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Satisfaction Towards Domiciliary Care Services and the Unmet Needs Among Stroke Patients in Kota Bharu District Dr Nurul Ain

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Satisfaction Towards Domiciliary Care Services and the Unmet Needs Among Stroke Patients in Kota Bharu District Dr Nurul Ain SATISFACTION TOWARDS DOMICILIARY CARE SERVICES AND THE UNMET NEEDS AMONG STROKE PATIENTS IN KOTA BHARU DISTRICT DR NURUL AIN BINTI MOHD EMERAN Dissertation Submitted in Partial Fulfilment of the Requirements for the Degree of Doctor of Public Health (Epidemiology) UNIVERSITI SAINS MALAYSIA April 2018 1 ACKNOWLEDGEMENTS بِ ْس ِمِ للاِ ال َّر ْح ٰم ِنِ ال َّر ِح ْي ِمِ Praise be to Allah S.W.T the most compassionate and most merciful, whose blessing have helped me through the study until the submission of this report. I would like to express my deepest gratitude and thank to the following individuals who had helped me in the preparation and during the completion of this dissertation. I would like to express my utmost gratitude to my main supervisor, Associate Professor Dr Nor Azwany binti Yaacob from Department of Community Medicine and Dr Muhammad Hafiz bin Hanafi from Department of Neuroscience for their support, willingness in providing constructive suggestions, proofreading, and the countless efforts generously channelled towards this research. My sincere appreciation is extended to my co-researchers Dr Mohd Harith bin Abdul Aziz from Department of Rehabilitation Medicine, Hospital Raja Perempuan Zainab II, and Dr Noor Aman bin A. Hamid for their treasured input. My appreciation is also directed to all staffs of Kota Bharu, Pasir Mas, and Tumpat District Health Office for their cooperation and to all respondents or staff who directly or indirectly participated in this study. Special thanks to Ministry of Health Malaysia for the opportunity for a full course of funded study leave and permission to conduct this study at their facilities. Last but not least, all thanks to my beloved parents Hj. Mohd Emran bin Abd Salam and Hjh. Zaiton binti Sha’ari, all lecturers, and my colleagues in Department of Community Medicine for their support and encouragement throughout this study. ii TABLE OF CONTENTS ACKNOWLEDGEMENTS ......................................................................................... ii TABLE OF CONTENTS ………………………………...………………………….iii LIST OF TABLES ..................................................................................................... vii LIST OF FIGURES ..................................................................................................... x LIST OF APPENDICES ............................................................................................. xi LIST OF ABBREVIATIONS .................................................................................... xii ABSTRAK…… ........................................................................................................ xiii ABSTRACT…. ........................................................................................... ………..xvi CHAPTER ONE ........................................................................................................ 18 INTRODUCTION ..................................................................................................... 18 1.1 Introduction .................................................................................................... 18 1.2 Problem statement .......................................................................................... 21 1.3 Study rationale ............................................................................................... 22 1.4 Research question(s) ...................................................................................... 22 1.5 Objective ........................................................................................................ 23 1.5.1 General objective ............................................................................... 23 1.5.2 Specific objectives ............................................................................. 23 1.6 Research hypothesis ....................................................................................... 23 CHAPTER TWO ....................................................................................................... 24 LITERATURE REVIEW .......................................................................................... 24 2.1 Introduction to stroke ..................................................................................... 24 2.2 Stroke’s burden .............................................................................................. 25 2.3 Stroke rehabilitation ....................................................................................... 27 2.4 Dependency level ........................................................................................... 29 2.5 Domiciliary care services ............................................................................... 33 2.6 Predictors in service satisfaction .................................................................... 39 2.7 Unmet needs for care ..................................................................................... 42 2.8 Conceptual framework ................................................................................... 47 CHAPTER THREE ................................................................................................... 49 METHODOLOGY .................................................................................................... 49 3.1 Research design ............................................................................................. 49 3.2 Study area ....................................................................................................... 49 iii 3.3 Operational definition .................................................................................... 49 3.3.1 Stroke patient ..................................................................................... 49 3.3.2 Caregiver ............................................................................................ 50 3.3.3 Adult caregiver ................................................................................... 50 3.3.4 Capable caregiver ............................................................................... 50 3.3.5 Shared caregiver ................................................................................. 50 3.3.6 Family conference .............................................................................. 50 3.3.7 Caregiver’s satisfaction ...................................................................... 50 3.3.8 Unmet needs ....................................................................................... 51 3.4 Part 1 : Retrospective record review .............................................................. 51 3.4.1 Study location .................................................................................... 51 3.4.2 Study period ....................................................................................... 51 3.4.3 Reference population ......................................................................... 51 3.4.4 Source population .............................................................................. 52 3.4.5 Sampling frame .................................................................................. 52 3.4.6 Study criteria ...................................................................................... 52 3.4.7 Sample size determination ................................................................. 52 3.4.8 Sampling method ............................................................................... 53 3.4.9 Research tools .................................................................................... 54 3.4.10 Method of data collection .................................................................. 55 3.4.11 Data analysis ...................................................................................... 55 3.5 Part 2 : Caregivers’ satisfaction ..................................................................... 56 3.5.1 Study location .................................................................................... 56 3.5.2 Study period ....................................................................................... 56 3.5.3 Reference population ......................................................................... 56 3.5.4 Source population .............................................................................. 56 3.5.5 Sampling frame .................................................................................. 56 3.5.6 Study criteria ...................................................................................... 56 3.5.7 Sample size determination ................................................................. 57 3.5.8 Sampling method ............................................................................... 57 3.5.9 Research tools .................................................................................... 57 3.5.10 Method of data collection .................................................................. 59 iv 3.6 Part 3 : Unmet needs in domiciliary service utilisation ................................. 60 3.6.1 Study location .................................................................................... 60 3.6.2 Study period ....................................................................................... 60 3.6.3 Reference population ......................................................................... 60 3.6.4 Source population .............................................................................. 60 3.6.5 Sampling frame .................................................................................
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