The psychosocial impacts of having eating and drinking difficulties after stroke: a qualitative evidence synthesis

PURPOSE: Eating and drinking difficulties after stroke extend beyond physical impairment, affecting emotional well-being and social participation. This review explored the psychosocial impacts of these difficulties from the perspectives of stroke survivors, informal carers, and healthcare professionals. MATERIAL AND METHODS: Following PRISMA guidelines and informed by the ENTREQ framework, a systematic search of eight databases (1990-2025) was conducted. A thematic synthesis was used to examine psychosocial experiences. RESULTS: A total of 1,419 records were identified. After screening and critical appraisal, 22 studies involving 645 informants were included. Two overarching domains were identified: psychological and social impacts. Psychologically, eating and drinking difficulties were experienced as a profound loss, not only of physical function but also of identity, routine, and sensory enjoyment. Survivors described intense fear and panic, especially around choking and aspiration. These were compounded by embarrassment, shame, and humiliation, particularly in social settings. Socially, participants reported self-imposed isolation, avoiding meals due to discomfort or fear of judgement. Nonetheless, many expressed a strong desire to re-engage in social dining and restore normality. CONCLUSIONS: Eating and drinking difficulties after stroke affect psychological well-being and social identity. Recovery must go beyond physical rehabilitation to address emotional and relational dimensions, supporting meaningful participation.