Cheras Rehabilitation Hospital in Malaysia (Hospital Rehabilitasi Cheras/HRC) was awarded a World Stroke Campaign Award for its work to raise awareness of key issues in treatment and rehabilitation of stroke patients. Here, project lead Dr Norhayati Hussein sets out why HRC got behind the 'Stroke is Treatable' campaign and how they went about raising awareness and engagement of senior government, clinicians, patients and families.
What would you say are the key issues in stroke treatment?
Stroke is more than a brain attack. It is a multidimensional life-altering event that, as well as affecting stroke survivors, affects their families, healthcare resources and wider society. Stroke patients can really struggle with accepting the effect of stroke on their lives and many find it difficult to adjust to a different life. For some, the reversal of caring roles following a stroke can also be really challenging. For these reasons rehabilitation is an incredibly important part of the treatment pathway for stroke patients. Previously, there has been much emphasis on the vascular pathology of stroke and acute treatments. Primary and secondary stroke prevention strategies are important and while the use of thrombolysis therapy has benefited a small proportion of patients, the majority of stroke patients are still affected by stroke- related impairments. The focus of stroke care needs to place equal emphasis on promoting recovery, in line with the growing evidence of the importance of stroke rehabilitation interventions. The challenge lies in ensuring that research gets translated into practice to ensure a comprehensive and balanced stroke care which incorporates rehabilitation as a major component.
Why did Cheras Rehabilitation Hospital choose this particular approach to increasing awareness and understanding treatment needs of stroke patients?
Hospital Rehabilitasi Cheras (HRC) / Cheras Rehabilitation Hospital is a rehabilitation facility which offers specialised stroke rehabilitation service. We strongly believe that rehabilitation is a critical step in the stroke treatment process and were committed to get behind the campaign as a way to raise awareness and action around stroke rehabilitation.
The strength of our campaign was the string of events, specially designed to encourage everyone to build awareness, drive action and push for better access to stroke treatments, with a focus on rehabilitation. The 360-degrees approach which we implemented was simple, yet creative and designed to cut across all target groups.
What would you say were the most successful parts of the campaign?
The campaign was successfully organized in collaboration with all services directly involved in stroke rehabilitation and truly embraced the tagline ‘Awareness, Access, Action’. Each aspect of the campaign is a winner in its own right. For the first time, the World Stroke Day brochure and infographic was translated to Bahasa Melayu which is the national language. This allowed us to reach a wider target audience for the World Stroke Campaign and to increase stroke awareness in Malaysia. Involving people in sharing the message through our stroke Infographic Competition generated wide participation from medical staff and the public - including a stroke survivor.
The Hospital CME highlighted malignant MCA Infarct, a previously life-threatening condition, while a patient- inspired ‘Santai Senam Silat’ incorporates traditional Malay martial art as means of wellness.
Our ‘Stroke for An Hour’ event was designed for caregivers to find out how it feels to physically experience a stroke and to instil the importance of preventing complications related to hemiplegia and unilateral neglect. Low-cost materials were used to simulate role-play activities in a ‘hemiplegic’ manner; focusing on transfer techniques, positioning and mobility. Sessions with catchy names eg ‘Single Magic Hand’, ‘Express Your Need’ and ‘Now You See...Now You Don’t’ allowed people to experience for themselves the significant and sometimes unseen effects of stroke on everyday tasks and communication.
In addition to participatory events, we organized interactive booths highlighting the various interdisciplinary teams involved in the rehabilitation management of stroke patients. A special interactive booth on Sexuality and Intimacy was an eye-opener to the often less discussed sexuality aspect of life after stroke.
There was also live demonstration on music therapy and art-doodling. This is in line with increasing evidence on music therapy and art therapy as treatment approaches which confer benefits to stroke survivors by improving fine-motor, visuo-spatial, eye-hand coordination and providing positive emotional benefit.
We also took the initiative to improve access to stroke rehabilitation in Hospital Rehabilitasi Cheras. A session aptly named ‘Information & Exposure: You Ask, We Answer’ was planned to provide a platform for interested parties to pose questions about the rehabilitation service offered for stroke patients. We also published World of HRC: NeurOne - a bulletin on the neurological rehabilitation service, focusing on stroke and stroke survivors.
As further proof that stroke is treatable and beatable, stroke survivors conducted domestic skill classes for making steam-buns (pau) and cupcakes. As a symbol of appreciation; stroke patients, survivors and their families were treated to a special tea party to acknowledge, appreciate and celebrate the courage of stroke survivors.
Can you describe the immediate impact of the campaign a) on the public and b) on healthcare professionals and policy makers?
The campaign enabled the public and the medical staff to acknowledge the courage and perseverance of stroke survivors. The Stroke Forum amongst stroke survivors provided valuable insights from the patients’ perspective and also contributed to our continuous service improvement.
A real achievement for our World Stroke Day Campaign celebrations was the attendance of the Director of Medical Development Division in the Ministry of Health at the peak highlight celebration. This event which was also attended by neurologists, geriatricians, internal physicians and allied health professionals from other hospitals increased awareness and action of top government stakeholders and other partners to solidly support the development of stroke rehabilitation provision in Malaysia.
Finally, what does it mean to you to receive an award from the World Stroke Campaign?
It is a tremendous honour to receive the award from an esteemed and prestigious organization such as WSO. Receiving the award helps to set a benchmark for stroke rehabilitation service in the country. The recognition has served as a driving factor for HRC, and has propelled us to provide better quality service in the future. We look forward to further fruitful partnership with the World Stroke Campaign.
You can find out more about the World Stroke Campaign on our campaign website and be first to hear about new campaigns by following us on Facebook
