Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

Hannah L Parke  1 , Eleni Epiphaniou  1 , Gemma Pearce  2 , Stephanie J C Taylor  1 , Aziz Sheikh  3 , Chris J Griffiths  1 , Trish Greenhalgh  4 , Hilary Pinnock  3
Affiliations

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

Hannah L Parke et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The process of adoption of self-management behaviours.
Fig 2
Fig 2. PRISMA flow chart.
Fig 3
Fig 3. Summary of what the evidence shows.
See this image and copyright information in PMC

References

    1. Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. (2009) Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 8: 355–69. 10.1016/S1474-4422(09)70025-0 - DOI - PubMed
    1. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. (2007) Heart Disease and Stroke Statistics—2007 Update: A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 115: e69–171. - PubMed
    1. World Health Organization. The World Health Report 2003—Shaping the Future Geneva: WHO, 2003.
    1. Hollander M, Koudstaal PJ, Bots ML, Grobbee DE, Hofman A, Breteler M. l (2003) Incidence, risk, and case fatality of first ever stroke in the elderly population. The Rotterdam Study. J Neurol Neurosurg Psychiatry 74: 317–21. - PMC - PubMed
    1. World Health Organization. (2002) Innovative care for chronic conditions: building blocks for action Geneva: WHO.

Publication types

LinkOut - more resources