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Wang S, Li D, Zhu S, Guo X, Xu M, Wang H, Zhang H. The supportive care needs of stroke patients: A scoping review. Res Nurs Health 2024. [PMID: 38932594 DOI: 10.1002/nur.22406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/22/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
The aims of the current review were to identify the current supportive care needs of stroke patients, categorize those needs according to the supportive care needs framework (SCNF), and to form a SCNF of stroke patients. Preferred Reporting Items for Systematic Reviews and Meta-Extension for Scoping Reviews (PRISMA-ScR) and Guidance for conducting systematic scoping reviews were followed. Ten databases were searched, including six English databases: PubMed, Embase, Web of Science, Cumulative Index to Nursing Allied Health Literature, Cochrane Library, and PsycINFO, and four Chinese databases: China National Knowledge Infrastructure, Wan Fang, China Biology Medicine Database and Chongqing VIP. The search period covers from the establishment of the database to December 31, 2022. Three thousand twenty-nine hits were screened resulting in the inclusion of 34 articles in the final literature review. The greatest need identified by stroke patients was information, followed by psychological, social, rehabilitation, practical, physical, emotional, and spiritual needs. The supportive care needs of stroke patients were identified. A preliminary SCNF of stroke patients was developed according to Fitch's SCNF. The multitude of existing needs of stroke patients need to be addressed. This review may represent the first time that SCNF for stroke patients has been developed. This work may lay the foundation for future research on the supportive care needs of stroke patients and provide a framework for the implementation of supportive care in clinical stroke units.
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Affiliation(s)
- Shuaiyou Wang
- School of nursing, Xinxiang medical University, Xinxiang, Henan, China
| | - Dingding Li
- School of nursing, Xinxiang medical University, Xinxiang, Henan, China
| | - Shanshan Zhu
- School of nursing, Xinxiang medical University, Xinxiang, Henan, China
| | - Xin Guo
- School of nursing, Xinxiang medical University, Xinxiang, Henan, China
| | - Meiqi Xu
- Nursing of Department, Xinxiang First People's Hospital, Xinxiang, Henan, China
| | - Hongru Wang
- Nursing of Department, Xinxiang First People's Hospital, Xinxiang, Henan, China
| | - Huimin Zhang
- School of nursing, Xinxiang medical University, Xinxiang, Henan, China
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Barcheus IM, Ranner M, Nyman A, Månsson Lexell E, Larsson-Lund M. Developing and testing the feasibility of a new internet-based intervention-A case study of people with stroke and occupational therapists. PLoS One 2023; 18:e0296364. [PMID: 38153937 PMCID: PMC10754454 DOI: 10.1371/journal.pone.0296364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 12/10/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Internet-based interventions are called for within rehabilitation to meet the limited access to support for self-management after stroke. Therefore, a new intervention program, "Strategies for Empowering activities in Everyday life" (SEE) was developed. The aim of this study was to explore and describe how clients with stroke and their occupational therapists experienced the SEE intervention process and whether SEE has the potential to promote an active everyday life. METHODS A qualitative descriptive case study was designed. Four people with stroke (two of each sex, mean age 66,5 years) and their two occupational therapists (one of each sex) were included. A mix of data collection methods as interviews, assessments, registration forms and fieldnotes was used to uncover the participants' experiences and potential changes. Data were analysed with pattern matching. FINDINGS The analysed data formed three categories: "Not being able to take on the internet-based intervention", "Being facilitated in the change process of everyday life through the internet-based intervention", and "Providing a new internet-based intervention is a transition from ordinary practice". These categories included two to four subcategories that reflected aspects of SEE feasibility and acceptability with a focus on content and delivery. CONCLUSION The first test of the intervention indicates that the content and delivery of SEE can be feasible and acceptable both for clients and occupational therapists. The findings suggest that SEE has the potential to support clients' self-reflections and their adoption of strategies that influence engagement in daily activities and satisfaction with life in various ways. Further research with large-scale studies is needed.
