What are the Mechanisms and Contexts for a Supported Life After Stroke Pathway: Protocol for a Rapid Realist Review

Area of Science:

• Rehabilitation medicine
• Health services research
• Stroke recovery

Background:

• Increasing numbers of stroke survivors face long-term consequences.
• Promoting agency and fulfillment in life after stroke is crucial but lacks consensus.
• Resources for supporting life after stroke are not well-defined.

Purpose of the Study:

• To conceptualize supports for life after stroke.
• To develop programme theories, including context-mechanism-outcome configurations (CMOCs), for supporting stroke survivors.
• To identify resources required for effective life after stroke support.

Main Methods:

• A realist review protocol following the RAMESES methodology.
• Development of initial programme theories for supporting life after stroke.
• Iterative refinement of programme theories using an Expert Panel and reference group.

Main Results:

• Programme theories will be developed to explain how supports function in the life after stroke pathway.
• Context-mechanism-outcome configurations (CMOCs) will be identified.
• Resources required for supporting life after stroke will be acknowledged.

Conclusions:

• The developed CMOCs will elucidate generative causation in the life after stroke pathway.
• Findings will inform policy and practice for stroke care.
• The review will guide future realist evaluations of life after stroke support pathways.