Mixed-Method

Background: In Nigeria, stroke is a major cause of death and disability, and recovery are greatly impacted by health-seeking behaviour (HSB). According to the biopsychosocial (BPS) model, these behaviours are shaped by a combination of biological, psychological, and social factors; however, little is known about how these factors interact among stroke survivors in Edo State, Nigeria. Purpose: This study aimed to use a mixed-methods design to examine the Biopsychosocial determinants of Health Seeking Behaviour among stroke survivors in Edo State. Methods: For the quantitative arm, a convergent parallel mixed-methods approach was used to recruit 55 stroke survivors through multistage sampling. Structured questionnaires (NIHSS, MAS, Berg Balance Scale, HADS, MSPSS) were used to evaluate Biopsychosocial factors and Health Seeking Behaviour. From this group, ten individuals were specifically chosen to participate in in- depth qualitative interviews. While qualitative data was subjected to thematic analysis, quantitative data was subjected to descriptive and inferential statistics (chi-square tests) using SPSS version 27.0. Results: No statistically significant correlations (p > 0.05) were found between Health Seeking Behaviour and any of the Biopsychosocial variables (such as social support, anxiety, comorbidities, and stroke severity). However, a qualitative analysis revealed five major themes that impact HSB: coping strategies, emotional reactions, family, community, and spiritual influences, clinical features and perceived cause, and health-system barriers. Notably, family support, financial limitations, and cultural beliefs played a significant role in the pathways and decisions surrounding care-seeking. Conclusion: Although there was no statistically significant correlation between HSB and standard BPS measures in this sample, qualitative findings highlight the significant impact of systemic, social, and cultural factors. The results emphasize the need for stroke rehabilitation services in Edo State that are accessible, family-inclusive, and culturally sensitive.