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Affiliation(s)
- Ida-Maria Barcheus
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Ranner
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Anneli Nyman
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Clinic and Geriatrics, Skåne University Hospital, Lund-Malmö, Sweden
| | - Maria Larsson-Lund
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
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Tan M, Li H, Wang X. Analysis of the current status of rehabilitation motivation and its influencing factors in older adults with stroke: a cross-sectional study. Front Aging Neurosci 2023; 15:1186681. [PMID: 37181623 PMCID: PMC10174289 DOI: 10.3389/fnagi.2023.1186681] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Objective Among stroke patients, exercise adherence is an important factor in reducing the rate of physical disability and mortality. Rehabilitation exercise after stroke is a safe and effective measure to restore normal body functions, but the analysis of factors influencing patients' motivation for rehabilitation is not well established. Therefore, this study will explore the influencing factors of rehabilitation motivation in older adults with stroke so as to reduce the disability rate of stroke. Method A convenience sampling method was used to study 350 patients in a stroke ward of a tertiary care hospital in Jinzhou, Liaoning Province. Patients' general demographic data, Multidimensional Scale of Perceived Social Support (PSSS), Questionnaire of Exercise Adherence (EAQ), Tampa scale of kinesiophobia (TSK-11), and Motivation in stroke patients for rehabilitation scale (MORE) were assessed. ANOVA or t-test analysis, correlation analysis, and linear regression analysis were used to explore the factors influencing the motivation for rehabilitation in older adults with stroke. Results The results showed that stroke patients' motivation for rehabilitation was at a moderate level. Perceived social support, exercise adherence, and stroke motivation were positively correlated (r = 0.619, p < 0.01; r = 0.569, p < 0.01), and kinesiophobia was negatively correlated with stroke motivation (r = -0.677, p < 0.01). Time of stroke, location of the lesion, perceived social support, exercise adherence, and kinesiophobia are influential factors affecting patients' motivation to recover. Conclusion In the rehabilitation program for older adult patients with stroke, healthcare providers should specify targeted rehabilitation measures according to the different degrees of the patient's condition, so as to improve the effectiveness of rehabilitation medical implementation.
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Affiliation(s)
- Mingyang Tan
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Hongyu Li
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
- *Correspondence: Hongyu Li,
| | - Xiuli Wang
- Department of Radiotherapy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- Xiuli Wang,
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Hall J, Kroll T, van Wijck F, Bassil-Morozow H. Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:877442. [PMID: 36189023 PMCID: PMC9397888 DOI: 10.3389/fresc.2022.877442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022]
Abstract
Background Stroke survivor narratives can provide valuable insight into experiences of healthcare and beyond. There is need to further understand collective lessons from stroke survivor narratives, yet prior studies utilizing digital storytelling tend to not synthesize lessons from individual experiences. This study aims to develop a novel method to co-create digital stories with stroke survivors that will aim to synthesize and portray important collective lessons from individual stroke survivors' experiences of interacting with healthcare professionals. Methods This study follows-up a qualitative study conducted with 30 stroke survivors exploring factors that help or hinder survivors to positively reconfigure their identity post-stroke. Five co-creation workshops were conducted with a subset of UK-based stroke survivors from this previous study. Participants were invited to join through: online workshops, an online bulletin board, and as an advisor. A four-stage workshop framework was developed through the integration of UK Design Council's Double Diamond method, digital storytelling strategies and the Behavior Change Wheel (BCW) framework for developing behavioral change interventions. Findings Six online workshop participants (three male, three female; aged 33–63; time since stroke 2–16 years) co-created digital stories that share six collective lessons aimed at increasing empathy and encouraging behavior change in healthcare professionals (HCPs) working with stroke survivors. Online bulletin board participants (n = 1) and advisors (n = 5) supported the co-creation process. Collective lessons identified were: (1) Stroke has a variety of symptoms that must all be considered; (2) Stroke can affect anyone of any age and not just the elderly; (3) Assumptions should not be made about a survivor's lifestyle or habits; (4) It is important to acknowledge the person behind the stroke and ensure that they are communicated with and listened to; (5) Stroke survivors can often feel unprepared for the reality of life after stroke; (6) Adapting to life after stroke is a long-term process requiring long-term support. Conclusion Stroke survivor stories highlighted preconceptions, attitudes and behaviors embedded within healthcare that negatively impacted their experiences and recovery. The novel methodology employed in this study enabled these stories to be synthesized into collective lessons to bring about improvements in these behaviors in future.
