Health professionals’ barriers to oral care provision for patients with stroke from multidisciplinary perspectives: a qualitative meta-synthesis using the COM-B model and theoretical domains framework

BACKGROUND: Patients with stroke often have poor oral health due to functional impairments. Healthcare professionals play a crucial role in providing oral care, yet such care is frequently assigned low priority. Existing reviews primarily focus on the experiences of nurses in delivering oral care to patients with stroke. Few studies focus on multidisciplinary perspectives. This study aims to synthesize evidence on barriers faced by multidisciplinary healthcare professionals in providing oral care to patients with stroke, using the COM-B model and the Theoretical Domains Framework (TDF). METHODS: Six English databases (PubMed, Cochrane Library, Embase, Scopus, Web of Science, and CINAHL) were searched from their inception to July 1, 2025. The screening process followed the PRISMA guidelines. Study quality was assessed using the Critical Appraisal Skills Programme checklist. Data synthesis was guided by the thematic synthesis approach for qualitative research proposed by Thomas and Harden (2008). Confidence of synthesized findings was assessed using the GRADE-CERQual framework. RESULTS: The initial search identified 895 records retrieved from electronic databases. Nine studies were included in the review, which yielded a total of 7 summary findings. Health professionals’ barriers to oral care provision in patients with stroke included knowledge (Lack of knowledge and skills), skills (Lack of skills), environmental context and resources (lack of standardized guidelines and care planning, resource allocation defects), social influences (HCPs’ perceptions of patient characteristics), beliefs about capabilities (lack of confidence and risk concerns), social/professional role and identity (multidisciplinary role expectation conflicts). CONCLUSIONS: This review represents the first meta-synthesis to explore barriers to oral care provision for patients with stroke from the perspective of multidisciplinary HCPs, underscoring the need for multifaceted interventions to improve oral care practices. TRIAL REGISTRATION: PROSPERO [CRD420251088856].