Evaluation of the Evidence for Self-Management Post-Stroke Within Clinical Practice Guidelines for People With Stroke: A Systematic Review
British Journal of Occupational Therapy
Henry, L., Leahy, S., et al. (2022).
British Journal of Occupational Therapy, 85(12), 923-946.
This umbrella systematic review synthesizes stroke self-management recommendations from guidelines for adults aged 18 years and older.
No funding received
January 2012 to July 2021
Guidelines
11 guidelines
The following 10 stroke self-management principles were generated using 161 recommendations from 11 stroke guidelines: <br />
<ul>
<li><span style="color: #333333;"><strong>problem-solving</strong> to overcome barriers (3 guidelines); </span></li>
<li><span style="color: #333333;"><strong>shared decision-making</strong> between clinicians, patients, and care partners (5 guidelines); </span></li>
<li><span style="color: #333333;"><strong>resource utilization</strong> (e.g., use of specialized services, telepractice, disability services; 4 guidelines); </span></li>
<li><span style="color: #333333;"><strong>partnership with healthcare professionals,</strong> with established points of contact (4 guidelines); </span></li>
<li><span style="color: #333333;"><strong>knowledge </strong>and the provision of information across various topics (10 guidelines); </span></li>
<li><span style="color: #333333;"><strong>involvement of care partners</strong> in the stroke recovery process (10 guidelines);</span></li>
<li><span style="color: #333333;"><strong>support </strong>by providers and care partners, both physically and psychologically, throughout the stroke recovery journey (5 guidelines);</span></li>
<li><span style="color: #333333;"><strong>reintegration into the community</strong> through collaborative goal setting, engagement in vocational activities, and use of community programs (3 guidelines); </span></li>
<li><span style="color: #333333;"><strong>collaborative goal setting</strong> with involvement of both the patient and their care partners (4 guidelines); and </span></li>
<li><span style="color: #333333;"><strong>behavior change </strong>to treat anxiety, depression, aphasia, and urinary incontinence (4 guidelines). </span></li>
</ul>
<span style="color: #333333;">The majority of self-management recommendations lacked high-quality underpinning evidence, and many recommendations stemmed from guideline panel consensus. The authors note that this review included only English-language documents from a limited number of countries. Additional limitations include the possibility of human error during the data extraction process. Future research on the duration and content (e.g., stroke prevention) of self-management interventions is needed to support additional guidance for adults post-stroke.</span>
