Cent Eur J Nurs Midw 2024, 15(4):2069-2081 | DOI: 10.15452/cejnm.2024.15.0026

Supporting self-management in adults after stroke – synthesis of qualitative studies

Romana Beèváĝová1, Elena Gurková2
1 Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Czech Republic
2 Department of Nursing, Faculty of Health Care, University of Presov, Slovakia

Aim: The aim of the review was to identify, analyse and synthesise the results of qualitative studies focusing on patients’ experiences of self-management after stroke. The research question according to the Participants, Phenomenon of Interest, Context format was as follows: What are patients’ experiences of self-management after stroke? Design: A literature review aimed at synthesising the findings of qualitative studies was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.

Methods: Qualitative studies were searched in the EBSCO, PubMed and Web of Science databases in November 2023. Searching and sorting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme. According to these criteria, 1072 studies were retrieved. Eight studies were included in the review.

Results: The analysis of the eight qualitative studies revealed four themes: understanding the meaning of self-management; individual capacity and readiness; needs; and resources and supports in this area. The fourth theme includes five subthemes: family, healthcare professionals, peers, environment, and technology.

Conclusion:  Findings can inform routine practice to develop self-management support after stroke. Self-management support can enable stroke survivors and their families to take control of their long-term condition, from diagnosis to living with the disease.

Keywords: lived experience, patient experience, qualitative, self-management, stroke

Received: August 7, 2024; Revised: November 27, 2024; Accepted: November 27, 2024; Published: December 9, 2024  Show citation

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Beèváĝová R, Gurková E. Supporting self-management in adults after stroke – synthesis of qualitative studies. Central European Journal of Nursing and Midwifery. 2024;15(4):2069-2081. doi: 10.15452/cejnm.2024.15.0026.
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    References

