title: Self-management: a systematic review of outcome measures adopted in self-management interventions for stroke.
abstract: OBJECTIVE
  To systematically review the psychometric properties of outcome measures used in stroke self-management interventions (SMIs) to (1) inform researchers, clinicians and commissioners about the properties of the measures in use and (2) make recommendations for the future development of self-management measurement in stroke.
  
  
  METHODS
  Electronic databases, government websites, generic internet search engines and hand searches of reference lists. Abstracts were selected against inclusion criteria and retrieved for appraisal and systematically scored, using the COSMIN checklist.
  
  
  RESULTS
  Thirteen studies of stroke self-management originating from six countries were identified. Forty-three different measures (mean 5.08/study, SD 2.19) were adopted to evaluate self-SMIs. No studies measured self-management as a discreet concept. Six (46%) studies included untested measures. Eleven (85%) studies included at least one measure without reported reliability and validity in stroke populations.
  
  
  CONCLUSIONS
  The use of outcome measures which are related, indirect or proxy indicators of self-management and that have questionable reliability and validity, contributes to an inability to sensitively evaluate the effectiveness of stroke self-SMIs. Further enquiry into how the concept of self-management in stroke operates, would help to clarify the nature and range of specific self-management activities to be targeted and aid the selection of existing appropriate measures or the development of new measures.
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK. e.j.boger@soton.ac.uk
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Boger
authors.forename: Sara
authors.initials: S
authors.lastname: Demain
authors.forename: Sue
authors.initials: S
authors.lastname: Latter
mesh_terms: D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D011594:Psychometrics; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D012648:Self Care / Q000379:methods*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome