Needs of Stroke Survivors as Perceived by Their Caregivers: A Scoping Review.
Shilpa Krishnan, Monique R Pappadis, Susan C Weller and 4 others
PMID 28628537WHAT IT FOUND
Caregivers most often reported environmental needs, especially support, services, safety and accessibility, after discharge.
They also noted psychosocial, physical, cognitive and speech needs. This review maps those needs. It does not test whether meeting them improves outcomes.
Key findings
01Among the 66 included studies, which involved 1,926 caregivers along with other stakeholders, caregivers in 62 studies (92%) stressed environmental needs, including support in 50 studies (76%), services in 44 studies (67%), safety in 17 studies (26%), and accessibility and accommodation in 14 studies (21%).
02Caregivers in 41 studies (62%) reported body functional needs, most often psychosocial function in 26 studies (39%), physical function in 15 studies (23%), cognitive function in 10 studies (15%), and uncertainty related to functional impairments in 9 studies (14%).
03Caregivers in 43 studies (65%) reported activity and participatory needs, including healthy lifestyle in 26 studies (39%), physical activities and independence in 15 studies (23% each), speech in 11 studies (17%), and cognitive activities and uncertainty in 2 studies (3% each).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a scoping review of caregiver-reported needs, not a trial or effectiveness review, so it cannot show that meeting these needs improves outcomes. Studies were included regardless of quality, and many qualitative and mixed-methods studies did not fully meet appraisal standards. The review did not clearly distinguish unmet, partially met and met needs. It searched only a limited set of databases and did not include gray literature, so it may not cover all available evidence. Most included studies were in community settings, so findings may not apply equally to acute or inpatient rehabilitation stages. The review did not compare caregivers by race, ethnicity, stroke type or care setting. Some needs could not be separated as belonging to stroke survivors or caregivers.
The easy way to misread this
Do not read this as proof that caregiver involvement or services improve stroke recovery. It is a scoping review of caregiver-reported needs, not a tested intervention, and the included studies did not establish whether the needs were met or changed outcomes.