    1. Audulv, Å., Hutchinson, S., Warner, G., Kephart, G., Versnel, J., & Packer T. L. (2021). Managing everyday life: self-management strategies people use to live well with neurological conditions. Patient Education and Counseling, 104(2), 413-421. https://doi.org/10.1016/j.pec.2020.07.025 Go to original source... Go to PubMed...
    2. Aziz, N. A., Pindus, D. M., Mullis, R., Walter, F. M., & Mant, J. (2016). Understanding stroke survivors' and informal carers' experiences of and need for primary care and community health services - a systematic review of the qualitative literature: protocol. BMJ Open, 6(1), e009244. https://doi.org/10.1136/bmjopen-2015-009244 Go to original source... Go to PubMed...
    3. Bally, E. L. S., Cheng, D., van Grieken, A., Sanz, M. F., Zanutto, O., Carroll, A., Darley, A, Roozenbeek, B., Dippel, D. W. J., & Raat, H. (2023). Patients' perspectives regarding digital health technology to support self-management and improve integrated stroke care: qualitative interview study. Journal of Medical Internet Research, 25, e42556. https://doi.org/10.2196/42556 Go to original source... Go to PubMed...
    4. Boger, E., Ellis, J., Latter, S., Foster, C., Kennedy, A., Jones, F., Fenerty, V., Kellar, I., & Demain S. (2015a). Self-management and self-management support outcomes: a systematic review and mixed research synthesis of stakeholder views. PLoS ONE, 10(7), e0130990. https://doi.org/10.1371/journal.pone.0130990 Go to original source... Go to PubMed...
    5. Boger, E. J., Demain, S. H., & Latter, S. M. (2015b). Stroke self-management: a focus group study to identify the factors influencing self-management following stroke. International Journal of Nursing Studies, 52(1), 175-187. https://doi.org/10.1016/j.ijnurstu.2014.05.006 Go to original source... Go to PubMed...
    6. CASP qualitative checklist. Critical Appraisal Skills Programme. (2018). https://casp-uk.net/casp-tools-checklists/
    7. Clark, E., Bennett K., Ward N., & Jones, F. (2018). One size does not fit all - stroke survivor's views on group self-management interventions. Disability and Rehabilitation, 40(5), 569-576. https://doi.org/10.1080/09638288.2016.1268653 Go to original source... Go to PubMed...
    8. Duncan Millar, J., Mason, H., & Kidd, L. (2023). What is important in supporting self-management in community stroke rehabilitation? A Q methodology study. Disability and Rehabilitation, 45(14), 2307-2315. https://doi.org/10.1080/09638288.2022.2087766 Go to original source... Go to PubMed...
    9. Fryer, C. E., Luker, J. A., McDonnell, M. N., & Hillier S. L. (2016). Self-management programmes for quality of life in people with stroke. The Cochrane Database of Systematic Reviews, 8, CD010442. https://doi.org/10.1002/14651858.CD010442.pub2 Go to original source... Go to PubMed...
    10. Fugazzaro, S., Denti, M., Accogli, M. A., Costi, S., Pagliacci, D., Calugi, S., Cavalli, E., Taricco, M., Bardelli, R., & On behalf of Look after Yourself Project. (2021). Self-management in stroke survivors: development and implementation of the Look after Yourself (LAY) intervention. International Journal of Environmental Research and Public Health, 18(11), 5925. https://doi.org/10.3390/ijerph18115925 Go to original source... Go to PubMed...
    11. Guo, Y., Zhang, Z., Lin, B., Mei, Y., Liu, Q., Zhang, L., Wang, W., Li, Y., & Fu, Z. (2021). The unmet needs of community-dwelling stroke survivors: a systematic review of qualitative studies. International Journal of Environmental Research and Public Health, 18(4), 2140. https://doi.org/10.3390/ijerph18042140 Go to original source... Go to PubMed...
    12. Holloway, A., Chandler, C., Reinso, L. A., Clarissa, C., Putri, A., Choi, H., Pan, F., Mitra, U., Hewitt, J., Cluckie, G., Smart, A., Noble, H., Harris, R., Reid, J., & Kelly, D. M. (2022). Young Adults Rehabilitation Needs and Experiences following Stroke (YARNS): a review of digital accounts to inform the development of age-appropriate support and rehabilitation. Journal of Advanced Nursing, 78(3), 869-882. https://doi.org/10.1111/jan.15076 Go to original source... Go to PubMed...
    13. Jaglal, S. B., Haroun, V. A., Salbach, N. M., Hawker, G., Voth, J., Lou, W., Kontos, P., Cameron, J. E., Cockerill, R., & Bereket, T. (2013). Increasing access to chronic disease self-management programs in rural and remote communities using telehealth. Telemedicine and e-Health, 19(6), 467-473. Go to original source... Go to PubMed...
    14. Jones, F., & Riazi, A. (2011). Self-efficacy and self-management after stroke: a systematic review. Disability and Rehabilitation, 33(10), 797-810. https://doi.org/10.3109/09638288.2010.511415 Go to original source... Go to PubMed...
    15. Jones, F., Pöstges, H., & Brimicombe, L. (2016). Building bridges between healthcare professionals, patients and families: a coproduced and integrated approach to self-management support in stroke. NeuroRehabilitation, 39(4), 471-480. https://doi.org/10.3233/NRE-161379 Go to original source... Go to PubMed...
    16. Klockar, E., Kylén M., Gustavsson, C., Finch, T., Jones, F., & Elf, M. (2023). Self-management from the perspective of people with stroke - an interview study. Patient Education and Counseling, 112, 107740. https://doi.org/10.1016/j.pec.2023.107740 Go to original source... Go to PubMed...
    17. Martinsen, R., Kirkevold, M., & Sveen, U. (2015). Young and midlife stroke survivors' experiences with the health services and long-term follow-up needs. Journal of Neuroscience Nursing, 47(1), 27-35. https://doi.org/10.1097/JNN.0000000000000107 Go to original source... Go to PubMed...
