Background/Aim:
Stroke disproportionately affects people from culturally and linguistically diverse backgrounds, often resulting in poorer outcomes. While stroke guidelines are crucial for promoting evidence-based care, no previous research has explored the extent to which these guidelines include cultural recommendations to address disparities in stroke outcomes. The review aims to identify and quantify cultural recommendations within international stroke guidelines.
Methods:
A document review based on the framework established by Steinberg et al, 2011 was conducted. A Google search identified English-language stroke guidelines published in the last five years (June 2019 – May 2024). Paired reviewers independently screened records and extracted recommendations related to culture, and the third person resolved any discrepancies between the reviewers. The quality of stroke guidelines was assessed using the AGREE-II tool.
Results:
A total of twenty-four stroke guidelines were reviewed, predominantly from Western countries. Out of the 24 stroke guidelines analysed, three (12%) included culture-related recommendations. These recommendations were derived from evidence of moderate to low quality. There were 2,991 stroke guideline recommendations, of which only six (0.2%) addressed cultural considerations related to pre-hospital care, acute care, rehabilitation, and palliative care.
Conclusion:
About 88% of international stroke guidelines do not include cultural recommendations, which reflects few stroke guidelines include studies related to cultural consideration. Recognising and integrating culture in stroke guidelines are essential for delivering culturally safe, effective, and equitable healthcare to reduce disparities in stroke outcomes.