About the Author(s)


Tawagidu Mohammed symbol
Department of Physiotherapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa

Department of Physiotherapy, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana

Gifty G. Nyante symbol
Department of Physiotherapy, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana

Joyce D. Mothabeng symbol
Department of Physiotherapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa

Citation


Mohammed, T., Nyante, G.G. & Mothabeng, J.D., 2023, ‘Perceptions of health professionals on structure and process of stroke rehabilitation in Ghana’, African Journal of Disability 12(0), a1116. https://doi.org/10.4102/ajod.v12i0.1116

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Perceptions of health professionals on structure and process of stroke rehabilitation in Ghana

Tawagidu Mohammed, Gifty G. Nyante, Joyce D. Mothabeng

Received: 21 July 2022; Accepted: 28 Jan. 2023; Published: 03 Apr. 2023

Copyright: © 2023. The Author(s). Licensee: AOSIS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Ensuring quality in the structure and process of stroke rehabilitation helps to attain a good outcome. However, knowledge on this is limited in resource-constrained settings such as Ghana.

Objectives: This study aimed to explore healthcare professionals’ (HCPs) views and experiences of the structure and process of stroke rehabilitation in three selected hospitals in Ghana.

Method: A qualitative study was carried out involving 26 HCPs directly involved in stroke rehabilitation from three selected hospitals in the Greater Accra Region of Ghana representing the different levels of healthcare. Interviews were conducted using an interview guide to understand participants’ views and experiences of the structure and process of stroke rehabilitation. Interview transcripts were analysed using thematic analysis.

Results: HCPs reported limitations with the structure of stroke rehabilitation with regards to the availability of rehabilitation units, bed capacity, approach to care, availability of protocol, staff capacity development and payment systems. With respect to the process of rehabilitation, the primary and secondary level hospitals were found not to have computed tomography (CT) and magnetic resonance imaging (MRI) scanning equipment. Participants also reported limitations with discharge planning, basis for discharge and post-discharge care across all three hospitals.

Conclusion: This study found limitations in the current structure and process of stroke rehabilitation, which when given some considerations for improvement, can help improve the quality of care and thereby improve the outcome of stroke patients in Ghana.

Contribution: This study provided data which helps to assess the quality of stroke rehabilitation in Ghana.

Keywords: stroke; stroke rehabilitation; structure; process; healthcare professionals; Ghana.

Introduction

Stroke continues to be of major public health concern globally, as stroke is the second leading cause of death and the third leading cause of disability (Katan & Luft 2018). About 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low- to middle-income countries (LMICs) such as sub-Saharan African countries (Feigin et al. 2021). Ghana, which is also categorised under LMICs is located in west Africa and has a population of about 25 million (Drislane et al. 2014). Ghana is rapidly undergoing epidemiological transitions of diseases and the burden of disease has now shifted from communicable to non-communicable diseases over the last few years (Sanuade et al. 2019). One cardiovascular disease that is on the rise is hypertension and this is a major risk factor for stroke. In Ghana, the mortality rate of stroke is about 40% (Baatiema et al. 2017a). Stroke has now become the major cause of adult medical admissions in Ghana and a major cause of adult disability (Agyei-Mensah & De-Graft Aikins 2010; Maredza, Bertram & Tollman 2015). Aside from the physical consequences of stroke, stroke has a serious economic impact on the Ghanaian working population as most of the stroke patients in Ghana are within the working age (Agyemang et al. 2012).

The cardinal effect of stroke on its survivors is disability (George & Steinberg 2015). The long-term physical consequences of a stroke put a lot of burden on the stroke patients, their families, the healthcare system and the economy at large (Brewer et al. 2013). Stroke patients in Ghana are also burdened with debilitating impairments and functional deficits as expected of all stroke patients (Baatiema et al. 2017a; William et al. 2017). Effective rehabilitation is key to reducing and improving the level of disability as well as improving the quality of life of stroke patients (Hatem et al. 2016). Stroke patients in LMICs such as Ghana are still burdened with disability despite undergoing rehabilitation whereas stroke survivors in high-income countries (HICs) often may experience better functional and participation outcomes such as return to work (Rhoda et al. 2015; William et al. 2017). This could be attributed to a couple of factors of which one could be the quality of stroke rehabilitation services provided. Stroke patients are probably doing better in function in HICs because of the better quality in their stroke rehabilitation services (Bernhardt et al. 2020) including all the necessary structure and process of rehabilitation. Quality of stroke rehabilitation seems to be better in these HICs because of the availability of data and evaluation of stroke rehabilitation services. Studies that have been conducted to evaluate stroke rehabilitation services in HICs have provided recommendations for improvements which when implemented, enhances the structure and process of stroke care, which then translated into better patient outcomes. However, in LMICs such as Ghana, data are lacking on the evaluation of the available stroke rehabilitation to help inform policy development on stroke rehabilitation that could improve the overall quality of stroke care. Therefore, there is the need to fill this gap in the research evidence on stroke rehabilitation in Ghana. In order to do so, there is the need to evaluate the structure and process of stroke rehabilitation available in LMICs such as Ghana.

The quality of care directly influences the outcome of the stroke patients. Ameh and colleagues affirm that a good structure can promote good process and in turn, a good process can promote a good outcome (Ameh et al. 2017). The structure and process of healthcare are therefore very important when considering the quality of care which translates into the better patient outcomes. Structure is considered as the physical and organisational aspects of healthcare. These are factors that affect the context in which healthcare is provided (Hoenig et al. 2002). The structural component of healthcare takes into consideration the personnel by looking at their education, training, experience and certification. It also considers the setting where healthcare is provided, which includes systemic organisation, staffing and equipment availability, among others (Haj, Lamrini & Rais 2013). Processes are the activities implemented in the rehabilitation services of patients with disabling conditions that help to progress patients’ health by promoting recovery, functional restoration, survival and even patient satisfaction (Hoenig et al. 2002). These process-related factors may include diagnosis, interventions, education, preventive treatment, guidelines as well as procedures, coordination of care, individualisation, amount and timing and specific interventions (Donabedian 2003).

This study aims to provide data to help in better understanding of the structure and process of stroke rehabilitation in Ghana to help in facilitating interventions to improve the quality of stroke rehabilitation, which in turn can improve the outcome of stroke patients. A preliminary study carried out in Ghana to assess the structure and process of stroke rehabilitation in Ghana was conducted by the authors of this study (Mohammed, Nyante & Mothabeng 2022) using quantitative methods. In order to have a better understanding of the structure and process of stroke rehabilitation that was recorded in the previous quantitative study, a qualitative study needed to be carried out. This qualitative study hopes to further validate the results obtained from the quantitative study and also provide more details of the structure and process of stroke rehabilitation available. The qualitative study will provide in-depth information, which will help to enrich the literature on the structure and process of stroke rehabilitation in Ghana. This study therefore aimed to explore stroke healthcare professionals views and experiences of the structure and process of stroke rehabilitation in three selected hospitals in Ghana in order to ensure interventions are implemented to improve the quality of stroke rehabilitation services locally.

Research methods and design

Study design

This study employed a descriptive phenomenological approach to clearly assess the views and experiences of HCPs directly involved in the rehabilitation of stroke patients in Ghana. Phenomenology involves describing the experiences and views of a group of individuals about a particular concept or phenomenon, resulting in several people sharing their experiences on the same matter (Creswell 2009).

