Search Terms

1. cerebrovascular disorders/ or exp basal ganglia cerebrovascular disease/ or exp brain ischemia/ or exp carotid artery diseases/ or exp cerebrovascular trauma/ or exp intracranial arterial diseases/ or exp intracranial arteriovenous malformations/ or exp "intracranial embolism and thrombosis"/ or exp intracranial hemorrhages/ or stroke/ or exp brain infarction/ or stroke, lacunar/ or vasospasm, intracranial/ or vertebral artery dissection/ or exp hypoxia, brain/

2. (stroke$ or post stroke or poststroke or post-stroke or apoplex$ or cerebral vasc$ or cerebrovasc$ or cva or SAH).tw.

3. ((brain or cerebr$ or cerebell$ or vertebrobasil$ or hemispher$ or intracran$ or intracerebral or infratentorial or supratentorial or middle cerebr$ or mca$ or anterior circulation or basilar artery or vertebral artery) adj5 (isch?emi$ or infarct$ or thrombo$ or emboli$ or occlus$ or hypoxi$)).tw.

4. ((brain$ or cerebr$ or cerebell$ or intracerebral or intracran$ or parenchymal or intraparenchymal or intraventricular or infratentorial or supratentorial or basal gangli$ or putaminal or putamen or posterior fossa or hemispher$ or subarachnoid) adj5 (h?emorrhag$ or h?ematoma$ or bleed$)).tw.

5. exp hemiplegia/ or exp paresis/ or exp aphasia/ or exp gait disorders, neurologic/ or hemianopsia/

6. (hempar$ or hemipleg$ or paresis or paretic or aphasi$ or dysphasi$ or hemianopsia or hemianopia or transient isch$ or isch?emic attack$ or TIA or TIAs).tw.

7. ((unilateral or visual or hemispatial or attentional or spatial) adj5 neglect).tw.

8. 1 or 2 or 3 or 4 or 5 or 6 or 7

9. randomized controlled trial.pt.

10. controlled clinical trial.pt.

11. randomized.ab.

12. placebo.ab.

13. drug therapy.fs.

14. randomly.ab.

15. trial.ab.

16. groups.ab.

17. 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16

18. Self Care/

19. (self adj (care or help or manag$ or led or directed)).tw.

20. self efficacy/

21. Patient Participation/

22. Self-Help Groups/

23. motivation/ or goals/ or problem solving/ or exp decision making/

24. (((behav$ adj3 chang$) or (problem$ adj3 solv$) or (goal$ adj3 setting) or (decision$ adj3 mak$) or coping) adj5 (patient$ or consumer$ or client$)).tw.

25. 18 or 19 or 20 or 21 or 22 or 23 or 24

26. 8 and 17 and 25

27. exp animals/ not humans.sh.