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Affiliation(s)
- Joseph Hall
- Department of Media and Journalism, Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, United Kingdom
- *Correspondence: Joseph Hall
| | - Thilo Kroll
- UCD Centre for Education, Research and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin (UCD), Dublin, Ireland
| | - Frederike van Wijck
- Research Centre for Health, School for Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Helena Bassil-Morozow
- Department of Media and Journalism, Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, United Kingdom
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Boerger TF, Hyngstrom AS, Furlan JC, Kalsi-Ryan S, Curt A, Kwon BK, Kurpad SN, Fehlings MG, Harrop JS, Aarabi B, Rahimi-Movaghar V, Guest JD, Wilson JR, Davies BM, Kotter MRN, Koljonen PA. Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity? Global Spine J 2022; 12:97S-108S. [PMID: 35174735 PMCID: PMC8859699 DOI: 10.1177/21925682211050925] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
STUDY DESIGN Narrative review. OBJECTIVE Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies. METHODS Literature search. RESULTS In other neurological disorders such as stroke and acute traumatic spinal cord injury (SCI), timely and strategic rehabilitation has been shown to be indispensable for maximizing functional outcomes, and it is imperative that appropriate perioperative rehabilitative interventions accompany surgical approaches in order to enable the best outcomes. In this review, the current state of knowledge regarding rehabilitation for PwCM is described. Additionally, various therapies that have shown to improve outcomes in comparable neurological conditions such as stroke and SCI which may be translated to DCM will be reviewed. CONCLUSIONS We conclude that locomotor training and arm/hand therapy may benefit PwCM. Further, we conclude that body weight support, robotic assistance, and virtual/augmented reality therapies may be beneficial therapeutic analogs to locomotor and hand therapies.
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Affiliation(s)
- Timothy F. Boerger
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Julio C. Furlan
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Armin Curt
- University Spine Center, Balgrist University Hospital, Zurich, Switzerland
| | - Brian K. Kwon
- Department of Orthopedics, Vancouver Spine Surgery Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Shekar N. Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael G. Fehlings
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - James S. Harrop
- Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Bizhan Aarabi
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Vafa Rahimi-Movaghar
- Department of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - James D. Guest
- Department of Neurosurgery and The Miami Project to Cure Paralysis, The Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jefferson R. Wilson
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | | | - Paul A. Koljonen
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Spasticity, Pain, and Fatigue. Rehabil Nurs 2021; 47:60-71. [DOI: 10.1097/rnj.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Drummond A, Nouri F, Ablewhite J, Condon L, das Nair R, Jones A, Jones F, Sprigg N, Thomas S. Managing post-stroke fatigue: A qualitative study to explore multifaceted clinical perspectives. Br J Occup Ther 2021. [DOI: 10.1177/03080226211042269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore, was to gain insights into the experiences of clinicians who routinely manage patients with fatigue. Method Qualitative interview study. The target was to recruit a purposeful sample of approximately 20 participants with expertise in managing PSF and fatigue arising from other conditions. Maximum variation sampling was used to ensure a balance of participants across different settings. Data were analysed using a framework approach, iteratively developed and refined by including emergent themes. Results We recruited 20 participants: nine occupational therapists (OTs), five physiotherapists, three nurses and three psychologists, which included three ‘fatigue experts’ from Europe and Australia. Analysis generated core themes around management and strategies used; these were similar regardless of professional background, clinical or geographical setting or condition treated. OTs felt a particular responsibility for fatigue management, although multidisciplinary teamwork was stressed by all. Conclusion There are clear similarities in clinicians’ experiences of managing PSF and fatigue across different conditions and also across professional groups. Clinicians rely predominantly on their own clinical knowledge for guidance.
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Affiliation(s)
- Avril Drummond
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
| | - Fiona Nouri
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
| | - Joanne Ablewhite
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
| | - Laura Condon
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
| | - Roshan das Nair
- Professor of Clinical Psychology & Neuropsychology, Division of Psychiatry & Applied Psychology, University of Nottingham, Institute of Mental Health, Nottingham, UK
| | - Amanda Jones
- Stroke Nurse Consultant and Clinical lead for Stroke pathway, Q1, Ward, Royal Hallamshire Hospital, Sheffield, UK
| | - Fiona Jones
- Professor of Rehabilitation Research, Faculty of Health, Social Care and Education, Kingston University and St Georges University of London, St George’s Campus, London, UK
| | - Nikola Sprigg
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
| | - Shirley Thomas
- Faculty of Medicine and Health Sciences, University of Nottingham, Floor B, Medical School, Queen’s Medical Centre, Nottingham, UK