Study population and sampling strategy

This study purposively sampled 26 stroke HCPs who were directly involved in the day-to-day rehabilitation of stroke patients from three selected hospitals in the Greater Accra Region of Ghana. Purposive sampling is a non-probabilistic sampling procedure used in sampling participants in qualitative studies. This sampling technique allows researchers to choose the sample based on who they think best fits to be part of the study (Crossman 2020). In this study, the researcher sampled a maximum of two stroke HCPs from each of the available rehabilitation professions at each of the three selected hospitals. The HCPs who were recruited included doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, clinical psychologists and dieticians. These HCPs were selected if they met the following criteria:

  • If they were 18 years and above
  • If they had worked in stroke rehabilitation for at least 1 year or if they had any formal training or specialisation in stroke rehabilitation.
Settings

This study was carried out at the general medical wards and stroke unit of three selected hospitals in the Greater Accra Region of Ghana. Greater Accra is the capital city of Ghana and most of the healthcare delivery settings are involved in rehabilitation. The selected sites represented all the levels of local healthcare and included a tertiary level hospital (TH) (Korle Bu Teaching Hospital), a secondary level hospital (SH) (Tema General Hospital) and a primary level hospital (PH) (Amasaman District Hospital). All the three levels of healthcare are involved in both inpatient and outpatient stroke rehabilitation.

Data collection

The first author visited the medical wards and stroke unit of the hospitals to identify HCPs who met the study inclusion criteria. Participants were provided with copies of the study information sheet, which explained the aims as well as the procedures of the study. Participants had the opportunity to ask questions about the study and answers were provided. Written informed consent was provided by each participant who agreed to participate through signing of the consent form. Individual in-depth interviews were conducted in English at a mutually agreed venue and time at the medical and stroke units of the selected hospitals. These individual interviews were conducted in-person in a quiet room. The first author was the moderator of the interview. A semi-structured interview guide (Appendix 1) was used to guide the interviews. Before the start of each interview, the interviewer (first author) engaged participants in informal conversation to establish rapport and prepare them for the interview. The interview questions were focused on two main themes, which were the structure and process of the local stroke rehabilitation. The interview questions were developed based on review of literature and also with guidance from a previous quantitative study conducted by the authors. With the permission of the participants, each interview was audio recorded using a digital voice recorder. The interview lasted between 30 min and 1 h. During the interview, the researcher intermittently summarises the participants’ contributions to ensure that their views were accurately understood. The recorded interviews were transcribed verbatim and entered into a Microsoft Word document.

Data analysis

Data analysis occurred concurrently with data collection as transcription was performed alongside data collection. Transcripts were assigned specific identification numbers. Analysis also included reading and re-reading of the transcripts to help generate codes by authors. A code book was then developed. Themes and sub-themes were generated to capture the codes. The first two authors worked together to develop codes. Themes and subthemes were then generated upon discussion among the authors. The third author cross-checked the coding and themes developed. The stages of thematic analysis served as a guide in the analysis process. NVivo software (QSR International company, Burlington, Massachusetts, United States) was used to manage the data.

Ethical considerations

Ethical approval was received from the Ethical and Protocol Review Committee of School of Healthcare Sciences, University of Pretoria (protocol no.: 68/2020), Ghana Health Service Ethics Review Committee (protocol no.: GHS-ERC 010/02/20) and Korle Bu Teaching Hospital Ethical and Protocol Review Committee (protocol no.: KBTH-IRB/000165/2019). Permission was sought from the heads of the hospitals and the departments where data were collected. Written informed consent was sought from each of the participant. Participants’ confidentiality and anonymity were assured. All coronavirus disease 2019 (COVID-19) safety measures were duly observed.

Results

The interviews conducted in this study included questions on the available structure and process of stroke rehabilitation, which gave rise to themes and sub-themes. Two main themes that were structure and process of stroke rehabilitation emerged with several sub-themes under each theme. The sub-themes for the structure of stroke rehabilitation included rehabilitation unit, bed capacity, approach of care, rehabilitation protocol, staff capacity development and payment system. For the process of stroke rehabilitation, the sub-themes that emerged were frequency of rehabilitation, duration of rehabilitation, length of hospital stay and discharge process, post-discharge care and follow-up and family or relative involvement in rehabilitation.

Participants

Twenty-six HCPs were recruited from the three selected hospitals. Of the total participants, there were six physiotherapists, two occupational therapists, two speech therapists, six nurses, two dieticians, two clinical psychologists and six medical doctors as shown in Table 1. Majority of participants (65.4%) were females with 34.6% being males. Table 1 shows the lack of some HCPs at the PH and SH, which were occupational therapists, speech therapist and clinical psychologists.

TABLE 1: Profession of participants.
Structure of stroke rehabilitation
Stroke rehabilitation unit

The participants revealed that rehabilitation of stroke patients was carried out in general medical wards and stroke unit in the TH. However, at the SH and the PH, respondents mentioned that stroke patients were rehabilitated at the general medical wards only. At the TH, some respondents mentioned that admission of stroke patients into either the medical wards or the stroke unit was mostly dependent on the availability of beds and the severity of the stroke:

‘Yes, normally what we do is, when the patient is brought to the emergency and there is space at the stroke unit, they are admitted there straight. But mostly the acute ones. And if there is a first-time stroke patient too, we admit at the stroke unit. But if there is no bed available, we admit at the main ward.’ (Participant 6, TH, Nurse)

Participants across all the rehabilitation settings recommended a stroke unit as the most effective setting for rehabilitation of stroke patients:

‘Of course, I will recommend the stroke unit.’ (Participant 7, TH, Psychologist)

‘Obviously if there was a separate section for stroke patients, then certainly the management will be enhanced.’ (Participant 18, PH, Nurse)

‘In a nutshell, what I’m recommending is that we should all have stroke units, you see? But with the requisite staffing, education, availability of extra beds.’ (Participant 25, SH, Doctor)

Bed capacity for stroke rehabilitation

Participants across all the three hospitals mentioned that there was inadequate bed capacity for rehabilitation of stroke patients. The inadequacy in bed capacity at the stroke unit of the TH was reported as the reason some of the stroke patients were admitted to the general medical wards. participants mentioned that the PH and SH had no designated beds for stroke rehabilitation:

‘Not at all, we do not have adequate bed capacities. Sorry to cut you short, but I mean it’s a straight no! When you discharge somebody in the morning, the next 30 minutes to 1 hour, another person is on that bed.’ (Participant 26, PH, Physiotherapist)

‘No. We don’t even have the capacity. We don’t really have beds for stroke patients.’ (Participant 14, SH, Nurse)

‘Well, we (at the stroke unit) have a few beds, so sometimes we are forced to admit some patients at the medical ward or any ward provided the bed there is suitable to accommodate the patient.’ (Participant 6, TH, Nurse)

Approach of care for stroke rehabilitation

Participants from the TH mentioned the use of a multidisciplinary team (MDT) approach to stroke rehabilitation. However, this MDT approach to care was only available at the stroke unit. In the PH and SH, the MDT approach to care was reported not to be available as stroke patients were managed with other medical cases:

