Sun Ning, Cui Xiaoli, Zhang Man, Zheng Xutong, Wang Xi, Song Di, Li Lingyu, Li Mengwen
Nursing Department of Shaanxi Provincial People's Hospital, West Youyi Road #256, Beilin District, Xi'an, China.
Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, China.
Sci Rep. 2025 May 23;15(1):17962. doi: 10.1038/s41598-025-02966-0.
Post-stroke self-management presents a challenge due to the multifaceted care needs and complex disabling consequences, hindering survivor engagement. This study aims to investigate the effects of a Trans-theoretical model-based Empowerment education on self-management behaviors, self-efficacy, and activities of daily living in young and middle-aged stroke survivors. A single-blind randomized controlled trial was conducted, dividing participants into a control group receiving conventional health education and an intervention group receiving a Trans-theoretical model-based Empowerment education. Outcome data were collected at baseline, 1 month, 3 months, and 6 months. Repeated measures ANOVA was used to assess changes in self-management behaviors, self-efficacy, and activities of daily living. A total of 101 young and middle-aged stroke survivors participated in the study. No significant differences were found between the intervention methods of the two groups in improving self-management behaviors (F = 0.608, P = 0.438). However, significant differences were observed in self-management behavior scores at different intervention time points (F = 77.048, P < 0.001), with an interaction effect between the intervention method and time factors (F = 19.714, P < 0.001). Simple effects analysis indicated that the intervention group scored significantly better in self-management behaviors at all time points compared to baseline (P < 0.05). Significant between-group differences in self-efficacy were observed between pre- and post-intervention periods (F = 3.993, P = 0.05). Additionally, within-group differences in self-efficacy scores across intervention time points demonstrated statistically significant variations (F = 5.900, P < 0.001). Significant differences in Barthel Index scores were observed between pre- and post-intervention periods (F = 7.893, P < 0.006). Additionally, The Barthel Index scores at different time points within the two groups showed statistically significant variations (F = 14.977, P < 0.001). The Trans-theoretical model-based Empowerment education improved self-management behaviors, enhanced self-efficacy, and increased daily activity living in young and middle-aged stroke survivors. These findings provide valuable insights for developing personalized intervention strategies and improving stroke survivor care protocols.
由于多方面的护理需求和复杂的致残后果，中风后的自我管理面临挑战，这阻碍了幸存者的参与。本研究旨在调查基于跨理论模型的赋权教育对年轻和中年中风幸存者自我管理行为、自我效能感和日常生活活动的影响。进行了一项单盲随机对照试验，将参与者分为接受常规健康教育的对照组和接受基于跨理论模型的赋权教育的干预组。在基线、1个月、3个月和6个月时收集结果数据。采用重复测量方差分析来评估自我管理行为、自我效能感和日常生活活动的变化。共有101名年轻和中年中风幸存者参与了该研究。两组的干预方法在改善自我管理行为方面没有显著差异（F = 0.608，P = 0.438）。然而，在不同干预时间点的自我管理行为得分上观察到显著差异（F = 77.048，P < 0.001），干预方法和时间因素之间存在交互作用（F = 19.714，P < 0.001）。简单效应分析表明，与基线相比，干预组在所有时间点的自我管理行为得分均显著更高（P < 0.05）。干预前后自我效能感存在显著的组间差异（F = 3.993，P = 0.05）。此外，干预时间点之间自我效能感得分的组内差异显示出统计学上的显著变化（F = 5.900，P < 0.001）。干预前后Barthel指数得分存在显著差异（F = 7.893，P < 0.006）。此外，两组内不同时间点的Barthel指数得分显示出统计学上的显著变化（F = 14.977，P < 0.001）。基于跨理论模型的赋权教育改善了年轻和中年中风幸存者的自我管理行为，增强了自我效能感，并增加了日常生活活动。这些发现为制定个性化干预策略和改进中风幸存者护理方案提供了有价值的见解。
