within this sample of Kuwaiti female patients. Health professionals suggested various strategies for enhancing self-efficacy and thereby life satisfaction post-stroke during the rehabilitation process in Kuwait. Despite the collectivist culture of Kuwait, the findings indicate that the patient's own confidence and sense of responsibility for progress may be relevant to rehabilitation

Life satisfaction, self-efficacy and religious faith in stroke patients living in Kuwait

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University, 11/11/2010.Aims: Life satisfaction and self-efficacy are psychosocial experiences that appear to profoundly influence the rehabilitation of a stroke patient. However, relevant studies have been mostly carried out on Western stroke survivors, with limited reports on stroke experience in the Middle East. Reviewed literature suggests a positive correlation between religious faith and health outcome, however studies investigating relationships among religious faith, self-efficacy and other psychosocial variables in stroke patients are limited. The aims of this study were therefore to (1) explore stroke experience and factors associated with life satisfaction post-stroke in Kuwait, (2) to investigate the relationships between self-efficacy, life satisfaction and religious faith in female stroke patients living in Kuwait, and (3) to identify cultural influences on stroke survivors in Kuwait from the health professionals‘ point of view. Method: The study was carried out in these four phases. 1) Phase 1:- Exploring stroke experience in patients in Kuwait with semi-structured interviews 2) Phase 2:- Client-Centred Adaptation of a Self-Efficacy measure for stroke patients living in Kuwait 3) Phase 3:- Assessing quantitative relationships between the three variables (self-efficacy, life satisfaction and religious faith) with questionnaires 4) Phase 4:- Exploring perceptions of health professionals regarding the world of the stroke patient and effects of culture on recovery and rehabilitation with semi-structured interviews Qualitative data were analysed with thematic analysis. Results: Significant correlations were found between general self-efficacy, and psychosocial adaptation self-efficacy. Self-efficacy (both general and psychosocial adaptation) showed significant correlations with life satisfaction post-stroke. Religious faith was not related to either life satisfaction or self-efficacy. Health professionals‘ interviews identified cultural characteristics specific to stroke patients living in Kuwait. These included family involvement, prevailing attitude towards stroke, dependency and access to maids, religious beliefs, and social stigma. Conclusion: Psychosocial self-efficacy was identified as having the strongest relationship to life satisfaction compared with the other variables tested. This study failed to show any significant relationship between religious faith and self-efficacy or life satisfaction in female stroke patients living in Kuwait. However, results from patient and health professional interviews identified religious beliefs as playing an important role in recovery, behaviour during rehabilitation and in interaction with the health professions. The qualitative aspects of this study, in particular, highlight the importance of taking into consideration religious and cultural influences during the rehabilitation of stroke patients in Kuwait

High Risk Human Papillomavirus in Head and Neck Squamous Cell Carcinoma Patients at Kenyatta National Hospital, Kenya

 Background : Human Papillomavirus (HPV) has been associated with a subset of Head and Neck Squamous Cell Carcinoma (HNSCC) in particular Oropharyngeal Carcinoma. Objective: To determine the prevalence and Clinicopathological predictors of high-risk HPV among patients with HNSCC at Kenyatta National Hospital (KNH) Nairobi, Kenya. Materials: One hundred and sixty(160) patients who presented themselves to the ENT clinic between 2015 and 2017 with HNSCC had their history taken. A complete physical examination was done along with the appropriate haematological and radiological work-up. Two tissue biopsies were taken from the primary tumour for histology and real time polymerase chain reaction. Methodology: One hundred and sixty(160) patients with HNSCC aged 16 to 87 years were recruited and set in groups of six. These groups were based on the primary site of the tumour present such as; Oral cavity, Oropharynx, Nasopharynx, Hypopharynx, Larynx and Sinonasal. There were 117 (73.1%) males and 43 (26.9%) female participants. Twelve 12(7.5%) patients tested positive for high risk HPV. The HPV genotypes detected were 56, 52 and 33. There were no predictors for HPV positivity. Conclusion: High risk HPV prevalence was low among HNSCC patients at Kenyatta National Hospital. No HPV 16 nor 18. The positive patients did not have profiles that matched those of HPV-positive HNSCC globally. Key Words: Human papillomavirus, carcinoma, head and nec

Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa UK Ltd.Purpose: The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Method: Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. Results: The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. Conclusion: To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere