Assessing stroke survivors' knowledge: a scoping review of tools and influencing factors.

Background: Stroke survivors' knowledge of their condition is essential for self-management and adherence to secondary prevention strategies. However, current methods for assessing stroke knowledge are not consistent. This scoping review aimed to review existing assessment tools, evaluate their characteristics, and identify factors associated with stroke knowledge to inform the development of more effective, patient-centred educational strategies.

Review design and methods: A scoping review was conducted to evaluate existing methods used to assess stroke knowledge and the factors influencing patients' knowledge among stroke survivors. Systematic searches of PubMed, Cochrane, and CINAHL were performed from inception to June 2025. Studies assessing stroke survivors' knowledge were included. Data were extracted on tool characteristics, assessed themes, administration methods, readability, validation, and knowledge-associated factors. Findings were qualitatively synthesised.

Results: Thirty-nine studies were included. Most studies assessed mixed cohorts of ischaemic, haemorrhagic, and TIAs. Stroke symptoms and risk factors were the most frequently assessed themes, while rehabilitation, medications, and lifestyle behaviours were less explored. Tools were primarily self-administered questionnaires, typically completed in under 15 min, but often lacked standardised cut-off values and demonstrated limited reporting of development processes. Factors positively associated with knowledge included higher education, younger age, and healthier lifestyles.

Conclusion: Existing assessments of stroke survivors' knowledge have considerable variability, limited validation, and inconsistent alignment with survivors' information needs. Developing standardised, validated, and patient-centred assessment tools that are tailored to stroke type and accessible across literacy levels is essential for advancing stroke education and supporting long-term recovery. These findings can inform policymakers in tailoring education efforts and designing interventions that directly address knowledge gaps across diverse stroke survivor populations. Future research should prioritise longitudinal evaluation of knowledge and its impact on clinical outcomes.