Departments of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, P. R. China.
Psychol Health Med. 2024 Apr;29(4):778-790. doi: 10.1080/13548506.2023.2235739. Epub 2023 Jul 16.
Although the association between self-regulation of fatigue and health-related quality of life (HRQoL) has been confirmed, the potential mechanism remains unclear. This study aimed to explore the role of health literacy, health behavior, and exercise frequency in the relationship among middle-aged and elderly patients with recurrent stroke. A cross-sectional survey was conducted. A total of 176 patients completed the survey, in which self-regulation of fatigue, HRQoL, health literacy and health behavior were measured by questionnaires. Based on Bootstrap analyses, a moderating sequential mediation model using PROCESS software was constructed with health literacy and health behavior as mediators and exercise frequency as the moderator. Of the participants, the mean age was 65.44 ± 12.43 years. Self-regulation of fatigue was found to affect HRQoL indirectly through two significant mediation pathways: (1) health literacy (β=-0.11, 95%CI = -0.20, -0.03), which accounted for 28.79% of the total effect, and (2) health literacy and health behavior (β=-0.02, 95%CI = -0.05, -0.00), which accounted for 4.80% of the total effect. Exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Specifically, the interaction term between self-regulating fatigue and exercise frequency significantly predicted HRQoL (β = 0. 25, = 2.55, < 0.05). These findings highlight the role of health literacy and health behavior as sequential mediators of the relationship between self-regulating fatigue and HRQoL. Moreover, exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Encouraging patients with recurrent stroke to increase exercise frequency appropriately might improve HRQoL for patients with poor health literacy and health behavior.
虽然自我疲劳调节与健康相关生活质量（HRQoL）之间的关联已得到证实，但潜在机制仍不清楚。本研究旨在探讨健康素养、健康行为和运动频率在中年和老年复发性脑卒中患者中的作用。采用横断面调查。共 176 名患者完成了问卷调查，其中自我疲劳调节、HRQoL、健康素养和健康行为通过问卷进行测量。基于 Bootstrap 分析，使用 PROCESS 软件构建了一个包含健康素养和健康行为作为中介变量、运动频率作为调节变量的调节顺序中介模型。参与者的平均年龄为 65.44±12.43 岁。自我疲劳调节通过两条显著的中介途径间接影响 HRQoL：（1）健康素养（β=-0.11，95%CI=-0.20，-0.03），占总效应的 28.79%，（2）健康素养和健康行为（β=-0.02，95%CI=-0.05，-0.00），占总效应的 4.80%。运动频率调节了自我调节疲劳与 HRQoL 之间的关系。具体来说，自我调节疲劳与运动频率的交互项显著预测了 HRQoL（β=0.25，=2.55，<0.05）。这些发现强调了健康素养和健康行为作为自我调节疲劳与 HRQoL 之间关系的顺序中介的作用。此外，运动频率调节了自我调节疲劳与 HRQoL 之间的关系。鼓励复发性脑卒中患者适当增加运动频率可能会提高健康素养和健康行为较差的患者的 HRQoL。