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Wan X, Chau JPC, Mou H, Liu X. Effects of peer support interventions on physical and psychosocial outcomes among stroke survivors: A systematic review and meta-analysis. Int J Nurs Stud 2021; 121:104001. [PMID: 34246069 DOI: 10.1016/j.ijnurstu.2021.104001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND High level of unmet needs were reported by stroke survivors after hospital discharge. Peer support interventions may play a valuable role in the management of stroke, but the evidence is unclear. OBJECTIVES To determine the effects of peer support interventions on physical and psychosocial outcomes of stroke survivors; and to identify the key characteristics of peer support interventions for stroke survivors.cv DESIGN: A systematic review and meta-analysis. REVIEW METHODS Seven English databases and four Chinese databases were searched to identify eligible articles. Two reviewers screened the eligible studies, appraised the risk of bias, and extracted the data independently. Version 2 of the Cochrane risk-of-bias tool was used to evaluate the risk of bias for randomized controlled trials, while the Risk of Bias in Non-randomized Studies of Interventions tool was used for the quasi-experimental studies. The Grading of Recommendations Assessment, Development and Evaluation profiler Guideline Development Tool was used to assess the quality of evidence. Meta-analyses were conducted using Review Manager 5.3, and narrative analyses were performed when meta-analysis was inappropriate. RESULTS Eleven studies were included. Peer support interventions could improve the activities of daily living (MD = 15.53, 95% CI: 1.39 to 29.68; P = 0.03, I2 = 99%; very low quality of evidence), limb function, depression (SMD = -1.27, 95% CI: -2.18 to -0.36; P = 0.006, I2 = 91%; very low quality of evidence) and anxiety. Although pooled analysis showed that social participation (SMD= 0.74, 95% CI: 0.09 to 1.39; P = 0.03, I2 = 69%; low quality of evidence) and quality of life (SMD = 0.41, 95% CI: 0.09 to 0.73; P = 0.01, I2 = 0%; low quality of evidence) improved after peer support interventions, the studies which were not pooled due to insufficient data drew inconsistent results. CONCLUSIONS Stroke survivors may benefit from peer support interventions to improve their physical and psychological outcomes. The evidence about the impact of peer support interventions on social participation and quality of life is very uncertain. It should be noted that the quality of evidence ranged from very low to low, thus highlighting the need for more research of higher quality to substantiate these findings.
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Affiliation(s)
- Xiaojuan Wan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China; School of Nursing, Yangzhou University, No.136 Hanjiang Middle Road, Yangzhou, Jiangsu Province, Mainland, China.
| | - Janita Pak Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China.
| | - Huanyu Mou
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China.
| | - Xu Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Esther Lee Building, Shatin, N.T., Hong Kong SAR, China.
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Lin BL, Mei YX, Wang WN, Wang SS, Li YS, Xu MY, Zhang ZX, Tong Y. Unmet care needs of community-dwelling stroke survivors: a systematic review of quantitative studies. BMJ Open 2021; 11:e045560. [PMID: 33879490 PMCID: PMC8061855 DOI: 10.1136/bmjopen-2020-045560] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/26/2021] [Accepted: 03/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Understanding the unmet needs of community-dwelling stroke survivors is essential for further intervention. This systematic review was performed to summarise their unmet needs from a quantitative viewpoint. DESIGN Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES A comprehensive search of six databases was conducted from inception to February 2020: PubMed, EMBASE, CINAHL, PsycINFO, SCOPUS and CBM. The methodological quality of the studies was assessed. Unmet needs were categorised, and a pooled analysis of the main outcomes was conducted. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included quantitative studies focused on the unmet needs of stroke survivors who live at homes rather than in any other institutionalised organisation. RESULTS In total, 32 of 2660 studies were included, and 1980 unmet needs were identified. The prevalence of patients with unmet needs ranged from 15.08% to 97.59%, with a median of 67.20%; the median number of unmet needs per patient ranged from 2 to 8 (0-31). The prevalence of unmet needs was high at 6 months post-stroke (62.14%) and 2 years post-stroke (81.37%). After categorisation, the main concerns among these patients were revealed to be information support, physical function and mental health; a few studies reported unmet needs related to leisure exercise, return to work and so on. Additionally, differences in the measurement tools used across studies affect what unmet needs participants report. CONCLUSIONS Sufficient, accurate, individualised and dynamic information support is a priority among community-dwelling stroke survivors. Physical function and mental health are also the most significant concerns for re-achieving social participation. It is essential to design and disseminate standard, effective and time-saving tools to assess unmet needs. TRIAL REGISTRATION NUMBER CRD42018112181.
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Affiliation(s)
- Bei-Lei Lin
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yong-Xia Mei
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Wen-Na Wang
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Shan-Shan Wang
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
- The Hong Kong Polytechnic University, Hong Kong, China
| | - Ying-Shuang Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng-Ya Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhen-Xiang Zhang
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Yao Tong
- School of Information Engineering, Zhengzhou University, Zhengzhou, China
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