Meaningful participation for people with stroke: a systematic review of qualitative studies.

Abstract

To determine what is meaningful participation from the perspectives and experiences of adults with stroke. A systematic review of qualitative and mixed-methods studies published in English was conducted across seven databases (PubMed, Scopus, EMBASE, Web of Science, PsycINFO, CINAHL, ASSIA) from inception to March 30, 2025. Eligible studies explored participation from the viewpoint of adults (≥18 years) with stroke. Two reviewers independently screened and appraised studies using the McMaster Critical Review Form. Data were extracted in Covidence, imported into NVivo, and synthesized inductively through a three-stage thematic process. From 7,328 records, 56 studies were included. A total of 699 codes were identified, organized into eight descriptive and three analytical themes: (1) Regaining normality (resuming pre-stroke activities, discovering a new normal), (2) Achieving independence (performing everyday activities, having control over decisions, doing one's share), and (3) Feeling valued (fulfilling roles, maintaining relationships, rebuilding social connections). Meaningful participation is a dynamic, evolving, and subjective experience extending beyond physical recovery to include identity, autonomy, and belonging. Rehabilitation should embed person-centred goal-setting and dialogue about individual needs, use tools capturing experiential outcomes, and study participation across recovery phases.