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Dyadic Capability in Stroke Survivors and Their Caregivers: A Systematic Review and Integrated Concept Analysis
Federico Cortese1, Eleonora Lombardi, Rosaria Alvaro
1Federico Cortese, RN, MSN, PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Eleonora Lombardi, RN, MSN, PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Rosaria Alvaro, RN, MSN, FESC, FAAN, Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Ercole Vellone, RN, PhD, FESC, FAAN, Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, Poland. Gianluca Pucciarelli, RN, PhD, FAHA, Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; Division of Research Methodology, Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, Poland. Davide Bartoli, RN, MSN, PhD, Assistant Professor, Department of Wellbeing, Health and Environmental Sustainability, University of Rome Sapienza, Italy.
Background:
Although educational and transitional interventions improve preparedness after stroke, it remains unclear whether this translates into real-world capability within stroke survivor-caregiver dyads. The concept of capability may better capture the ability to convert knowledge and resources into meaningful action, yet it remains poorly defined and operationalized in stroke research.
Purpose:
To systematically review the literature on capability and related constructs in stroke survivors and caregivers and to clarify the concept of dyadic capability through integrated concept analysis.
Methods:
A systematic review was conducted according to PRISMA 2020 guidelines, with protocol registration in PROSPERO. Seven databases were searched from inception to May 2025. A total of 2318 records were screened and 373 full-text articles assessed, with 22 studies included. Methodological quality was appraised using the Joanna Briggs Institute tools. Findings were synthesized narratively and integrated with a Walker and Avant concept analysis.
Results:
Dyadic capability emerged as a multidimensional construct characterized by 3 defining attributes: self-efficacy, resilience, and motivation. Antecedents included poststroke disability and contextual factors, while consequences encompassed improved autonomy, enhanced dyadic quality of life, reduced caregiver burden, and more effective care management. Notably, no validated instruments specifically measuring dyadic capability were identified.
Conclusions:
Dyadic capability represents a critical yet underdeveloped construct in stroke care. Its clarification provides a theoretical foundation for future measurement development and for designing nursing interventions that enhance the translation of knowledge into real-world action in stroke survivor-caregiver dyads.
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