Published Online
on April 22, 2004

A more recent version of this article appeared on June 1, 2004

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Submitted on December 17, 2003
Revised on January 23, 2004
Accepted on February 16, 2004

Qualitative Studies of Stroke: A Systematic Review

Christopher McKevitt PhD^*; Judith Redfern MSc; Freda Mold PhD; and Charles Wolfe MD

From King’s College London, London, UK.

^* To whom correspondence should be addressed. E-mail: Christopher.mckevitt{at}kcl.ac.uk.

Background and Purpose--Qualitative studies are increasingly used to investigate social processes and phenomena influencing health behaviors and service provision. We aimed to identify the scope of published qualitative studies of stroke, consider their relevance to development and delivery of services for people with stroke, and make recommendations for future work.

Methods--Literature review of published articles was identified by systematically searching online literature databases using keywords from the start of each database until 2002. Articles were reviewed by 2 authors, using a standardized matrix for data extraction. The 2003 European Stroke Initiative recommendations for stroke management were used to categorize the literature for consideration of its contribution to stroke research.

Results--We included 95 articles. Their empirical contribution includes an emphasis on recording the "human" experience of stroke; identification of needs as perceived by patients and their families, differences in priorities between patients and professionals, and barriers to best-quality care. We identified 12 papers that were specifically undertaken to develop or evaluate interventions.

Conclusions--Qualitative studies have addressed a wide range of issues related to the impact of stroke on individuals and caregivers, and to the organization and delivery of services. Significant problems remain in ensuring the delivery of best-quality stroke care, which such studies have the potential to address. Maximizing this potential requires greater collaboration between nonclinical and clinical scientists, service providers, and users to formulate research questions of interest as well as new research strategies, such as meta-analysis, to pool qualitative research findings and multisited investigations.

Key words: qualitative research • caregivers • delivery of health care • evaluation studies • quality of health care • stroke

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