title: Factors shaping the delivery of acute inpatient stroke therapy: a narrative synthesis.
abstract: OBJECTIVE
  To investigate factors shaping the delivery of acute inpatient stroke therapy (i.e. occupational therapy, physiotherapy, and speech and language therapy).
  
  
  METHODS
  A systematic search using electronic databases: AMED, CINAHL, Medline, Web of Knowledge and EMBASE.
  
  
  METHODS
  Qualitative studies (n = 31) investigating delivery of inpatient stroke therapy, published since 1998, were included.
  
  
  METHODS
  Narrative synthesis was used as the review method. Textual descriptions, tabulation and thematic ana-lysis were used to categorize findings and explore relationships between studies.
  
  
  RESULTS
  DATA SYNTHESIS generated the following themes: the need for a therapeutic environment; power and decision-making; intensity, motivation and appropriateness for active therapy; therapy behind the scenes; the role of teamwork in creating a therapeutic environment. Delivery of therapy was influenced by conceptual, individual and professional factors.
  
  
  CONCLUSIONS
  Conceptual, individual and professional factors impact on the delivery of rehabilitation. Further research is needed to examine how therapists negotiate the sometimes conflicting factors shaping delivery of therapy.
authors.affiliation: Primary Care and Public Health Sciences, King's College London, SE1 3QD London, United Kingdom. elizabeth.taylor@kcl.ac.uk.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Taylor
authors.forename: Christopher
authors.initials: C
authors.lastname: McKevitt
authors.forename: Fiona
authors.initials: F
authors.lastname: Jones
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D007297:Inpatients; D007808:Language Therapy; D009788:Occupational Therapy; D010564:Personnel, Hospital; D026741:Physical Therapy Modalities; D036301:Qualitative Research; D013070:Speech Therapy; D000071939:Stroke Rehabilitation