Abstract
Background: Stroke has undergone different medical constructions over the years. While the medical profession posits that disease is a biological condition, universal and unchanging, social constructionists perceive illness as the social meaning of the biological condition. Even though the medical notion of stroke is monolithic and sometimes contradicts the representations by local community residents, little attention has been paid to understanding the cultural meanings of stroke. This study explores the cultural meanings of stroke in five different cultural settings across Ghana. Methods: 30 focus group discussions (FGDs) were conducted with local community members in five communities (Ga Mashie, Tafo, Gyegyeano, Chanshegu and Agorve) located in five regions in Ghana. The FGDs were conducted in Ga, Twi, Fante, Ewe and Dagbani, and were transcribed verbatim into English. The transcripts were analysed thematically. Results: The local words used for stroke in all the five cultural settings focused on physical disability associated with stroke after its onset, and this formed the dominant source of fear about the condition. Participants mentioned that spiritual and left-side stroke have the most debilitating impact on the sufferer. Although there was a general consensus that anyone can be at risk of stroke, there was a gender dynamics in the explanation of risk relativity. Participants believed that stroke can be cured through early detection and treatment, use of herbal medicines, and availability of financial resources. Compared to other disabling conditions, the community residents perceived stroke to be more severe due to the multifaceted disabilities associated with the condition. Conclusions: This study showed that the social meanings of stroke in the five communities are multifaceted, and reflected co-existence of biomedical and cultural frameworks. The findings showed the need to pay good attention to the sociocultural context when developing interventions strategies on stroke prevention and control in Ghana.
Highlights
Over the years, stroke has undergone different medical constructions globally, and these influence perceptions and practice on management and prognosis
Many of the community members were familiar with the word ‘stroke’ and could recognise who a stroke survivor is in line with medical descriptions
Ga Mashie participants referred to stroke as a ghost illness “sisa hela”; they mentioned that this term was developed in the 1960s when community knowledge on causes and management of stroke was low
Summary
Stroke has undergone different medical constructions globally, and these influence perceptions and practice on management and prognosis. From the time of Hippocrates to the first half of the twentieth century, medical science mostly referred to stroke as “apoplexy”, meaning any sudden condition that began with loss of consciousness especially one in which the sufferer died within a matter of seconds after losing consciousness (Cooke, 1824, cited in Pound et al, 1997). Even though there was pessimism about the prognosis of apoplexy, most especially during the 18th century, physicians hoped for a future in medical advancement with prospects of better outcomes. Based on the medical construction of cerebrovascular disease, the emphasis on the person experiencing the condition began to fade away and ‘patients became less and less visible in medical texts’ (Pound et al, 1997). During the 1950s, new treatment procedures such as angiography, cerebrovascular surgery and anticoagulants were developed for cerebrovascular disease and this formed the basis for a gleam of hope for better prognosis
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