‘No. We don’t come together as a team. Ideally, that would have been good, so that in the morning when we are doing our rounds, we have the pharmacist around, the physiotherapist around, the dietician around. That would be very ideal. But unfortunately, we cannot do that here. Here, everything has different schedules. Our numbers are not enough to be able to put key members together to form the stroke team. What we however do is, the physicians do their rounds first. When they finish their rounds, they check the blood pressure and make sure the patients are fine and there’s no issue. Then we write a referral note for the dietician to come and see and play his part before the physiotherapist will come and see and also play his part. So, at the end of the day, everybody gets to see the patient. So, we don’t all go together as a team but we benefit from each team’s expertise.’ (Participant 25, SH, Doctor)

‘There’s nothing like a stroke rehab team; we work separately.’ (Participant 19, PH, Physiotherapist)

‘You know, you need a team to work. So, if you are alone, you can do a few things but you might not be able to do it properly. So, they might not be able to nurse them properly at the medical ward as compared to what we are doing at the stroke unit.’ (Participant 5, TH, Nurse)

Stroke rehabilitation protocol

Participants from some professions at the TH mentioned having site-specific protocols for stroke rehabilitation although not visibly displayed in the hospital. At the PH, protocols for stroke rehabilitation were displayed at the emergency unit and the general medical wards, which served as guide for the nursing staff specifically. The SH was reported to have site-specific protocol for general management of medical cases, but not for stroke management:

‘[…] Usually the in-charge of the unit has the protocol but usually they will educate you. You are oriented. But I have not seen the document. But it is there.’ (Participant 2, TH, Physiotherapist)

‘Yes, we have protocols that we have modified.’ (Participant 11, TH, Dietitian)

‘It’s just a general medical protocol. So, I think if we have a protocol for stroke management, I think it will be very helpful.’ (Participant 14, SH, Nurse)

Staff capacity development

Participants from the TH mentioned that there was the availability of staff capacity development programmes at the stroke unit. These programmes involved weekly meetings to learn more on stroke rehabilitation through discussions and presentations. Staff capacity development programmes for stroke rehabilitation were reported not to be available at the general medical wards of the TH, SH and PH:

‘Normally after our MDTs we do our presentations. So maybe this week it will be the turn of the nurses, the doctors and then we pick other few topics and then discuss, and then do a whole presentation.’ (Participant 5, TH, Nurse)

The majority of the participants acknowledged the need for continuous education programmes related to stroke rehabilitation for staff, which were not available at their facilities:

‘Most staffs should be trained on how best we can handle our stroke patients. It would be very helpful.’ (Participant 21, PH, Nurse)

‘The first thing will be regular training, regular training.’ (Participant 24, SH, Dietitian)

Payment for stroke rehabilitation

All participants from the TH mentioned that stroke patients paid for rehabilitation services out of pocket at the stroke unit. For stroke patients managed in the general medical wards, the payment system allowed for the use of the national health insurance scheme (NHIS) for some rehabilitation services at all the hospitals. Also, it was revealed by some participants that ability to pay for rehabilitation services was also a factor for admission of stroke patients either to the stroke unit or general medical ward at the TH:

‘Most patients here (in the stroke unit) who are discharged its cash and carry. But the Medical Ward is covered by Health Insurance and this is even a factor for placing patients.’ (Participant 5, TH, Nurse)

The NHIS did not cover stroke rehabilitation services such as physiotherapy for inpatient rehabilitation. Participants recommended that stroke rehabilitation should be completely covered by the NHIS:

‘Ok. So, I can speak for physio. If they can advocate for physio inpatient. Presently, outpatient is catered for by the national health insurance. But inpatient, insurance does not cater for.’ (Participant 17, SH, Physiotherapist)

‘It’s more and less like cash and carry. You’ll pay, then when you pay, I attend to you. it’s not helpful because, right from the onset when you tell them they’re supposed to pay for the service, they don’t appreciate that idea. This is because, they feel the medical service is being paid for by the N.H.I.S.’ (Participant 26, PH, Physiotherapist)

Process of stroke rehabilitation
Frequency of rehabilitation sessions

The number of rehabilitation sessions patients received was found to be similar in all the hospitals where stroke patients received rehabilitation once a day for five days. However, at the stroke unit, it was revealed from the responses that rehabilitation sessions could occur more than once per day depending on the patient’s needs. This was possible because the various HCPs were resident at the stroke unit. It was reported by the HCPs that the number of rehabilitation sessions received per week by patients at the general medical wards was based on affordability:

‘Okay. So, for stroke unit per week, we come to work from Monday to Friday. So, from Monday to Friday, we treat for the stroke unit. But for the medical unit, first of all, we give you a bill for treatment session. Or sometimes even if we see that you can pay, we just give you the bill for the week. So, we can give you five sessions of therapy within the week. But normally we start with three sessions. Because of affordability we cannot know whether the patient can. So, you pay for three sessions. Within the week, we do the three sessions for you. After that if you need more, we write another session for you to go and pay.’ (Participant 2, TH, Physiotherapist)

Duration for sessions

A minimum of 30 min – 45 min of rehabilitation was reported for patients at all the three hospitals but stroke patients in the stroke units were reported to receive more rehabilitation time because of staff availability.

Availability of computed tomography scan and magnetic resonance imaging

Computed tomography (CT) scan and magnetic resonance imaging (MRI) availability in the facilities were reported by participants to be of high relevance to the rehabilitation of stroke patients as they help in diagnosis and also help guide stroke management. Even though this was found to be of much relevance, only TH was equipped with these:

‘Yes. Basically, it helps us to determine which type of stroke it is and the extent to which the stroke has occurred. I think they should be done as early as possible after you’ve done your physical examination and make the diagnosis. That’s the next thing you should be. Unfortunately, we don’t have in-house CT scan machine or MRI machines.’ (Participant 25, SH, Doctor)

‘The unfortunate thing is that we don’t have. So, for most of our situation, we usually have to manage for the first two or three days without a definite diagnosis which is quite daunting because you have to really hedge. But when it happens that we have to take a scan, we have facilities around where we can do the scan.’ (Participant 22, PH, Doctor)

Length of hospital stay and process of discharge

Discharge of stroke patients was reported by all participants to be carried out by doctors. For all the hospitals, participants mentioned that stroke patients were discharged from inpatient rehabilitation on the basis of medical stability to continue their rehabilitation on an outpatient basis. Stroke patients at the TH were reported to be discharged within 2–14 days of admission. At the SH and PH, patients were discharged within 3–4 days of admission:

‘And so, we [doctors] discharge the patient when we are sure that the home care of the patient can be managed by those either at home or at a nursing care and that the patient no longer has urgent needs in which we need to manage at the ward. We have an average from between two to fourteen days but we give that by the tenth they should have gone home.’ (Participant 9, TH, Doctor)

Post-discharge care and follow-up

Participants from all the three hospitals reported that stroke patients who were discharged usually go home to continue rehabilitation on an outpatient basis. There were no follow-up visits by HCPs to patient homes although some of the HCPs mentioned that follow-up visits to patients’ homes could help monitor the patients’ condition and progress of improvement. It was also reported that some stroke patients requested for home follow-up visits to their homes and these follow-up visits were however reported to be at the patient’s affordability:

