Content » Vol 47, Issue 2

Review article

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

Elizabeth Taylor , Christopher McKevitt, Fiona Jones
Primary Care and Public Health Sciences, King's College London, SE1 3QD London, United Kingdom. E-mail:

DOI: 10.2340/16501977-1918


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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