28. 26 not 27

Table:Description of self-management interventions

Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location of the intervention / Duration of the intervention
Aben et al. [53] and Aben et al. [54] / Memory self-efficacy / Group format / Trained psychologist / Title: Memory self-efficacy intervention
Content:1) A general introduction on memory and stroke, including the consequences of actual memory deficits and how to cope with these
2) Training in internal and external memory strategies to improve compensating abilities (e.g. visualization, diary use, taking notes)
3) Psychoeducation on the influence of beliefs, anxiety, memory-related worries, and motivation on memory performance; and
4) Realistic goal setting regarding memory-demanding tasks, using cognitive behavioural therapeutic aspects
Patients received a training booklet with information about the sessions, and homework assignments were handed out after each session / Rehabilitation clinic (participants living in the community) / 9 twice weekly group sessions of 1 hour
Allen et al. [55] / Wagner’s chronic care model / Individual home visits and telephone follow-up. / Advanced practice nurse care manager/interdisciplinary post stroke consultation team / Title: Enhanced case-management and review plus self-management component
Content: goal setting, problem solving, care planning, educational resources, skills training, access to community resources. / Community / 6 months (contact varied upon level of need but contacted at least once a week by telephone for the first month and monthly thereafter until 6 months)
Allen et al. [56] / As above / As above / As above / As above / As above / As above
Cadilhac et al. [57] (supplementary information from Battersby et al.[93]) / Social Cognitive Theory of Self-Efficacy / Group format / Trained stroke educator and peer facilitator / Title: Stroke Self-Management programme
Content: stroke specific information provision, problem solving, identifying and accessing local resources, healthy lifestyle behaviour change / Community / 2 ½ hours once a week for 8 weeks
Table:Description of self-management interventions (continued)
Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location of the intervention / Duration of the intervention
Chumbler et al.[58] and Chumbler et al. [59] (Supplementary information obtained from published protocol Chumbler et al. [92] / Self-efficacy / Individual home visits and telephone calls / Occupational and physiotherapists / Title:Multifaceted stroke telerehabilitation (STeleR)
Content: Goal-setting, review, treatment planning, physical exercise, adaptive strategies / Community (home-based) / 3 months (three one-hour home visits,
daily participant use of an in-home messaging
device that is monitored weekly by the teletherapist,
five telephone intervention calls between the teletherapist
and the participant)
Damush et al. [60] / Social Cognitive Theory of Self-Efficacy / Individual telephone calls / Trained facilitators (nurse, physician assistant, masters level social scientist) / Title: Stroke self-management programme
Content: Facilitated goal setting and problem solving / Community (home-based) / Six 20 minute bi-weekly telephone calls
Fido [61] / Theory of planned behaviour / Face to face visit and diary keeping / Researcher / Title: Diary Plan
Content: Diary keeping to facilitate participation in meaningful activities- included aspects of planning and behavioural goal setting. Intervention group were also helped to form 'implementation intentions' with regard to diary keeping / Community (home-based) / 1 home visit with a researcher to administer instructions for keeping the diary. Participants were required to keep the diary daily for 2 weeks
Frank et al. [62] / Control cognitions theory / Face to face visits and telephone calls / Researcher / Title: Workbook based intervention
Content: Information provision, enhancing coping resources, rehearsing planning, problem-solving skills, recovery plan. / Community (home-based) / 2 home visits and 3 telephone calls over 5 weeks
Table:Description of self-management interventions (continued)
Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location of the intervention / Duration of the intervention
Glass et al. [63] / Psychosocial Model / Individual / Psychologist or social worker trained in Cognitive Behavioural Therapy / Title: Psychosocial intervention
Content: Assessment of social assets, coping strategies, goal setting, planning, behavioural strategies / Community (home-based) / 16 meetings over 6 months
Guidetti et al. [64]
And
Guidetti and Ytterberg [65] / ? / Individual / Occupational therapist / Title: Client centred self-care intervention
Content: ‘Goal, plan, do’ strategy, supportive goal setting planning and review. Training diary to assume responsibility for goals and self-care. / Rehabilitation clinic / ?
Harwood et al. [66] / Social Cognitive Theory of Self-Efficacy / Individual / Trained research assistants / Title of intervention 1: Inspirational DVD:
Content: Coping, encouraging meaningful activity and participation
Title of intervention 2: Take Charge session:
Content: Goal setting, information provision on individual risk factor, planning / Community / 1 x 80 minute session
Johnston et al. [67] / Control cognitions theory / Face to face visits and telephone calls / Workbook implementer / Title: Workbook based intervention
Content: Coping skills, self-management instruction, goal setting, relaxation and breathing exercises / Community (home-based) / 3 home visits and 2 telephone calls over a 5 week period
Jones et al. [68] / Social cognition theory / Individual / OT, Physios, Speech therapists and rehab support workers / Title: Bridges self-management programme
