Financial burden, non-medical drivers of health, and early caregiving role formation after stroke: a scoping review.

Authors

Munachi Okpala, Mariel Flake-Rojas, Edwin Akomaning, Shelby Woodall, Alexis Simpkins, Okechukwu Chukwuekezie, Layomi Oladunjoye, Anjail Z Sharrief

Published in

Topics in stroke rehabilitation. Pages 1-11. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Family caregivers are essential to stroke recovery, yet existing assessments may not adequately capture structural factors influencing caregiving capacity. Financial toxicity, non-medical drivers of health (NMDOH), and caregiver role formation during early post-stroke recovery remain poorly characterized. This scoping review evaluated how current caregiver assessments address these domains.
A scoping review using the Arksey and O'Malley and Levac frameworks was reported according to PRISMA-ScR guidelines. Four databases were searched for studies published within the past 10 years examining informal caregiving during hospitalization, inpatient rehabilitation, or early transition home after stroke. Data were extracted on caregiver assessments, financial toxicity, NMDOH, and caregiver role formation.
Sixteen studies were included. Assessments commonly capture caregiver burden, psychosocial distress, preparedness, social support, and caregiving tasks. Financial toxicity was absent in seven studies; most others assessed only subjective financial strain or a single objective indicator, such as income loss. Only one study assessed financial toxicity multidimensionally, incorporating income loss, direct costs, and debt. Employment and healthcare access were the most frequently assessed NMDOH domains (11 studies each), while housing and transportation were less frequently addressed; food security was absent. All studies addressed aspects of caregiver role formation, most commonly preparedness, but only one examined its relationship with financial toxicity.
Caregiver assessments inconsistently capture financial toxicity and NMDOH. Future instruments should integrate multidimensional financial toxicity and NMDOH measures with caregiver role formation to better identify vulnerability and support equitable, sustainable stroke recovery.

PMID:
42865022
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.