‘It would be better if we do follow ups, because most cases you discharge them stable. But when they come back, most of them might have changed and gone worst. So, if they can do the follow ups, it would be better.’ (Participant 20, PH, Doctor)

‘It would be better if we could follow-up at home. That will be best, that will be best. If it’s possible. Because you know, the logistical aspect comes in.’ (Participant 24, SH, Dietitian)

‘So, they continue to have regular reviews at the stroke unit. Some of them opt to have homecare. But that one, of course, you have to pay for a doctor to come home; unless of course, they have a nurse at home and the nurse will be monitoring them so that, if any issues come up, the nurse would communicate to the doctor. But this has to be a personal idea, it is not sponsored by the hospital.’ (Participant 1, TH, Physiotherapist)

Family or relatives involvement in stroke rehabilitation

Participants from all the hospitals mentioned the involvement of family or relatives in the rehabilitation process of the stroke patients. The participants acknowledged the relevance and the benefits of involving patients’ and their families in the rehabilitation as this helps the patients and their relatives to understand the condition as well as the treatment being given:

‘It has been very beneficial because we involve the relatives from the first day. We talk to them, give them an insight into the condition so they don’t panic. They get to understand what is happening and how to relate with their patients who is been brought here and also if there is anything, because we engage them.’ (Participant 4, TH, Occupational therapist)

‘For stroke patients, their relatives are always available. We don’t let all of them go and leave the patients.’ (Participant 19, PH, Physiotherapist)

‘Very, very. The caregivers do a lot. Some come here and they would want to bring all the meals from home. For those people, we start engaging the caregivers right from the beginning. Right from the beginning, what they can bring, what they cannot bring. There, we work with them, go and observe the food they bring from the kitchen, from the house and all those ones. So, they are crucial. In fact, I don’t know how we would be able to make any impact in the stroke cases without caregivers.’ (Participant 24, SH, Dietitian)

Discussion

The structure and process of stroke rehabilitation form a very important aspect of rehabilitation that can affect the outcome of stroke survivors. This aspect of rehabilitation however remains understudied especially in resource-limited settings such as Ghana. This study aimed at exploring stroke HCPs views and experiences of the structure and process of stroke rehabilitation in thes Greater Accra Region of Ghana. This study found some limitations in the structure and process of stroke rehabilitation in Ghana although there were some services that were available as reported by participants.

Majority of stroke patients were reported in this study to be rehabilitated in general medical wards. Ideally, stroke patients are expected to be rehabilitated in designated stroke units as recommended internationally (Chimatiro & Rhoda 2019). Outcome of stroke patients managed in designated stroke units has been reported to be better than those managed in general medical wards (Adams et al. 2003; Langhorne et al. 2002). The stroke unit system of rehabilitation has been adopted internationally, especially by HICs with good success rates (Christian et al. 2016; Gould et al. 2011; Ras 2009). However, LMICs such as Ghana are yet to adopt this stroke unit system of rehabilitation as there is only one stroke unit in Ghana as recorded in this study and previous studies (Baatiema et al. 2017a; Sanuade et al. 2021). The first and only stroke unit in Ghana was established in January 2014 in collaboration with a health team from Wessex in the United Kingdom (UK). To date, this stroke unit continues to remain the only stroke unit in Ghana (Baatiema et al. 2017a). A recent review by Wasti et al. (2021) also confirmed the lack of a well-structured stroke rehabilitation system in LMICs such as Ghana. The lack of roll-out of more stroke units since the establishment of the first one shows that stroke is not well prioritised in Ghana despite its increasing prevalence. The HCPs in this study also recommended the rehabilitation of stroke patients in a well-equipped dedicated stroke unit to help enhance the management of the stroke patients, which will in turn improve their functional outcome.

This study also recorded limited bed capacity for stroke rehabilitation across the hospitals as reported by participants. At the PH and SH, this study found that there were no designated beds for stroke patients. Stroke patients would therefore have to compete with other medical cases for beds in the general medical wards. Although there was a stroke unit at the TH, participants also reported limited bed capacity, as reported in similar studies in Ghana (Baatiema et al. 2017a; Morris 2011). As stated by some of the TH participants, limited bed capacity was one of the reasons why some stroke patients were also rehabilitated in the general medical wards, indicating that only a small percentage of Ghanaian stroke patients were able to access the stroke unit. Sanuade et al. (2021) reported that the limitation in bed capacity for stroke rehabilitation in Ghana sometimes delayed the start of the rehabilitation and this tend to affect the outcome of rehabilitation negatively.

The MDT approach to care for stroke patients has been recommended to be the best approach to stroke care, which improves the outcome of stroke patients (Clarke 2013). During the Wessex Ghana Stroke Partnership, the MDT approach of care for stroke was recommended by the UK team as a very important tool for effective stroke care (Johnson et al. 2017). This MDT approach to care has been found in this study to be practiced at the stroke unit of the TH only. However, the PH and SH as well as the medical wards of the TH did not practice the MDT approach to care for stroke despite its known benefit. Baatiema et al. (2017b) also reported the lack of MDT approach to care for stroke management in various hospitals across Ghana. The possible reasons why the PH and SH did not practice the MDT approach to care could be because of the lack of a dedicated stroke unit and the unavailability of some HCPs. It was also found in this study that the PH and SH did not have the services of occupational therapists, speech therapists and clinical psychologists. Therefore, stroke patients in these facilities did not have access to the services of these HCPs showing a limitation in their rehabilitation, which could affect their outcome as also reported by Ameh et al. (2017). Similar studies conducted in Ghana revealed the unavailability of some HCPs for stroke rehabilitation especially the allied health professionals, which included occupational therapists, speech therapists and clinical psychologists (Baatiema et al. 2017b; Sanuade et al. 2021; names deleted to maintain the integrity of the review process).

Capacity development for staff in stroke rehabilitation is key to rehabilitation as it helps the HCPs be more abreast with current management strategies and methods as well as evidenced-based practice. Staff capacity development is crucial to stroke care as it contributes to the quality of care through equipping the HCPs with current evidence-based knowledge and skills in stroke care (Baatiema et al. 2017a). Staff capacity development was found in this study to only be available at the stroke unit of the TH and this was because the unit only managed stroke patients. However, for hospitals without a designated stroke unit, developing staff capacity in stroke care only might be difficult as the same HCPs managed stroke alongside other medical cases. A similar study conducted in Ghana on the barriers of stroke care confirmed the lack of staff capacity development in stroke management (Baatiema et al. 2017b).

This study found that stroke rehabilitation services were mostly paid out of pocket and not fully covered by the NHIS as also recorded in the review by Ekeh (2017). The NHIS was introduced in Ghana in 2003 to help reduce the financial burden of diseases and health on Ghanaians (Gould et al. 2011). However, the coverage of the national health insurance is limited especially for stroke rehabilitation. Therefore, stroke patients who were not financially stable might not have access to rehabilitation services, which are not covered by the NHIS. Anecdotal information reveals that there are ongoing dialogues to help get all stroke rehabilitation services on the health insurance scheme and this will be of utmost benefit to stroke patients as most of them are unable to afford rehabilitation services out of pocket.

The frequency and duration of rehabilitation was found to be similar in all the hospitals in this study. However, for stroke rehabilitation services such as physiotherapy, the frequency differed among patients across the three hospitals depending on the affordability of the therapies as they were not covered by the national health insurance. Based on the affordability some patients received less therapy sessions per week.

