Living After the Stroke: A Qualitative Meta-Synthesis of Patients’ Lived Experiences and Policy Implications for Comprehensive Stroke Care (2000–2025)

Background: Stroke is among the leading causes of death and disability, with over 101 million survivors worldwide.^1^ While advances in acute therapies have improved survival, stroke survivors’ lived experiences—shaping recovery, identity, and reintegration—remain underrepresented in evidence syntheses.^2^ Individual qualitative studies describe loss of self, communication barriers, and caregiver strain, but findings are fragmented.^4–9^ This review systematically synthesizes global qualitative evidence on stroke survivors’ experiences to inform policy and practice. Methods: We conducted a qualitative evidence synthesis (2000–2025) following PRISMA 2020 and ENTREQ guidance.^36,37^ Eligible studies included adults with stroke reporting first-person lived experiences through qualitative or mixed-methods designs. Databases searched: MEDLINE, Embase, CINAHL, PsycINFO, Scopus, Web of Science, plus grey sources. Two reviewers independently screened, extracted, and appraised studies with CASP.^38^ Data were synthesized thematically,^39^ and confidence in findings assessed with GRADE-CERQual.^40^ Results: Across 32 studies in 18 countries (≈1,245 participants), six analytical themes emerged: (1) fractured identity and self-reconstruction; (2) invisible symptoms such as fatigue and cognitive fog; (3) communication barriers, particularly aphasia; (4) precarious transitions between hospital and community; (5) family co-recovery and caregiver strain; and (6) pathways of hope through spirituality, peer networks, and technology. Confidence in findings ranged from moderate to high. Identity, invisible symptoms, and family co-recovery showed high confidence, while evidence on technology-enabled recovery and peer support was moderate due to limited studies and contextual variability.^4–35^ Conclusions: Stroke survivors’ experiences highlight needs beyond biomedical outcomes, including communication support, structured care transitions, and caregiver inclusion. Policy Implications: By 2027, ≥80% of stroke units should implement co-designed discharge plans with caregiver training, universal aphasia-sensitive communication tools, and 30-day navigator follow-up, audited through national registries.^3,42^