Nursing Interventions to Enchance Dependent Care Agency and Self Care In Post Stroke Patients: A Scoping Review

Intervensi Keperawatan untuk Meningkatkan Kemampuan Perawatan Dependen dan Perawatan Mandiri pada Pasien Pasca-Stroke: Sebuah Tinjauan Cakupan (Scoping Review)

Abstract

Introduction: Stroke is a leading cause of long-term disability worldwide, survivors frequently experience functional, cognitive and communication impairments that produce a self-care deficit and create dependence on family caregivers. Within Orem's Self-Care Deficit Nursing Theory, optimal recovery depends on strengthening both the survivor's self-care agency and the family caregiver's dependent-care agency, yet the range of nursing interventions targeting these dual capacities has not been systematically mapped. To map and synthesise the scientific evidence on nursing interventions designed to enhance dependent-care agency and self-care among post-stroke patients and their family caregivers and to construct an integrative conceptual framework grounded in Orem's Self-Care Deficit Nursing Theory.

Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Scopus, PubMed, Google Scholar, and CINAHL were searched for studies published between January 2021 and June 2026. Eleven intervention studies (six randomised controlled trials and five quasi-experimental studies) met the inclusion criteria and were analysed using thematic synthesis.

Results: Four themes were identified: (1) structured education and skills training to build dependent-care agency; (2) self-care support and self-efficacy enhancement programmes; (3) hospital-to-home transitional and family-based care and (4) psychosocial, communication and resilience-oriented support. Interventions consistently improved caregiver knowledge, skill, self-efficacy, resilience and quality of life and enhanced patient self-care ability, functional status and adherence while reducing caregiver burden and rehospitalisation.

Discussion: Nursing interventions that operate as supportive educative nursing systems strengthen the dyadic capacity for self-care and dependent care after stroke. The integrative framework supports a shift from a patient only focus toward dyad-centred agency building care.