Content: One to one rehab sessions using seven principles integrated into each therapy session to support self-management: 1) Problem solving 2) Reflection 3) Goal setting 4) Accessing resources 5) Self-discovery 6) Activity 7) Knowledge. Stroke workbook including vignettes, activities, ideas and solutions from other stroke survivors for successful self-management and space to record and reflect upon goals and progress / ? / ?
Table:Description of self-management interventions (continued)
Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location / Duration
Kendall et al. [69] / Social Cognitive Theory of Self-Efficacy / Group format / Trained health professionals / Title: Chronic Disease Self-Management course plus stroke specific information session
Content: Information provision (health, wellbeing, exercise, relaxation) problem solving, goal setting, communication with healthcare team and family / Community / 2 hours per week for 6 weeks
Marsden et al. [70] / ? / Group format / Stroke multidisciplinary team (Physiotherapist, social worker, dietician, nurse, speech pathologist and occupational therapist) / Title: Community Living After Stroke for Survivors and Carers
Content: Education, physical activity, self-management principles (goal setting, risk factors and prevention, fatigue management, stress and relaxation, community participation and accessing resources) / Hospital (with community based stroke survivors) / 2 ½ hours per week for 7 weeks
McKenna et al. [71] / Self-efficacy / Individual / Members of the community stroke team who had previously undergone training in the program / Title: Bridges Supported Self-Management Programme
Content: Goal-setting, problem-solving, progress review, stroke workbook to record goals and achievements / Community / One session of up to one hour per week over 6 weeks
Polatajko et al. [72] / Meichenbaums problem-solving strategy / Individual / Occupational therapist / Title: Cognitive Orientation to daily Occupational Performance
Content: Goal setting, cognitive problem solving, strategy identification, skill acquisition, supported goal achievement. / Community / 10 x 1 hour treatment sessions
Table:Description of self-management interventions (continued)
Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location / Duration
Robinson et al. [73] / ? / Individual / Problem-solving therapy- 'trained therapist' / Title: Problem-solving therapy
Content: patients selects a problem and then goes through 7 steps to arrive at a course of action / ? / Problem-solving therapy-consisted of 6 treatment sessions over the first 12weeks (weeks 1, 2, 3, 4, 6,and 10) and 6 reinforcement sessions (months 4, 5, 6, 8, 10, and 12)
Sabariego et al. [74] / Social Cognitive Theory of Self-Efficacy / Group format / Psychologist / Title: ICF based patient education programme
Content: Problem identification, problem solving, planning, cognitive representation / Inpatient rehabilitation / 1 hour sessions over 5 days
Sackley et al. [75] / ? / Individual / Occupational therapist / Title: Occupational therapy intervention
Content: Goal setting, skills training, progress review, carer and care home education / Care home / 3 month period but frequency and duration dependent upon agreed goals
Taylor et al. [76] / ? / Individual / Occupational therapist / Title: Structured goal setting using Canadian Occupational Performance Measure
Content: Facilitated goal setting,
Feedback on goals to clinical team / Inpatient rehabilitation / One administration
Tielemans et al. [77] / ? / Group format / Psychologist or occupational therapist / Title: Self-management intervention
Content: Taught proactive action planning strategies within four themes:
1) Handling negative emotions, 2) Social relations and support, 3) Participation in society
4) Less visable stroke consequences / Hospital and rehabilitation outpatient facilities / 10 weeks with 6 x 2hr sessions for 6 weeks followed by 1 x 2hr session in week 10
Table:Description of self-management interventions (continued)
Authors / Theoretical Rationale / Mode of delivery / Facilitators / Title and Content of intervention (s) / Location / Duration
Visser et al. [78] / ? / Group format / A trained neuropsychologist / Title: Problem solving therapy
Content: Problem orientation and 4 step problem solving including:
1) Define problem and goal
2) Generate multiple solutions
3) Select a solution
4) Implement and evaluate / ? / 8 group sessions, 1.5 hours per week with additional homework exercises
Wolf et al. [79] / ? / Group format / OT and/or peer facilitator (depending upon availability) / Title:Improving Participation after Stroke Self-Management Program (IPASS)
Content: A structured efficacy building process that focused upon medical, emotional, role and participation management to guide participants to develop skills related to problem-solving, decision making, resource utlilisation, client/provider/service partnerships, action planning and self-tailoring over time. / ? / 12 sessions

Key: [ ?: Insufficient information]

Meta-analysis 1

Activities of daily living 3 months: Barthel Index and NEADL (General self management interventions)

Meta analysis 2

Activities of daily living 6 months: Barthel Index (General self-management interventions)

Meta analysis 3

Stroke specific quality of life 3 months: SSQOL and SAQOL(General self management interventions)

Meta analysis 4

Global measure of disability 3 months: Functional Independence Measure (Occupational based self management interventions)

Meta analysis 5

Activities of daily living 3 months: Barthel Index (Occupational based self management interventions)