Stakeholder Perspectives on Digital Health Technologies in Poststroke Self-Management and Rehabilitation: Systematic Review Based on the NASSS Framework.
Jing Zhao, Jie Zhao, Xiaohan Liu et al.
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In 30 seconds
This systematic review synthesized stakeholder perspectives on digital health technologies (DHTs) for poststroke self-management and rehabilitation, mapping findings to the NASSS framework. It included 42 primary studies published between 2019 and 2025, using qualitative, quantitative, or mixed methods. Stakeholders valued personalized features, intuitive interfaces, timely feedback, and digital support that complemented human care. Reported barriers included stroke-related impairments, unequal digital access and literacy, caregiver demands, staff workload and training, and poor workflow integration. Evidence was limited on organizational and wider-system factors, and no included study directly examined interaction and adaptation over time.
Key findings
- The review included 42 studies: 24 qualitative, 8 quantitative, and 10 mixed methods studies.
- Stakeholders valued personalized functions, intuitive interfaces, timely feedback, and digital support that complemented human care.
- Barriers included stroke-related impairments, unequal digital access and literacy, caregiver demands, staff workload and training needs, and poor clinical workflow integration.
- No eligible study directly examined interaction and adaptation over time; evidence on organizational readiness and wider-system determinants was limited.
Why it matters
The findings show that implementation challenges extend beyond whether a technology is usable. Poststroke impairments, caregiver and staff capacity, clinical workflows, privacy, and financing can all shape whether DHTs fit care contexts. Considering these factors during design and evaluation may help align digital support with stakeholder needs, while the evidence gaps caution against assuming that acceptability translates into sustained adoption or wider implementation.
What to keep in mind
The review reports methodological concerns in included studies, including nonresponse bias and insufficient interpretation of integrated findings in some mixed methods studies. Evidence on organizational and wider-system factors was limited.