Abstract:
The number of people living with disabilities is increasing. Good adherence to rehabilitative
programmes is critical for optimal health and health systems in developing countries are under
pressure to meet multiple health needs. Overworked practitioners assume that if the patients fail
to show up for their appointments they have lost interest. The purpose of the study was to explore
reasons for the poor adherence of patients with neurological disorders at rehabilitative services.
This study used a phenomenological approach and purposive sampling. One-on-one interviews
with patients booked to receive therapy at a South African public sector hospital and who failed
to attend therapy were done (n=12). For triangulation purposes interviews were conducted with
patients who had never missed sessions (n=5). A total of eight of the participants from both
groups said that they had not accepted their condition. All five dimensions of adherence
described in the literature were found. The participants gave very positive feedback on the
rehabilitative programmes received at the hospital, but said circumstances beyond their control
had caused them to miss a session. These included fear of losing jobs, unavailability of transport,
and perception of poor services at primary health care clinics when down referred. The reasons
for adherence or lack of it are not easily established. Contributing factors however were noted in
this study. Information obtained from the study will assist health professionals to understand the
patients’ context and can inform rehabilitation programmes to support adherence.
