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

Reed, Mary; Wood, V A; Harrington, R.; Paterson, Jane

doi:10.3109/09638288.2011.613511

Cited by 46 publications

(75 citation statements)

References 43 publications

(97 reference statements)

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“…Reed 2012 (p. 558) 68 All studies were in agreement that the effects of stroke and how they are perceived is highly personalised and dependent on the biography and personal nature of the individual. For example, a stroke could, in part, be accepted by an older person as part of the aging process where ill health might be anticipated, whereas for many people stroke represented a massive disruption in the perceived trajectory of their lives Stroke survivors were also shown to compare their current situation with their pre-stroke life.…”

Section: Resultssupporting

confidence: 57%

“…More weight was applied to the results of the four papers that scored highly (30+) during the quality assessment, 64,66,68,69 and less weight applied to the three lower (< 30) scoring papers 65,67,70 (Table 14). A high level of data saturation emerged around the arising themes, suggesting similar experiences being discussed in the majority of qualitative studies.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Following title and abstract screening, 18 full-text reports were reviewed and seven syntheses were included in the meta-review. [64][65][66][67][68][69][70] Across all the LTCs examined, the qualitative systematic reviews often failed to comment…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

“…64,65,67,69 The second was based on reviews examining people's views of services offered to those who had experienced a stroke, investigating challenges faced and potential solutions found. [65][66][67][68]70 Four reviews focused on the experiences of stroke survivors, 64,[67][68][69] and three included both stroke survivors and others involved in their lives, such as caregivers, family and friends. 65,66,70 Most reviews carried out syntheses using extraction matrices, with only three describing their analytical approach (clustering technique, 66 meta-summary, 67 and meta-synthesis and lines-of-argument synthesis with a meta-ethnographic approach 68 ).…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

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A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

338

451

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BackgroundDespite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked.AimTo undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts.MethodsSelf-management is ‘the tasks . . . individuals must undertake to live with one or more chronic conditions . . . [including] . . . having the confidence to deal with medical management, role management and emotional management of their conditions’. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (‘quantitative meta-reviews’); and systematic overviews of systematic reviews of qualitative studies of patients’ experiences relating to self-management (‘qualitative meta-reviews’). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support.ResultsWe included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patients’ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need.ConclusionsSupporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations.Study registrationThis study is registered as PROSPERO CRD42012002898.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Resultssupporting

confidence: 57%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

See 2 more Smart Citations

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

338

451

View full text Add to dashboard Cite

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“…Previous meta-syntheses of cognitive rehabilitation focused on people with stroke (Reed, Wood, Harrington, & Paterson, 2012) and long-term neurological conditions in general (dasNair et al, 2015). The latter meta-synthesis was limited to group-based rehabilitation programmes.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

Klein

Drummond

Mhizha-Murira

et al. 2017

Neuropsychological Rehabilitation

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While previous randomised controlled trials and meta-analyses offer only limited evidence for the effectiveness of cognitive rehabilitation, qualitative studies examining patient perspectives report more positive outcomes. This meta-synthesis of qualitative studies examined patient perspectives of cognitive rehabilitation for memory, attention, and executive function problems in people with multiple sclerosis. Using set eligibility criteria, we screened electronic databases, reference lists, and academic networks for

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A systematic review and critical appraisal of qualitative metasynthetic practice in public health to develop a taxonomy of operations of reciprocal translation

Melendez‐Torres

Grant

Bonell

2015

Research Synthesis Methods

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

Abstract: 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.

Cited by 46 publications

References 43 publications

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Effectiveness of cognitive rehabilitation for people with multiple sclerosis: a meta-synthesis of patient perspectives

A systematic review and critical appraisal of qualitative metasynthetic practice in public health to develop a taxonomy of operations of reciprocal translation

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