Identifying contributing factors for poor adherence to rehabilitative services in patients with neurological conditions

Abstract

Introduction Good adherence to rehabilitative services is critical for optimal health. Practitioners assume that if the patients fail to show up for their appointments they have lost interest. This study sought to establish the reasons for the poor adherence of patients with different forms of neurological disorders at the rehabilitative services of the outpatients department of Tambo Memorial Hospital (TMH). Methods This study used a mixed methods study design. One-on-one interviews with patients booked to receive therapy at TNM and who failed to attend therapy were done (n=12). For triangulation purposes interviews were conducted with the patients who have never missed sessions (n=5). Results A total of eight of the participants from both groups said that they had not accepted their condition. The participants gave very positive feedback on the rehabilitative services received at the hospital, but said circumstances beyond their control had caused them to miss a session. The need to earn income among those working in the informal sector was a negative influence on adherence. Conclusion The reasons for adherence or lack of it are not easily established. Contributing factors however were noted in this study. These include participants not being able to go to their therapy sessions due to a fear of losing their jobs, unavailability of a mode of transport, poor services at primary health care clinics when down referred. Information obtained from the study will assist health professionals at TMH to provide services that are more tailored to the patients and improve adherence.