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PLoS One. 2015 Jul 23;10(7):e0131448. doi: 10.1371/journal.pone.0131448. eCollection 2015.

Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.

Author information

1
Multidisciplinary Evidence Synthesis Hub (mEsh), Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, United Kingdom.
2
Centre for Technology Enabled Health Research (CTEHR), Coventry University, Coventry, United Kingdom.
3
Usher Institute of Medical Informatics and Population Health Sciences, The University of Edinburgh, Edinburgh, United Kingdom.
4
Nuffield Department of Primary Care Health Sciences, Medical Sciences division, University of Oxford, Oxford, United Kingdom.

Abstract

BACKGROUND:

There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients.

DESIGN:

Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services.

METHODS:

We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings.

RESULTS:

From 12,400 titles we selected 13 systematic reviews (published 2003-2012) representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year) improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death). There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community.

CONCLUSIONS:

Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.

PMID:
26204266
PMCID:
PMC4512724
DOI:
10.1371/journal.pone.0131448
[Indexed for MEDLINE]
Free PMC Article

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