The effectiveness of self-management interventions with action-taking components in improving health-related outcomes for adult stroke survivors: a systematic review and meta-analysis

Abstract

Purpose

This systematic review and meta-analysis aims to synthesise the evidence of the effectiveness of self-management interventions with action-taking components in improving self-efficacy, health-related quality of life, basic and instrumental activities of daily living, and depression for adult stroke survivors.

Materials and methods

Nine electronic databases were searched for relevant studies, including grey literature and ongoing studies. Randomised controlled trials targeting adult stroke survivors comparing health-related outcomes of patients receiving self-management interventions with action-taking components to usual care, placebo, or no-treatment were included. Screening, data extraction, and methodological quality assessment were conducted by two reviewers. Meta-analyses were performed. Overall quality of evidence was assessed using the GRADE tool.

Results

A total of seventeen studies were included. Meta-analyses showed that the intervention may result in a slight increase in self-efficacy (SMD = 0.29, 95% CI [0.07–0.52], p = 0.010, I² = 47%) and basic activities of daily living (SMD = 0.31, 95% CI [0.16–0.46], p < 0.001, I² = 0%), but not for the other outcomes.

Conclusions

Self-management interventions with action-taking components may result in a slight improvement in self-efficacy and rehabilitation of basic activities of daily living. Future research should investigate which core self-management skill, or combination of them, is most effective in improving short-term and long-term outcomes.

IMPLICATIONS FOR REHABILITATION

• Stroke can be a chronic condition as approximately half of stroke survivors suffer from permanent disabilities.

• Self-management interventions are one form of rehabilitation programmes available to stroke survivors.

• Self-management interventions with action-taking components may result in a slight increase in patient self-efficacy and carrying out basic activities of daily living compared to usual care given.

Keywords:

• Meta-analysis
• self-efficacy
• self-management
• stroke
• systematic review
• transient ischaemic attack

Acknowledgements

We thank the National University of Singapore Medical Library team, particularly Ms Chin Mien Chew, Annelissa, for their guidance and advice on the search strategy for this review.

Disclosure statement

No potential conflict of interest was reported by the authors.