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Objective: Self-management support can improve quality of life, mood, self-efficacy, and physical function following a stroke. Knowledge of how people with stroke understand and experience self-management in different contexts is crucial to developing effective self-management support. This study explored how people with stroke understand and practice self-management during the post-acute phase. Method: A descriptive study using qualitative content analysis to explore data from semistructured interviews Results: Eighteen participants were interviewed. Most participants interpreted self-management as ‘taking care of their business’ and ‘being independent”. However, they encountered difficulties performing daily activities, for which they felt unprepared. Although interest in implementing self-management support increases, participants did not report receiving specific advice from healthcare professionals. Conclusion: People continue to feel unprepared to manage everyday activities after hospital discharge and must largely work things out for themselves. There is an overlooked opportunity to start the process of self-management support earlier in the stroke pathway, with healthcare professionals and people with stroke combining their skills, ideas and expertise. This would enable confidence to self-management to flourish rather than decrease during the transition from hospital to home. Practical implications: Individual tailored self-management support could help people with stroke more successfully manage their daily lives post-stroke. © 2023 The Authors

Background: Stroke may pose significant challenges to individuals and healthcare systems worldwide, and there is a clear need to understand ways to provide effective self-management support. This systematic review aims to identify barriers and enablers for the implementation of self-management support for stroke survivors across various settings.

Methods: We conducted a mixed-methods systematic review following PRISMA guidelines, searching CINAHL, Embase, Medline, and Scopus for studies on self-management support with long-term follow-up. Studies of qualitative, quantitative and mixed methods, conducted between 2009-2024 and written in English were included and any kind of outcomes was accepted. Following a narrative synthesis of barriers and enablers for implementation (of self-management support), we applied the Consolidated Framework for Implementation Research (CFIR) to systematically organize and interpret the findings. CFIR provided a comprehensive structure for understanding contextual influences across studies. 

Results: After screening 7275 studies and rigorous selection criteria, 37 articles were included. The findings revealed that the implementation of self-management support interventions for stroke survivors is influenced by various enablers and barriers, including training for healthcare professionals, participant motivation, and tailored support. Notable barriers included design and compatibility issues, funding constraints, and local context challenges.

Conclusions: Effective self-management interventions must be tailored to meet the diverse needs of stroke survivors. Enhancing sustainability and impact requires ongoing support, such as booster sessions and community resources, along with robust evaluation methods. Developing objective measures to complement self-reported data is essential for providing reliable insights and meaningful and effective self-management support.

OBJECTIVE: To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) from English to Swedish and to evaluate psychometric properties of the questionnaire.

METHODS: A cross-sectional study design, where the translation followed a process including initial translation, synthesis, backward translation, expert committee, and pretest. Content validity was assessed using Content validity index (CVI). Psychometric assessments included floor-ceiling effects and internal consistency.

RESULTS: Language and cultural congruence were achieved, and content validity index scores were high (0.923-1). The psychometric evaluations provided acceptable outcomes concerning internal consistency, with Cronbach's alpha scores for the total scale (0.902), the activities subscale (0.861) and the self-management subscale (0.818) respectively. Ceiling effects were evident, but no floor effects.

CONCLUSION: This study found the Swedish version of the SSEQ promising as a tool for assessment of self-efficacy in a Swedish stroke care setting, although further psychometric assessments are recommended in future studies.