Understanding capability in stroke dyads: implications for nursing practice from a systematic review

Stroke is one of the leading causes of long-term disability worldwide. After the acute phase, many stroke survivors experience persistent physical and psychological impairments that require ongoing support at home. These challenges place a substantial burden on informal caregivers, often affecting their well-being and quality of life. Transitional care interventions and educational programmes have been shown to be useful in preparing caregivers; however, understanding whether and how such preparation translates into real opportunities for action within survivor–caregiver dyads remains crucial. The concept of capability offers a useful framework to explore this process in post-stroke care.

To synthesise the literature on capability in stroke survivor–caregiver dyads, with a focus on implications for nursing practice.

The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search for articles was conducted in various databases, including PsycINFO, PubMed, Scopus, and Web of Science. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tools. The synthesis was explicitly guided by the capability approach as a theoretical framework. A narrative synthesis was conducted due to the substantial methodological heterogeneity among the included studies.

Twenty-two studies conducted between 1991 and 2025 were included, mainly in Europe, Asia, and North America. The most common study type was qualitative, followed by randomized controlled trials, observational studies, and pilot studies. The included studies were found to be of high overall methodological quality (mean score 91.9%). The results of the systematic review allowed us to explore capability within the dyad. Capability acts as a link between involvement, preparedness, and empowerment, thereby supporting continuity and safety in post-stroke care.

This review highlights capability as a meaningful construct for understanding how stroke survivors and caregivers transform preparedness into effective everyday functioning. For nurses, these findings underscore the importance of interventions that go beyond knowledge transmission to also address contextual support, relational dynamics, and opportunities for action. The lack of validated dyadic capability measures represents a critical gap, supporting the need for nursing-led research to develop assessment tools and interventions that strengthen adaptive capacity, continuity of care, and autonomy after stroke.