Self-management programs for promoting recovery in community-dwelling stroke survivors: A systematic review

Abstract

Review question This systematic review is undertaken to answer the following review question: ‘What is the effectiveness of theory-based self-management programs for community-dwelling stroke survivors in promoting their post-stroke recovery after discharge from hospitals?’ Review objectives The objective of this systematic review is to present the best available research evidence pertaining to the effectiveness of theory-based self-management programs for community-dwelling stroke survivors to promote post-stroke recovery. An effective community-based self-management program with a theoretical basis for stroke survivors is crucial to optimize their physical, psychological and social outcomes of post-stroke recovery after discharge from hospitals, and ultimately to enhance the prognosis of stroke recovery. Population: All community-dwelling stroke survivors, aged 18 years or above, with first-ever or recurrent stroke. Intervention: All studies that examined the effectiveness of a structured self-management program designed with a theoretical basis for improving post-stroke recovery of community-dwelling stroke survivors. Comparison: A self-management program based on a theory that is different from the theory used for the intervention group; a self-management program without a theoretical basis; conventional or usual care; or no intervention. Outcomes: Primary outcomes: - Quality of life - Self-management behaviours Secondary outcomes: - Physical outcomes: activities of daily living - Psychological outcomes: depression, self-efficacy - Social outcomes: community reintegration, perceived social support The specific review objectives are to: (1) Determine the effectiveness of theory-based self-management programs in enhancing quality of life of community-dwelling stroke survivors (2) Determine the effectiveness of theory-based self-management programs in facilitating the participation of community-dwelling stroke survivors in stroke self-management behaviours. (3) Determine the effectiveness of theory-based self-management programs in improving physical outcomes of community-dwelling stroke survivors. (4) Determine the effectiveness of theory-based self-management programs in improving psychological functioning of community-dwelling stroke survivors. (5) Determine the effectiveness of theory-based self-management programs in improving social functioning of community-dwelling stroke survivors.