title: Understanding stroke survivors' and informal carers' experiences of and need for primary care and community health services--a systematic review of the qualitative literature: protocol.
abstract: BACKGROUND
  Despite the rising prevalence of stroke, no comprehensive model of postacute stroke care exists. Research on stroke has focused on acute care and early supported discharge, with less attention dedicated to longer term support in the community. Likewise, relatively little research has focused on long-term support for informal carers. This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services. The review will inform the development of a primary care model for stroke survivors and informal carers.
  
  
  METHODS
  We will systematically search 4 databases: MEDLINE, EMBASE, PsycINFO and CINAHL for published qualitative evidence on the needs and experiences of stroke survivors and informal carers of postacute care delivered by primary care and community health services. Additional searches of reference lists and citation indices will be conducted. The quality of articles will be assessed by 2 independent reviewers using a Critical Appraisal Skills Programme (CASP) checklist. Disagreements will be resolved through discussion or third party adjudication. Meta-ethnography will be used to synthesise the literature based on first-order, second-order and third-order constructs. We will construct a theoretical model of stroke survivors' and informal carers' experiences of primary care and community health services.
  
  
  BACKGROUND
  The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. The study does not require ethical approval as no patient identifiable data will be used.
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK Department of Family Medicine, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: N A
authors.initials: NA
authors.lastname: Aziz
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Pindus
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: R
authors.initials: R
authors.lastname: Mullis
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: F M
authors.identifier: http://orcid.org/0000-0002-7191-6476
authors.initials: FM
authors.lastname: Walter
authors.affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Mant
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003153:Community Health Services; D006801:Humans; D008134:Long-Term Care; D011320:Primary Health Care; D036301:Qualitative Research; D012944:Social Support; D020521:Stroke / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D000078202:Systematic Reviews as Topic
keywords: COMMUNITY HEALTH SERVICES; LONG-TERM CARE; PRIMARY CARE; QUALITATIVE RESEARCH; STROKE SURVIVORS