Self-management after stroke: time for some more questions?

Abstract

To discuss current research and issues which contribute towards the debate on the direction of self-management programmes for individuals after stroke and make recommendations for future research. This paper includes a critical discussion on self-management specifically applied to stroke. The findings are positioned in the context of the wider stroke literature and debates on the suitability of different programmes. Three main areas of concern and potential opportunities were identified which contribute to the debate on self-management; the "individual stroke survivor"; "professional models and practice" and "organizational context". The body of literature on self-management programmes for people with stroke is relatively new and although research is building many issues are unknown. We have highlighted a number of potential areas of inquiry and concern. In order to further advance the research on stroke and self-management we believe a convergence of the evidence base for chronic disease self-management programmes and research which has illuminated the specific challenges and barriers of living with stroke is warranted. There is also a need to avoid the potential consequence of focusing on a "one-size" programme but rather develop interventions which can be inclusive of social aspects of self-management, and identify new methods of delivery.