Impact of stroke: a functional, psychological report of an inner-city multiracial population

Aims: To investigate the experiences of life after stroke among different racial groups living within
a diverse inner city population.
Background: Provision of health services within inner cities is complex and demanding and
requires careful attention to cultural sensitivities. Lack of awareness of these differences can impact
on stroke survivors.
Methods: Data was collected from 213 patients attending an East London hospital outpatient clinic
for 12 months. Twenty-eight attendees (12m, 16f) had suffered a TIA and were excluded from
further analysis. The data was analysed with respect to gender within 4 groupings (White, Afro -
Caribbean, Asian and Other) using Kruskal Wallis and Mann Whitney U tests.
Results: Of the 185 stroke patients (108 m, 77 f) who had suffered a stroke, there was little
difference in respect of age, males (68.7 ± 12.9 years) and females (68.2 ± 11.9 years). The Asian
men (n=21) reported significantly lower Barthel indices, dressing and greater sleeping difficulties.
They required more carer support and had lower health ratings. For the female groupings, the Asian
women needed significantly more help with bathing than the Afro-Caribbean group.
Conclusion: In respect of ethnicity, there was more diversity in terms of functional, psychological
and social parameters within the male group. Women may under report their need for assistance,
as retaining stoicism can be salient for identity in an inner city community. Understanding of the
impact of stroke within different ethnic inner city groups could aid the design and provision of
stroke aftercare.
Relevance to Clinical Practice: Profiling of stroke patients can help in design and provision of post
stroke care. Understanding how different racial groups report performing activities of daily living
can contribute to culturally sensitive nursing care.