Understanding the Sociocultural Health Belief Model Influencing Health Behaviors among Saudi Stroke Survivors


Understanding patients’ beliefs of stroke, especially that cultural model which influences the medical management, is important. Professionals normally hold medical knowledge only about stroke, rather than the patients’ perceptions, which leads to limitations in cultural competency. Little is known about Saudi stroke survivors’ beliefs and behaviors related to their strokes. Methods: A qualitative methodology was used to collect in-depth information from stroke survivors. From March 2010 to October 2014, 45 stroke survivors were recruited from outpatient rehabilitation clinic at King Fahad Medical City (KFMC-RH), during their follow-up treatments. Results: Thematic content analysis yielded four major themes of the causes of stroke: medical, cultural, psychological and environmental. Three major themes were determined regarding stroke interventions: medical, lifestyle and behavioral, as well as cultural interventions. Stroke is most likely to be associated with a wide range of cultural beliefs by stroke survivors, leading them to cultural behaviors and management. All of these cultural interventions were typically used as an adjunct rather than an alternative to medical care. Conclusions: Health professionals need to be aware that cultural beliefs and their management are common problems for stroke survivors undergoing rehabilitation in a hospital. This study could be one step forward to help health professionals become culturally competent when working with stroke survivors in a rehabilitation setting in Saudi Arabia.

