Stroke is a common and frequently occurring disorder of the nervous system that may lead to a variety of neurological deficits that may affect walking, communication, and other activities of daily living.1 Stroke remains a common and burdensome condition despite numerous advances in its prevention and management.2 It was the second leading cause of death and the third leading cause of death and disability combined worldwide in 2019.3 In clinical practice, nearly 70 % of stroke survivors have cognitive impairment, approximately 20–25 % of stroke survivors have anxiety, and up to 30 % of stroke survivors suffer from depression.4,5 In order to solve this serious problem, stroke rehabilitation is necessary to improve the cognitive and mental disorders of stroke survivors and prolong their survival time.6

Recovery from stroke after discharge is a major challenge for survivors.7 With an estimated 33–42 % of patients still requiring daily living assistance six years after stroke and 36 % of patients still disabled five years after stroke, community stroke rehabilitation should be a major component of health service delivery to maximize the quality of life.2 At present, with fewer stroke hospital stays, most of the continuing care and rehabilitation of stroke survivors is in the community.8

Community nursing has the advantages of being rational and scientific, and could provide stroke survivors with rational and scientific guidance on rehabilitation, including guidance on diet, medication, mobility, sleep and psychology.9 Since stroke survivors lack the expertise and skills for stroke rehabilitation, it is necessary to provide them with community nursing. And its purpose is to improve the prognosis, quality of recovery, and the quality of life for patients.

A randomized clinical trial (RCT) highlighted the importance of developing community nursing and recommended the development of vertical and holistic care, including usual care (disease related information, food/nutrition, pharmaceutical care, mobility, bed placement) and vertical family visits (verbal orientation, practical demonstrations of care activities, written information provided).10 Another RCT study suggested that family-centered empowerment program(FCEP) implemented by nurses can improve the quality of life for stroke survivors.11 However, a Dutch study showed that a comprehensive multidisciplinary rehabilitation program had no effect on activity levels in frail elderly stroke patients.12 Hence, the effectiveness of different community nursing measures for stroke survivors during recovery remains to be validated.

Moreover, there are few studies evaluating the effects of community care in stroke rehabilitation, and there is a sparse systematic review of the field. Sauvé-Schenk K et al. conducted a review of social service and community resource interventions following stroke. Although the results indicated some benefits to providing information or support for access to social services and community resources, the impact of specific interventions on stroke survivors was not analyzed.13 The review by Graven C et al. demonstrated that rehabilitation interventions can reduce symptoms of depression, but lacked the ability to summarize the effects of rehabilitation measures on anxiety symptoms.14 Magwood GS et al. reviewed community-based interventions for stroke provided by nurses and community health workers, showing that community interventions can be used to improve stroke outcomes globally. However, this study did not further investigate what stroke outcomes were changed by the community interventions.15

Therefore, this meta-analysis study aimed to systematically sorted out community nursing measures, analyzed the impact of community nursing on activities of daily living, motor function, nerve function, anxiety and depression for stroke survivors, and provide guidance for the development of community nursing for stroke survivors.