    18. Norrving, B., Barrick, J., Davalos, A., Dichgans, M., Cordonnier, C., Guekht, A., Kutluk, K., Mikulik, R., Wardlaw, J., Richard, E., Nabavi, D., Molina, C., Bath, P. M., Stibrant Sunnerhagen, K., Rudd, A., Drummond, A., Planas, A., & Caso, V. (2018). Action plan for stroke in Europe 2018-2030. European Stroke Journal, 3(4), 309-336. https://doi.org/10.1177/2396987318808719 Go to original source... Go to PubMed...
    19. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLoS Medicine, 18(3), e1003583. https://doi.org/10.1371/journal.pmed.1003583 Go to original source... Go to PubMed...
    20. Parke, H. L., Epiphaniou, E., Pearce, G., Taylor, S. J. C., Sheikh, A., Griffiths, C. J., Greenhalgh, T., & Pinnock H. (2015). Self-management support interventions for stroke survivors: a systematic meta-review. PLoS ONE, 10(7), e0131448. https://doi.org/10.1371/journal.pone.0131448 Go to original source... Go to PubMed...
    21. Pearce, G., Pinnock, H., Epiphaniou, E., Parke, H. L., Heavey, E., Griffiths, C. J., Greenhalgh, T., Sheikh, A., & C. Taylor, S. J. (2015). Experiences of self-management support following a stroke: a meta-review of qualitative systematic reviews. PLoS ONE, 10(12), e0141803. https://doi.org/10.1371/journal.pone.0141803 Go to original source... Go to PubMed...
    22. Pereira, C. M., Greenwood, N., & Jones, F. (2021). From recovery to regaining control of life - the perspectives of people with stroke, their carers and health professionals. Disability and Rehabilitation, 43(20), 2897-2908. https://doi.org/10.1080/09638288.2020.1722263 Go to original source... Go to PubMed...
    23. Richard, A. A., & Shea K. (2011). Delineation of self-care and associated concepts. Journal of Nursing Scholarship, 43(3), 255-264. https://doi.org/10.1111/j.15475069.2011.01404.x Go to original source... Go to PubMed...
    24. Ruksakulpiwat, S., & Zhou, W. (2021). Self-management interventions for adults with stroke: a scoping review. Chronic Diseases and Translational Medicine, 7(3), 139-148. https://doi.org/10.1016/j.cdtm.2021.03.001 Go to original source... Go to PubMed...
    25. Sadler, E., Wolfe, C. D., & McKevitt, C. (2014). Lay and health care professional understandings of self-management: a systematic review and narrative synthesis. SAGE Open Medicine, 2, 2050312114544493. https://doi.org/10.1177/2050312114544493 Go to original source... Go to PubMed...
    26. Sadler, E., Wolfe, C. D. A., Jones F., & McKevitt, C. (2017). Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK. BMJ Open, 7(3), e011631. https://doi.org/10.1136/bmjopen-2016-011631 Go to original source... Go to PubMed...
    27. Sahely, A., Giles, D., Sintler, C., Soundy, A., & Rosewilliam, S. (2023). Self-management interventions to improve mobility after stroke: an integrative review. Disability and Rehabilitation, 45(1), 9-26. https://doi.org/10.1080/09638288.2022.2028019 Go to original source... Go to PubMed...
    28. Satink, T., Cup, E. H., Ilott, I., Prins, J., de Swart, B. J., & van Nijhuis der Sanden, M. W. (2013). Patients' views on the impact of stroke on their roles and self: a thematic synthesis of qualitative studies. Archives of Physical Medicine and Rehabilitation, 94(6), 1171-1183. https://doi.org/10.1016/j.apmr.2013.01.011 Go to original source... Go to PubMed...
    29. Satink, T., Cup E. H., de Swart, B. J., & van Nijhuis der Sanden, M. W. (2015). How is self-management perceived by community living people after a stroke? A focus group study. Disability and Rehabilitation, 37(3), 223-230. https://doi.org/10.3109/09638288.2014.918187 Go to original source... Go to PubMed...
    30. Schulman-Green, D., Jaser, S., Martin, F., Alonzo, A., Grey, M., McCorkle, R., Redeker, N. S., Reynolds, N., & Whittemore, R. (2012). Processes of self-management in chronic illness. Journal of Nursing Scholarship, 44(2), 136-144. https://doi.org/10.1111/j.1547-5069.2012.01444.x Go to original source... Go to PubMed...
    31. Taule, T., Strand, L. I., Skouen, J. S., & Råheim, M. (2015). Striving for a life worth living: stroke survivors' experiences of home rehabilitation. Scandinavian Journal of Caring Sciences, 29(4), 651-661. https://doi.org/10.1111/scs.12193 Go to original source... Go to PubMed...
    32. Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45 Go to original source... Go to PubMed...
    33. Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. C. (2012). Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology, 12(1), 181. https://doi.org/10.1186/1471-2288-12-181 Go to original source... Go to PubMed...
    34. Warner, G., Packer, T., Villeneuve, M., Audulv, A., & Versnel, J. (2015). A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors. Disability and Rehabilitation, 37(23), 2141-2163. https://doi.org/10.3109/09638288.2014.996674 Go to original source... Go to PubMed...
    35. Wray, F., Clarke, D., & Forster, A. (2018) Post-stroke self-management interventions: a systematic review of effectiveness and investigation of the inclusion of stroke survivors with aphasia. Disability and Rehabilitation, 40(11), 1237-1251. https://doi.org/10.1080/09638288.2017.1294206 Go to original source... Go to PubMed...
    36. Zawawi, N. S. M., Aziz, N. A., Fisher, R., Ahmad, K., & Walker, M. F. (2020). The unmet needs of stroke survivors and stroke caregivers: a systematic narrative review. Journal of Stroke and Cerebrovascular Diseases, 29(8), 104875. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104875 Go to original source... Go to PubMed...
    37. Zeng, Z., Wu, T., Lv, M., Qian, J., Chen, M., Fang Z, Jiang, S., & Zhang, J. (2022). Impact of mobile health and telehealth technology on medication adherence of stroke patients: a systematic review and meta-analysis of randomized controlled trials. International Journal of Clinical Pharmacy, 44(1), 4-14. https://doi.org/10.1007/s11096-021-01351-x Go to original source... Go to PubMed...

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