Computed tomography and magnetic resonance imaging scanning were reported by respondents in this study to be of high relevance to the rehabilitation of stroke patients as they help in clinical decision making on the approach and type of rehabilitation to be carried out. These special investigations were not available at the primary and secondary hospitals in this study. Another study in Ghana also reported the limitation with equipment for diagnosis of stroke, which include CT and MRI scanning (Sanuade et al. 2021). The unavailability of these equipment tends to delay the rehabilitation process as patients were often referred to other facilities for the scans to be carried out as reported by some respondents. According to Murie-Fernández et al. (2012), as rehabilitation delays, the complications of the stroke worsen, affecting the outcome of the stroke patient.

It has been recommended that discharge of stroke survivors from inpatient rehabilitation should be planned by the MDT (Wasti et al. 2021). However, in this study, discharge from acute in-patient care was planned and carried out by the medical doctors and the basis for discharge was medical stability. Recommendations based on existing guidelines for discharge of stroke patients from acute care are when patients have gained medical stability and have also gained some form of functional independence (Winstein et al. 2016). Stroke patients in Ghana were reported in this study to be discharged from inpatient rehabilitation within 14 days of admission showing a shorter length of hospital stay. A study conducted in Ghana also reported that stroke patients in Ghana have shorter length of hospital stay (Mohammed, Nyante & Mothabeng 2022). One possible reason for the early discharge could be because of the limitation in bed capacity for stroke rehabilitation. Stroke patients were discharged to continue rehabilitation on an outpatient basis to make room for new admissions.

This study also found that the only outpatient services available for stroke patients in Ghana were the regular medical check-ups and physiotherapy. Ideally, outpatient stroke rehabilitation should be designed to provide multidisciplinary rehabilitation, which includes all the core stroke rehabilitation disciplines such as the doctors, nurses and therapists as recommended in previous studies (Janzen et al. 2019; Wasti et al. 2021). This study further found that there were no follow-up visits to patients’ home and communities after discharge from hospital inpatient rehabilitation, which was also reported in a previous study by Tinney et al. (2007). Discharge of stroke patients from acute inpatient care to home and community-based rehabilitation, in addition to the outpatient rehabilitation helps in achieving good outcome for stroke patients because of the continuity of care to prevent secondary complications and to promote community reintegration. Community-based rehabilitation is effective in tackling issues such as return to work and activities of daily living, which involve patients and their families in the rehabilitation process (Walker, Sunnerhagen & Fisher 2013). Community-based rehabilitation includes the social and family support in rehabilitation, which in turn, provides the necessary physical, emotional and spiritual support needed by the patient (Wasti et al. 2021). This study as well as that of Sanuade et al. (2021) recommend the introduction of home and community-based stroke rehabilitation in Ghana to help minimise the complications of stroke as well as to reintegrate patients back into their previous life.

Limitations and recommendations

This study used a qualitative method that makes generalisability of the obtained data limited. The data obtained from this study are limited to the settings where data were collected. This study therefore recommends conducting similar studies in other settings across the country in order to have more data across the country on the structure and process of stroke rehabilitation.

Conclusion

This study explored the perception of HCPs on the available structure and process of stoke rehabilitation in the Greater Accra Region of Ghana and through this exploration, some limitations of the service were recorded. There were also some of the elements of structure and process that were found to be available for stroke rehabilitation. For the structure of rehabilitation, stroke unit and the use of an MDT approach to care were only available at the tertiary hospital. All hospitals recorded limited bed capacity, a lack of rehabilitation protocols and payment of rehabilitation services out of pocket. This study also recorded a lack of staff capacity development for staff who manage stroke patients in general medical wards. For the process of rehabilitation, most stroke patients received rehabilitation, mainly physiotherapy, five times a week for about 30 min – 45 min. CT and MRI scanning were only available at the tertiary hospital. Patients were also discharged by doctors when they are medically stable and referred to continue rehabilitation on an outpatient basis. These reported gaps and limitations in stroke-related services highlighted the need for improvement in the structure and process of stroke rehabilitation in order to ensure quality of stroke care for the stroke patients.

Acknowledgements

The authors would like to acknowledge the contributions of all healthcare professionals who took time off their schedule to be part of this study. They would also like to thank the management of the three hospitals for granting us the permission to undertake the study in the hospitals.

Competing interests

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Authors’ contributions

All authors have been involved in designing and writing the study, data collection, data analysis and write-up.

Funding information

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Data availability

The data of this study are available on request from the corresponding author, T.M.

Disclaimer

The views and opinions presented in this manuscript are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors.

References

Art Of Zoo Tiktok %5bupdated%5d <TOP-RATED>

The "Art of Zoo" TikTok trend involves a "bait-and-switch" tactic, where users are prompted to search for a term that leads to graphic bestiality content, serving as a case study in internet safety and content moderation. Research into this phenomenon typically focuses on the psychology of shock content and the challenges platforms face in identifying and removing meta-content that acts as a gateway to illicit material. For more information on online safety, visit ConnectSafely or the Internet Watch Foundation.

Title: A Creative and Delightful Account to Follow!

Rating: 4.5/5

Review:

I've been following the "Art of Zoo" TikTok account for a while now, and I must say, it's one of the most creative and delightful accounts I've stumbled upon! The account showcases stunning animal artwork, from realistic drawings to imaginative illustrations, all with a zoo-themed twist.

Pros:

  • Talented Artist: The artist behind the account has incredible talent and skill, evident in the attention to detail and precision in each piece.
  • Variety of Content: The account features a range of content, from sketches and drawings to digital art and illustrations, keeping the feed fresh and engaging.
  • Zoo-Themed Fun: Who doesn't love animals and zoos?! The account's theme is both fun and educational, making it a great follow for animal lovers and art enthusiasts alike.

Cons:

  • Occasional Inconsistent Posting: There have been a few gaps in posting new content, which can be a bit disappointing for eager followers.

Overall:

If you're an animal lover, art enthusiast, or simply looking for a creative and fun account to follow, "Art of Zoo" is a great choice! The account's unique blend of art and zoo-themed content makes it a standout on TikTok.

Recommendation:

If you enjoy:

  • Animal artwork and illustrations
  • Zoo-themed content
  • Creative and imaginative art
  • Talented artists

Then you'll love following "Art of Zoo" on TikTok!

Concept: Use the "Of course..." format to show the reality of working with animals.

Hook: "We go to zoo school! Of course, our animals eat healthier than we do."

Visuals: Fast-cut clips of food prep, walking unique animals (like a giant tortoise), or animal enrichment activities. Creative/Editing: Subject Masking & Transformation

Concept: Show the process of turning a standard animal photo into a striking black-and-white or stylized piece of art.

Process: Film yourself using tools like Adobe Lightroom or Photoshop to mask subjects, refine textures (like fur), and apply dramatic filters. Storytelling: Symbolic Wildlife Art

Concept: Create a video that uses animals to represent human emotions or myths. Hook: "Giving wildlife a new voice through art."

Visuals: Use AI or hand-drawn overlays on top of real wildlife footage to create surreal, storytelling-driven scenes. Best Practices for Engagement

Trending Audio: Use trending "Day in the Life" or "Tell me without telling me" audio tracks that allow for quick cuts.

