Factors shaping the delivery of acute inpatient stroke therapy : a narrative synthesis

Taylor, Elizabeth, McKevitt, Christopher and Jones, Fiona (2015) Factors shaping the delivery of acute inpatient stroke therapy : a narrative synthesis. Journal of Rehabilitation Medicine, 47(2), pp. 107-119. ISSN (print) 1650-1977

Abstract

OBJECTIVE: To investigate factors shaping the delivery of acute inpatient stroke therapy (i.e. occupational therapy, physiotherapy, and speech and language therapy). DATA SOURCES: A systematic search using electronic databases: AMED, CINAHL, Medline, Web of Knowledge and EMBASE. STUDY SELECTION: Qualitative studies (n = 31) investigating delivery of inpatient stroke therapy, published since 1998, were included. DATA EXTRACTION: 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. DATA SYNTHESIS: 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. CONCLUSION: 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.

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