{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:49:51Z","timestamp":1785761391285,"version":"3.56.0"},"reference-count":31,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,23]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Stroke is a severe cerebrovascular disease characterised by high morbidity, high recurrence rate, high disability rate, high mortality rate and significant economic burden. The unmet needs of stroke patients are universal and diverse and closely related to their health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol describes a mixed-methods systematic review to identify unmet needs in stroke patients. A comprehensive search will be performed in the following databases: PubMed, CINAHL, Embase, Web of Science, PsycINFO, CNKI, Wanfang Database and CQVIP. Google Scholar and ProQuest Dissertations &amp; Theses Global were searched as grey literature sources. The search will target studies published in English or Chinese between January 2018 and April 2026. Quantitative, qualitative and mixed-methods study designs will be included. Two independent reviewers will conduct the selection process and cross-check the data extraction. The Mixed-Methods Assessment Tool (2018 version) will be employed to evaluate study quality. The convergent integrated approach and thematic synthesis will be used to synthesise and map extracted data to the social ecological model. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach will be used for the certainty assessment of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required for this systematic review, as it will use data extracted exclusively from published studies and other publicly available sources. The findings of this review will be disseminated through publication in a peer-reviewed journal and presentation at relevant academic and clinical conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420261366175.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121457","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:05:52Z","timestamp":1785758752000},"page":"e121457","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unmet needs for stroke patients based on the social ecological model: protocol for a mixed-methods systematic review"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3213-9221","authenticated-orcid":false,"given":"Haibo","family":"Xu","sequence":"first","affiliation":[{"name":"Neurology Department, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"He","sequence":"additional","affiliation":[{"name":"Neurology Department, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjue","family":"Wei","sequence":"additional","affiliation":[{"name":"Neurology Department, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Nursing, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026080305052698000_16.8.e121457.1","first-page":"973","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"23","year":"2021","journal-title":"Lancet Neurol"},{"key":"2026080305052698000_16.8.e121457.2","first-page":"1873","article-title":"Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023","volume":"406","year":"2023","journal-title":"Lancet"},{"key":"2026080305052698000_16.8.e121457.3","doi-asserted-by":"crossref","first-page":"3377","DOI":"10.1080\/09638288.2020.1743775","article-title":"The experience of upper-limb dysfunction after stroke: a phenomenological study","volume":"43","author":"Purton","year":"2021","journal-title":"Disabil Rehabil"},{"key":"2026080305052698000_16.8.e121457.4","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2282"},{"key":"2026080305052698000_16.8.e121457.5","doi-asserted-by":"crossref","DOI":"10.3390\/jcm14217735","article-title":"Cognitive Impairment and Psychological Morbidity Among Stroke Survivors in Rehabilitation: A Cross-Sectional Analysis","volume":"14","author":"Bumbea","year":"2025","journal-title":"J Clin Med"},{"key":"2026080305052698000_16.8.e121457.6","doi-asserted-by":"crossref","DOI":"10.1007\/s00415-026-13782-5","article-title":"Influence of preexisting cognitive impairment and comorbidities on post-stroke outcomes: Dijon Stroke Registry","volume":"273","author":"Kassir","year":"2026","journal-title":"J Neurol"},{"key":"2026080305052698000_16.8.e121457.7","doi-asserted-by":"crossref","unstructured":"Poostchi AJ , Collett G , Gupta AK . 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