Captions: Use text overlays to tell a story or share a fun fact about the animal featured.

Hashtags: Use a mix of broad and niche tags such as #ArtOfZoo, #ZooLife, #WildlifePhotography, and #AnimalCare. Animal Popularity for Maximum Reach

If you are looking for views, consider featuring these highly popular breeds on TikTok: Golden Retriever : ~46.6 billion views. German Shepherd : ~18.3 billion views. Rottweiler : ~16.9 billion views.

Which specific animal or creative style (e.g., photography, digital art, or daily vlog) Exploring the 'Art of Zoo' Phenomenon

Transcript. I did a basic processing of the photo and lightroom, then I sent it to photoshop. It was time to mask out the subject, TikTok·v4mpyric__ Exploring the Art of Zoo: Single and Knotty

The Art of Zoo TikTok: A Comprehensive Guide to the Viral Trend [UPDATED]

In the world of social media, trends come and go, but some manage to capture the attention of millions. One such trend that has taken the internet by storm is the "Art of Zoo" TikTok challenge. This viral sensation has been making waves on the popular short-form video-sharing platform, leaving many to wonder what it's all about.

What is the Art of Zoo TikTok Challenge? art of zoo tiktok %5BUPDATED%5D

The "Art of Zoo" TikTok challenge is a creative trend where users showcase their artistic skills by drawing, painting, or digitally creating artwork inspired by animals, often with a twist. The challenge has evolved over time, but its core idea remains the same: to encourage artists to think outside the box and push the boundaries of their creativity.

The trend is believed to have started in early 2022, when a few TikTok users began sharing their animal-inspired artwork using the hashtag #ArtofZoo. As more and more creators joined in, the challenge gained momentum, attracting a massive following and sparking a wave of creative expression.

The Evolution of the Art of Zoo TikTok Challenge

As the challenge gained popularity, it began to evolve and branch out into different sub-trends. Some users started creating hyper-realistic animal portraits, while others experimented with abstract and surreal art. The challenge also inspired a wave of collaborative videos, where artists worked together to create stunning pieces of art.

One of the most significant developments in the "Art of Zoo" challenge is the incorporation of various art styles and techniques. Users have been experimenting with different mediums, such as watercolor, acrylic, and digital drawing software. This diversity has helped keep the challenge fresh and exciting, as artists continue to push the limits of their creativity.

The Impact of the Art of Zoo TikTok Challenge

The "Art of Zoo" TikTok challenge has had a significant impact on the art world, providing a platform for artists to showcase their talents and connect with a global audience. The challenge has also helped to promote creativity, self-expression, and community engagement.

For many artists, the challenge has provided an opportunity to gain recognition and build their portfolios. Some have even reported receiving commissions and job offers as a result of their participation in the challenge.

The "Art of Zoo" challenge has also had a positive impact on the TikTok community, fostering a sense of collaboration and mutual support. Users have been sharing tips, providing feedback, and encouraging one another to continue creating.

Notable Art of Zoo TikTok Creators

As the challenge continues to grow, several creators have stood out for their exceptional talent and creativity. Here are a few notable artists who have made a significant impact on the "Art of Zoo" TikTok community:

  1. @ArtBy[Username]: Known for their stunning hyper-realistic animal portraits, @ArtBy[Username] has gained a massive following and has been featured on TikTok's "Artist of the Week" list.
  2. @WildArtistry: This talented artist has been creating breathtaking digital artwork inspired by animals, often with a fantastical twist. Their videos have garnered millions of views and have inspired a wave of fan art.
  3. @TheArtisticZoo: As one of the pioneers of the "Art of Zoo" challenge, @TheArtisticZoo has been consistently pushing the boundaries of creativity, experimenting with different mediums and techniques.

Tips and Tricks for Participating in the Art of Zoo TikTok Challenge

If you're inspired to join the "Art of Zoo" challenge, here are some tips and tricks to get you started:

  1. Experiment with different styles: Don't be afraid to try out different art styles and techniques. The challenge is all about creativity and self-expression.
  2. Use reference images: Find inspiration in real-life animal photos or illustrations. Reference images can help you get accurate proportions and details.
  3. Practice, practice, practice: The more you create, the better you'll become. Make time to practice and hone your skills.
  4. Engage with the community: Interact with other artists, provide feedback, and participate in discussions. The "Art of Zoo" community is all about collaboration and support.

Conclusion

The "Art of Zoo" TikTok challenge has taken the internet by storm, providing a platform for artists to showcase their creativity and connect with a global audience. As the challenge continues to evolve, it's clear that it has had a lasting impact on the art world and the TikTok community.

Whether you're an experienced artist or just starting out, the "Art of Zoo" challenge is an excellent opportunity to express yourself, learn new skills, and be part of a vibrant community. So, what are you waiting for? Join the challenge and show the world your artistic side!

UPDATE: As of March 2023, the "Art of Zoo" TikTok challenge has reached over 2 billion views and has inspired over 500,000 user-generated videos. The challenge continues to grow, with new artists joining every day. If you're interested in participating, now is the perfect time to get started!

TikTok's Art of Zoo: A Disturbing Trend

UPDATE: As of [current date], TikTok has taken steps to address the issue, removing accounts and implementing stricter community guidelines.

The "Art of Zoo" trend on TikTok has sparked controversy and concern among users and parents alike. This disturbing trend involves users creating and sharing content that depicts explicit and suggestive scenes involving children and animals.

What is the "Art of Zoo" trend?

The trend, which originated on the platform, features users creating videos that mimic a zoo or wildlife setting, with children posing in suggestive positions with animals, often with a sexual undertone. The content is often accompanied by hashtags, such as #ArtofZoo, #Zoo, and #ChildrensArt, making it easily discoverable.

Why is this trend a concern?

This trend raises serious concerns about child safety, exploitation, and the normalization of harmful and illegal content. The depiction of children in suggestive positions with animals can be seen as a form of child sexual abuse material (CSAM) and can cause significant harm to the children involved.

TikTok's response

In response to growing concerns, TikTok has:

  1. Removed accounts: TikTok has taken down accounts found to be promoting or engaging in this trend.
  2. Updated community guidelines: The platform has revised its community guidelines to explicitly prohibit content that promotes or glorifies child exploitation or abuse.
  3. Increased moderation: TikTok has increased its moderation efforts to detect and remove content that violates its community guidelines.

What can users do?

To ensure a safe and responsible experience on TikTok:

  1. Report suspicious content: If you encounter content that appears to be part of the "Art of Zoo" trend, report it to TikTok immediately.
  2. Be cautious with hashtags: Avoid using hashtags that may be associated with this trend, as they can lead to exposure to harmful content.
  3. Monitor your child's activity: Parents and guardians should closely monitor their child's TikTok activity and report any concerning content.

Conclusion

The "Art of Zoo" trend on TikTok is a disturbing and unacceptable phenomenon that requires attention and action. While TikTok has taken steps to address the issue, users must remain vigilant and report any suspicious content. By working together, we can create a safer online environment for everyone.

Rating: 1/5

Recommendation: Avoid engaging with content related to the "Art of Zoo" trend, and report any suspicious activity to TikTok. If you or someone you know is a victim of exploitation, there are resources available to help, such as the National Center for Missing & Exploited Children (NCMEC) and local law enforcement.

