title: A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors.
abstract: OBJECTIVE
  A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing specifically on function and participation outcomes.
  
  
  METHODS
  Twelve databases were searched for the years 1986-2012 to identify self-management programs for stroke survivors. Pre-post, quasi-experimental and randomized controlled trial study designs were included. Descriptive information about the intervention was scrutinized to identify what self-management support strategies were present in the intervention and comparisons were made between programs using a group versus a one-to-one format. All outcomes were included and categorized.
  
  
  RESULTS
  The most prominent strategies identified in our review were goal setting and follow-up, and an individualized approach using structured information and professional support. There are indications that self-management programs can significantly increase participation and functional ability. However, the high level of clinical heterogeneity in program delivery, outcomes and level of stroke severity made it impossible to conduct a meta-analysis. Further examination of individual self-management support strategies, such as linking rehabilitation goal setting to post-acute self-management programs, the inclusion of family members and the contribution of peer-support is warranted.
  
  
  CONCLUSIONS
  Self-management programs for stroke survivors. Linking post-acute self-management programs to rehabilitation goal setting could improve outcomes. Involving family members in self-management programs may benefit stroke survivors.
authors.affiliation: a School of Occupational Therapy, Dalhousie University , Nova Scotia , Canada .
authors.forename: Grace
authors.initials: G
authors.lastname: Warner
authors.affiliation: a School of Occupational Therapy, Dalhousie University , Nova Scotia , Canada .
authors.forename: Tanya
authors.initials: T
authors.lastname: Packer
authors.affiliation: b Faculty of Health Sciences , University of Sydney , Sydney , NSW , Australia , and.
authors.forename: Michelle
authors.initials: M
authors.lastname: Villeneuve
authors.affiliation: a School of Occupational Therapy, Dalhousie University , Nova Scotia , Canada .|c Department of Nursing , Mid Sweden University , Sundsvall , Sweden.
authors.forename: Asa
authors.initials: A
authors.lastname: Audulv
authors.affiliation: a School of Occupational Therapy, Dalhousie University , Nova Scotia , Canada .
authors.forename: Joan
authors.initials: J
authors.lastname: Versnel
mesh_terms: D000203:Activities of Daily Living; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D012107:Research Design; D012648:Self Care / Q000379:methods* / Q000592:standards; D020377:Self Efficacy; D000071939:Stroke Rehabilitation; D017741:Survivors / Q000523:psychology
keywords: Family-centred care; function; goal-setting; participation; self-management; stroke