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M. J. Alqahtani, M. (2015) Understanding the Sociocultural Health Belief Model Influencing Health Behaviors among Saudi Stroke Survivors. Neuroscience and Medicine, 6, 149-159. doi: 10.4236/nm.2015.64023.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] (2005) World Health Organization Preventing Chronic Diseases: A Vital Investment. WHO, Geneva.
[2] Lutz, B.J., Young, M.E., Cox, K.J., Martz, C. and Creasy, K.R. (2011) The Crisis of Stroke: Experiences of Patients and Their Family Caregivers. Topics in Stroke Rehabilitation, 18, 786-797.
[3] Ang, S.Y., Tin, A.S., Pavitar, G., May, W., Peh, C., Peng, X.J. and Tye, S.N.J. (2013) A Qualitative Study into Stroke Caregivers’ Educational Needs—Perspectives of Caregivers and Healthcare Professionals. Proceedings of Singapore Healthcare, 22, 166.
[4] Ezzati, M., Lopez, A.D., Rodgers, A., Vander Hoorn, S. and Murray, C.J. (2002) Selected Major Risk Factors and Global and Regional Burden of Disease. The Lancet, 360, 1347-1360.
[5] Painter, J.E., Borba, C.P.C., Hynes, M., Mays, D. and Glanz, K. (2008) The Use of Theory in Health Behavior Research from 2000 to 2005: A Systematic Review. Annals of Behavioral Medicine, 35, 358-362.
[6] Farooqui, M., Hassali, M.A., Shatar, A.K., Shafie, A.A., Seang, T.B. and Farooqui, M.A. (2011) A Qualitative Exploration of Malaysian Cancer Patients’ Perspectives on Cancer and Its Treatment. BMC Public Health, 11, 525.
[7] Rodgers, H., Bond, S. and Curless, R. (2001) Inadequacies in the Provision of Information to Stroke Patients and Their Families. Age and Ageing, 30, 129-133.
[8] Coreil, J., Wilke, J. and Pintado, I. (2004) Cultural Models of Illness and Recovery in Breast Cancer Support Groups. Qualitative Health Research, 14, 905-923.
[9] Ferraro, G.P. (1990) The Cultural Dimension of International Business. Prentice Hall, Englewood Cliffs.
[10] Kreuter, M. and Strecher, V. (1995) Changing Inaccurate Perceptions of Health Risk: Results from a Randomized Trial. Health Psychology, 14, 56-63.
[11] Samsa, G.P., Cohen, S.J., Goldstein, L.B., Bonito, A.J., Duncan, P.W., Enarson, C., et al. (1997). Knowledge of Risk among Patients at Increased Risk for Stroke. Stroke, 28, 916-921.
[12] Hanger, H.C., Fogarty, B., Wilkinson, T.J. and Sainsbury, R. (2000) Stroke Patients Views on Stroke Outcomes: Death versus Disability. Clinical Rehabilitation, 14, 417-424.
[13] Paul, S.L., Sturm, J.W., Dewey, H.M., Donnan, G.A., Macdonell, R.A.L. and Thrift, A.G. (2005) Long-Term Outcome in the North East Melbourne Stroke Incidence Study Predictors of Quality of Life at 5 Years after Stroke. American Heart Association, 36, 2082-2086.
[14] Saenger, A.K. and Christenson, R.H. (2010) Stroke Biomarkers: Progress and Challenges for Diagnosis, Prognosis, Differentiation, and Treatment. Clinical Chemistry, 56, 21-33.
[15] Alqahtani, M.M. (2015) Evaluating Patients’ Needs among Rehabilitation Setting. Human, 5, 4-10.
[16] Langhorne, P., Bernhardt, J. and Kwakkel, G. (2011) Stroke Rehabilitation. The Lancet, 377, 1693-1702.
[17] Langhorne, P., Coupar, F. and Pollock, A. (2009) Motor Recovery after Stroke: A Systematic Review. The Lancet Neurology, 8, 741-754.
[18] Bendz, M. (2003) The First Year of Rehabilitation after a Stroke—From Two Perspectives. Scandinavian Journal of caring Sciences, 17, 215-222.
[19] Pajalic, Z., Karlsson, S. and Westergren, A. (2006) Functioning and Subjective Health among Stroke Survivors after Discharge from Hospital. Journal of Advanced Nursing, 54, 457-466.
[20] Hartigan, I., O’Connell, E., McCarthy, G. and O’Mahony, D. (2011) First Time Stroke Survivors’ Perceptions of Their Status and Their Goals for Recovery. International Journal of Nursing and Midwifery, 3, 22-29.
[21] Britten, N. (1995) Qualitative Research: Qualitative Interviews in Medical Research. BMJ, 311, 251-253.
[22] Smith, J.A., Harré, R. and Van Langenhove, L., Eds. (1995) Rethinking Methods in Psychology. Sage, London.
[23] Rahman, T.T.A., Gaafary, E. and Mohamed, M. (2009) Montreal Cognitive Assessment Arabic Version: Reliability and Validity Prevalence of Mild Cognitive Impairment among Elderly Attending Geriatric Clubs in Cairo. Geriatrics & Gerontology International, 9, 54-61.
[24] Pope, C., Ziebland, S. and Mays, N. (2000) Analysing Qualitative Data. BMJ, 320, 114-116.
[25] Alqahtani, M.M. (2012) Understanding Autism in Saudi Arabia: A Qualitative Analysis of the Community and Cultural Context. Journal of Pediatric Neurology, 10, 15-22.
[26] Al Shafaee, M.A., Ganguly, S.S. and Al Asmi, A.R. (2006) Perception of Stroke and Knowledge of Potential Risk Factors among Omani Patients at Increased Risk for Stroke. BMC Neurology, 6, 38.
[27] Woloshynowych, M., Valori, R. and Salmon, P. (1998) General Practice Patients’ Beliefs about Their Symptoms. British Journal of General Practice, 48, 885-889.
[28] Donnellan, C., Hevey, D., Hickey, A. and O’Neill, D. (2006) Defining and Quantifying Coping Strategies after Stroke: A Review. Journal of Neurology, Neurosurgery & Psychiatry, 77, 1208-1218.
[29] Alqahtani, M.M. and Salmon, P. (2008) Cultural Influences in the Aetiological Beliefs of Saudi Arabian Primary Care Patients about Their Symptoms: The Association of Religious and Psychological Beliefs. Journal of Religion and Health, 47, 302-313.
[30] Hussain, R. (2002) Lay Perceptions of Genetic Risks Attributable to Inbreeding in Pakistan. American Journal of Human Biology, 14, 264-274.
[31] Pieroni, A. and Quave, C. (2005) Traditional Pharmacopoeias and Medicines among Albanians and Italians in Southern Italy. Journal of Ethnopharmacology, 101, 258-270.
[32] Shahin, S.H. and Daly, E.B. (1999) Knowledge, Attitudes and Beliefs about Psychotropic Medication among Saudi Hospitalized Psychiatric Patients. International Journal of Nursing Studies, 36, 51-55.
[33] Al-Krenawi, A. and Graham, J.R. (2000) Culturally Sensitive Social Work Practice with Arab Clients in Mental Health Settings. Health & Social Work, 25, 9-22.
[34] Jan, M.M., Basamh, M.S., Bahassan, O.M. and Jamal-Allail, A.A. (2009) The Use of Complementary and Alternative Therapies in Western Saudi Arabia. Saudi Medical Journal, 30, 682-686.
[35] Giaquinto, S., Spiridigliozzi, C. and Caracciolo, B. (2007) Can Faith Protect from Emotional Distress after Stroke? Stroke, 38, 993-997.
[36] Dubovsky, S.L. (1983) Psychiatry in Saudi Arabia. American Journal of Psychiatry, 140, 1455-1459.
[37] Hasan, I., Ahmad, T. and Ahmad, S. (2014) Management of Hypertension by Wet Cupping Therapy (Al-Hijamah): A Case Study. International Journal of Pharmacology & Toxicology, 4, 24-27.
[38] Shenoy, R., Bialasiewicz, A., Khandekar, R., Al Barwani, B. and Al Belushi, H. (2009) Traditional Medicine in Oman: Its Role in Ophthalmology. Middle East African Journal of Ophthalmology, 16, 92-96.
[39] Azaizeh, H., Saad, B., Cooper, E. and Said, O. (2010) Traditional Arabic and Islamic Medicine: A Re-Emerging Health Aid. Evidence-Based Complementary and Alternative Medicine, 7, 419-424.
[40] Beach, M.C., Price, E.G., Gary, T.L., Robinson, K.A., Gozu, A., Palacio, A., et al. (2005) Cultural Competency: A Systematic Review of Health Care Provider Educational Interventions. Medical Care, 43, 356-373.
[41] Rashidi, A. and Rajaram, S.S. (2001) Culture Care Conflicts among Asian-Islamic Immigrant Women in US Hospitals. Holistic Nursing Practice, 16, 55-64.
[42] Saha, S., Beach, M.C. and Cooper, L.A. (2008) Patient Centeredness, Cultural Competence and Healthcare Quality. Journal of the National Medical Association, 100, 1275-1285.
[43] Campinha-Bacote, J. (2002) The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care. Journal of Transcultural Nursing, 13, 181-184.
[44] Campinha-Bacote, J. (2001) A Model of Practice to Address Cultural Competence in Rehabilitation Nursing. Rehabilitation Nursing, 26, 8-11.
[45] Becker, S. (2004) Detection of Somatization and Depression in Primary Care in Saudi Arabia. Social Psychiatry and Psychiatric Epidemiology, 36, 962-966.
[46] Dwairy, M. and Van Sickle, T. (1996) Western Psychotherapy in Traditional Arabic Societies. Clinical Psychology Review, 16, 231-249.

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