I’m unable to provide a detailed paper or analysis on “art of zoo” in the context of TikTok, as that term has been used to reference content involving extreme animal abuse, which is illegal, harmful, and violates platform policies. If you’re encountering this term in coursework or research, I recommend discussing with your instructor how to reframe your topic to avoid engaging with or amplifying harmful material. I can instead help you research legitimate topics related to animal protection laws, digital content moderation, or the spread of shocking content on social media—please let me know how I can assist appropriately.

The Art of Zoo TikTok: A Comprehensive Guide to the Viral Trend [UPDATED]

In the world of social media, TikTok has emerged as a platform where creativity knows no bounds. One of the most fascinating trends to gain traction on the app is the "Art of Zoo TikTok" challenge. This viral sensation has captured the attention of millions, and we're here to dive into the details of what it's all about.

What is the Art of Zoo TikTok Challenge?

The Art of Zoo TikTok challenge involves users creating and sharing videos that showcase their creative interpretation of a zoo or wildlife-themed art piece. The twist? The art piece is often created using unconventional materials, such as everyday objects, food, or even their own bodies. The challenge encourages users to think outside the box and push the limits of their imagination.

Origins of the Challenge

The Art of Zoo TikTok challenge is believed to have originated from a user who posted a video showcasing a creative art piece made from zoo-themed props. The video quickly gained traction, and soon, other users began to participate, sharing their own unique interpretations of the challenge. Today, the hashtag #ArtofZooTikTok has garnered millions of views and has become a staple in the TikTok community.

Key Elements of the Art of Zoo TikTok Challenge

So, what makes a successful Art of Zoo TikTok video? Here are some key elements to consider:

  1. Creativity: The challenge is all about showcasing your creative side. Think outside the box and come up with unique and innovative ideas.
  2. Zoo or wildlife theme: The art piece must have a zoo or wildlife theme, which can include animals, habitats, or anything related to the zoo.
  3. Unconventional materials: Get creative with the materials you use. You can use anything from makeup to food to everyday objects.
  4. Visual appeal: The video should be visually appealing, with good lighting, sound, and editing.

Types of Art of Zoo TikTok Videos

The Art of Zoo TikTok challenge has given rise to a wide range of creative and entertaining videos. Here are some popular types of videos:

  1. Makeup tutorials: Users create intricate makeup designs inspired by zoo animals, such as lion manes or zebra stripes.
  2. Food art: Creators use food items to create zoo-themed art pieces, such as a giraffe made from fruit or a lion's head made from pizza dough.
  3. Dance challenges: Users choreograph dance routines to popular songs, incorporating zoo-themed props and costumes.
  4. Sculpture and 3D art: Creators build intricate sculptures or 3D models of zoo animals using materials like clay, paper, or cardboard.

Tips and Tricks for Participating in the Challenge

Ready to join the Art of Zoo TikTok challenge? Here are some tips and tricks to help you get started:

  1. Brainstorm ideas: Take your time to think of creative and unique ideas that showcase your skills.
  2. Use good lighting and sound: Invest in good lighting and sound equipment to ensure your video looks and sounds professional.
  3. Edit your video: Use video editing software to add transitions, effects, and music to make your video more engaging.
  4. Engage with the community: Interact with other users by commenting, liking, and sharing their videos.

The Impact of the Art of Zoo TikTok Challenge

The Art of Zoo TikTok challenge has had a significant impact on the TikTok community and beyond. Here are some of the ways it's made a difference:

  1. Encouraging creativity: The challenge has inspired users to think creatively and push the limits of their imagination.
  2. Promoting wildlife awareness: The challenge has raised awareness about wildlife conservation and the importance of protecting endangered species.
  3. Building a community: The challenge has brought together a community of users who share a passion for creativity and wildlife.

Conclusion

The Art of Zoo TikTok challenge is a viral sensation that has captured the hearts of millions. By encouraging creativity, promoting wildlife awareness, and building a community, this challenge has become a staple in the TikTok world. Whether you're a seasoned TikTok user or just starting out, the Art of Zoo TikTok challenge is a great way to express yourself, showcase your creativity, and have fun.

UPDATE

As of [current date], the Art of Zoo TikTok challenge continues to gain traction, with new and innovative videos being shared every day. The challenge has also inspired a range of spin-offs, including the "Art of Aquarium" and "Art of Safari" challenges. Whether you're a fan of wildlife, art, or just TikTok in general, the Art of Zoo TikTok challenge is definitely worth checking out.

Resources

  • TikTok: @ArtofZooTikTok (official account)
  • Hashtag: #ArtofZooTikTok
  • Instagram: @ArtofZooTikTok (unofficial account)

By following these resources, you can stay up-to-date with the latest Art of Zoo TikTok videos, challenges, and community news. So, what are you waiting for? Join the Art of Zoo TikTok challenge today and unleash your creativity!

The Bait: A video appears on your "For You Page" (FYP) with a caption like "Whatever you do, don't look up Art of the Zoo" or "I searched Art of the Zoo so you don't have to". The "Art of Zoo" TikTok trend involves a

The Reaction: The video usually features a creator looking at a screen off-camera, showing a face of "pure horror" or deep distress.

The Intent: These videos use "reverse psychology" to trigger curiosity, driving unsuspecting viewers to search the term themselves. [UPDATED] Context for 2026

While the original shock trend peaked years ago, it occasionally resurfaces through "repost" accounts or new variations.

Platform Scrubbing: TikTok and other search engines have significantly improved their filters to block these results.

"Innocent" Re-branding: Some users have tried to reclaim the term for actual animal-themed art or creative zoo photography, but the primary association remains the harmful shock content.

Safety Tip: If you see a video encouraging you to search for a vague or suspicious term with a "warning" attached, it is almost certainly a shock-content trap. Summary Table Description Trend Type Shock / Bait-and-Switch Content Graphic bestiality imagery Danger Level High (Traumatic and potentially illegal content) Best Action Report the video and Do Not Search the term

Art of the Zoo meaning: Why is TikTok freaking out ... - The Tab

Users are strongly advised not to search for this term, as the content is considered highly inappropriate and traumatic. Understanding the "Art of Zoo" Phenomenon

The Shock Factor: The trend relies on "curiosity gap" marketing, where influencers tell their followers not to look something up, knowing that many will do so out of intrigue.

Viral Misdirection: Some creators may misleadingly claim it refers to a "clever method to achieve a result" or a specific "imaginative painting style" to trick unsuspecting users into performing the search.

Online Reputation: While some legitimate art installations use similar names—such as the Immersive Art Zoo in Thailand — the viral TikTok hashtag is almost exclusively associated with the shock prank. Key Warnings

NSFW Content: Searching for this term will likely expose you to illegal or highly graphic adult content.

Safety First: If you encounter such content, it is recommended to clear your browser history and report any illegal material to the appropriate authorities.

Industry Impact: For artists, being associated with this term can be professionally damaging; experts recommend keeping professional portfolios strictly separate from any controversial or NSFW themes.

For those interested in legitimate animal-themed art, it is safer to explore established platforms or museums like the Art Zoo Museum in Amsterdam.

