Developing stroke rehabilitation and community services: a meta-synthesis of qualitative literature

Abstract

Purpose: To identify the key factors that are necessary to account for in planning and developing rehabilitation and community services for stroke based on users’ perspectives. Method: A meta-synthesis of qualitative research comprising three stages: (i) systematic searching and identification of relevant reports; (ii) critical appraisal of selected reports; (iii) analysis and synthesis of included reports. Results: A total of 138 reports were identified, 101 were rejected after applying the inclusion criteria. Following critical appraisal, 18 papers were included. The main interconnecting themes relate to how the impact of stroke is influenced by: (i) the person; (ii) close social relationships; (iii) the social environment; (iv) interactions between all three. The lines-of-argument synthesis relates to the social world a person inhabits and its effect on how a person will perceive and deal with their stroke. Support will be most effective when delivered in the context of this social world. Conclusion: How stroke is perceived is highly dependent on a person’s identity. Support can be effective if delivered within the existing structures of a stroke survivor’s unique social world.Implications for RehabilitationRehabilitation of stroke survivors needs to be considered in its broadest context and include an equal focus on the social, psychological and physical aspects.Traditional rehabilitation practice needs to be expanded if stroke survivors are to be supported in maintaining an active and positive presence in their unique social world.