• Jenni Murray, Robert Ashworth, Anne Forster, and John Young.
• Bradford Elderly Care and Rehabilitation Research, St Luke's Hospital, Little Horton Lane, Bradford BD5 ONA. jenni.murray@bradfordhospitals.nhs.uk
• Br J Gen Pract. 2003 Feb 1; 53 (487): 137142137-42.

AbstractThe aim of this review was to identify the most frequently encountered longer-term problems experienced by stroke patients and their informal carers. Systematically identified qualitative studies describing self-reported experiences of stroke-related long-term problems were independently reviewed and the findings analysed using a clustering technique. Twenty-three qualitative studies, which included approximately 500 patients and 180 carers, were identified by the search methods. Most of the studies were cross-sectional, United Kingdom-based, and employed semi-structured individual interviews. The review identified 203 problem areas, which were categorised into five domains: hospital experience; transfer of care; communication; services; and social and emotional consequences. The largest domain was the social and emotional consequences of stroke, representing 39% of all problem areas. These included problems relating to mood, social changes, attitudes to recovery, and changes in self-perception and relationships. Service deficiencies, encompassing both health and social care, was the second largest domain, accounting for 29% of the problem areas. The review provides a basis for a user-focused, longer-term stroke service. The need for responses that go beyond the traditional physical rehabilitation approach is evident, and research to identify broader treatment strategies is now required.

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