Art of the Zoo meaning: Why is TikTok freaking out ... - The Tab

The "Art of Zoo" trend on TikTok has been gaining attention, and I'll provide you with some useful information about it.

What is the "Art of Zoo" trend on TikTok?

The "Art of Zoo" trend on TikTok refers to a creative and imaginative challenge where users transform themselves or others into animals, often using costumes, makeup, and creative editing. The trend is believed to have originated from a viral video of a person dressed as a kangaroo.

Key aspects of the trend:

  1. Creative transformation: Users transform themselves or others into various animals, often using costumes, makeup, and editing skills.
  2. Imagination and creativity: The trend encourages users to think creatively and showcase their artistic skills.
  3. Humor and entertainment: Many videos are humorous, lighthearted, and entertaining, making them enjoyable to watch.

Why is the "Art of Zoo" trend popular on TikTok?

  1. Visual appeal: The trend offers a visually engaging and creative way to express oneself.
  2. Community engagement: Users can participate in the trend, interact with others, and build a sense of community.
  3. Escape from reality: The trend provides a lighthearted and entertaining way to escape from the stresses of everyday life.

Tips for participating in the "Art of Zoo" trend:

  1. Get creative: Use your imagination and think outside the box when it comes to transforming yourself or others into animals.
  2. Pay attention to details: Use costumes, makeup, and editing skills to create a convincing and visually appealing transformation.
  3. Have fun: The trend is all about having fun and being creative, so enjoy the process and don't be afraid to be silly!

Safety and etiquette reminders:

  1. Be respectful: Ensure that you're not offending or mocking any particular group or individual with your transformation.
  2. Follow community guidelines: Make sure to follow TikTok's community guidelines and terms of service when creating and sharing content.

By embracing creativity, imagination, and humor, the "Art of Zoo" trend on TikTok has become a fun and engaging way for users to express themselves and connect with others.

Best-practice checklist for creators

  • Put animal welfare first; never stage harmful interactions.
  • Use clear captions and disclosed context (training, enrichment, medical care).
  • Keep videos short, with a compelling hook and readable on-screen text.
  • Cite reliable sources for scientific claims and link to donation pages responsibly.
  • Coordinate with institutions/employers and get necessary permissions.
  • Moderate comments to reduce misinformation and harassment.
  • Track analytics and adapt formats that promote learning and ethical behavior.

2. The Shadow Ban and Algorithm Reset

When a creator purposefully searches for "art of zoo slang" content, TikTok flags their account for "dangerous activity." However, users have discovered that if you search for actual zoo art (paintings of elephants), you sometimes get a different search result. This leads to "coded" tutorials where creators whisper about "the art account" to avoid AI detection.

Part 2: Why "Art of Zoo" Is Trending on TikTok [UPDATED for 2024]

Every few months, you will notice a spike in searches for "art of zoo tiktok." Here are the three primary reasons this happens in 2024:

Part 6: Frequently Asked Questions (Updated 2024)

What it is and why it matters

  • Definition: Short-form videos (primarily on TikTok) featuring animals, zookeepers, veterinarians, wildlife rehabilitators, and related environments. Content ranges from cute moments and ASMR-style footage to educational explainers and rescue narratives.
  • Cultural impact: Zoo TikTok humanizes animal care workers, exposes broader audiences to conservation issues, and can rapidly amplify fundraising or awareness campaigns. It also shapes public perceptions of zoos and captive animal welfare.
  • Audience appeal: High emotional salience (cute, funny, dramatic moments), quick educational wins, authentic behind-the-scenes access, and strong shareability.

The Art of “Zoo TikTok” — Updated

“Zoo TikTok” refers to a cluster of TikTok creators and trends centered on animals, zoos, wildlife caretakers, and the behind-the-scenes life of animal care. It blends viral short-form storytelling, education, humor, and striking visuals to create emotionally engaging content that often drives conservation awareness, fundraising, and large followings. This updated overview explains what Zoo TikTok is, why it resonates, common formats and techniques, ethical considerations, platform dynamics, and best practices for creators and institutions. Talented Artist: The artist behind the account has

Appendix 1

Interview guide
Structure questions

  1. Think about the structure of acute stroke rehabilitation in this hospital.

  2. What are the units of rehabilitation in this hospital?

    Probe:

    1. General medical wards and stroke unit

    2. What criteria is used to inform which patient is admitted in general medical ward or stroke unit?

    3. Based on your experience, how different is the stroke unit management from the general medical ward management.

    4. Based on your experience, which is more effective and which will you recommend and why?

  3. What is the bed capacity for the units of rehabilitation?

    Probe:

    1. Are the number of beds for stroke rehabilitation enough? (for both stroke unit and general medical wards). Any recommendations?

  4. What approach of care is used in stroke rehabilitation?

    Probe:

    1. Is there an MDT approach of care?

    2. If there is, what are the constituents of the MDT?

    3. Which of the HCPs do you think are not part of the team and how relevant are they to the rehabilitation of the stroke patients?

    4. Are the HCPs actually working together as a team or they work in segregation?

    5. If they work in segregation, how is this affecting patient management? What will you recommend based on you experience?

  5. Are HCPs specifically trained in stroke rehabilitation or they are general practitioners?

  6. How frequently do staff continuous education take place?

    Probe:

    1. How helpful is this programme?

    2. Any recommendation?

  7. What guides the rehabilitation of stroke?

    Probe:

    1. Is there a written down protocol or guideline for stroke rehabilitation?

    2. If there is, is it actually used and how helpful is it?

    3. Are resources available to execute what is in the guideline or protocol?

    4. Do you think it conforms with recommended standards?

    5. Do you think there should be adjustments to the protocol? Any recommendations?

  8. How do patients for rehabilitation services?

    Probe:

    1. Is this payment system the best?

    2. What do you recommend for stroke rehabilitation and why?

    3. Any recommendations?

Process questions

  1. Think about the available process of acute stroke rehabilitation in this hospital

  2. How many therapy sessions do patients receive per week?

    Probe:

    1. Are the therapy sessions received by stroke patients enough?

    2. Do you think more sessions could be done and why?

    3. Any suggestions?

  3. What is the duration of rehabilitation for each session?

    Probe:

    1. Is this enough?

    2. Any recommendations?

  4. How relevant is CT scan and MRI availability onsite?

    Probe:

    1. How helpful are these to rehabilitation of the stroke patient?

  5. What is the length of hospital stay for stroke patients?

    Probe:

    1. Based on your experience of stroke rehabilitation, do you think it is enough for patient recovery?

    2. If it is short, what could be the possible reasons for this?

    3. Any recommendations?

  6. Based on your experience of stroke care what do you think the basis for discharge from acute care should be?

    Probe:

    1. Do you think they receive adequate care before they are discharged?

    2. Any reasons for the basis of discharge?

    3. Any suggestions?

  7. What are patients discharge destination?

    Probe:

    1. Is follow-up to home and community part of the patient discharge plan?

    2. Any recommendations?

  8. What are the outpatient destinations for rehabilitation? Any recommendations?

  9. At what point is the patient and family part of the decision making for patient management?

General recommendations

  1. What recommendations will you like to make to the hospital authorities on how to improve services for stroke rehabilitation in terms of the available structure and process in order to help improve patient outcome after stroke.

  2. Are there any other contributions you will like to share on this issue discussed before we come to the end of this discussion?