Dyadic capability in transitional stroke rehabilitation care: a conceptual framework

Background To understand long-term outcomes after stroke, careful assessment is needed of how survivors and their caregivers manage care needs in daily life. Nursing research has emphasized that professional support, training, and caregiver preparation are key elements of transitional care. The capability approach, developed by Amartya Sen, offers the perspective of focusing on real opportunities to act and thrive in their living environment, with a view to responding to ever-changing needs. However, capability has not yet been systematically conceptualised or assessed at the dyadic level in stroke care. Aim To develop a theory-driven conceptual framework of dyadic capability in stroke survivor–caregiver dyads, grounded in the Capability Approach, and to articulate its implications for nursing research and practice. Methods The Dyadic Capability Framework will be developed through an integrative, multi-phase approach combining theoretical analysis and empirical grounding. A systematic review and contextual analysis will provide the basis for an initial conceptualization of capability in the field of post-stroke care. The results will be further refined through qualitative research into experiences, identifying individual, contextual, and relational dimensions. The reference framework will guide the subsequent longitudinal study, including the development of theory-based measurement tools. Results Dyadic capability is expected to emerge as a dynamic, multidimensional construct arising from the interaction between stroke survivors and caregivers within their social and healthcare contexts. Although capability may manifest differently in each member of the dyad, their interdependence is expected to play a central role in adaptive functioning after stroke. Educational and supportive nursing interventions are anticipated to act as key enablers, facilitating the transformation of available resources and perceived preparedness into sustained adaptive action. Conclusions By shifting the focus from perceived readiness to real opportunities for adaptive care, this framework is expected to advance stroke nursing research and practice. It will provide a theoretically grounded foundation for assessing dyadic capability and for designing nursing interventions aimed at enhancing autonomy, participation, and quality of life in post-stroke survivor–caregiver dyads.