Cheng Jingxia, Jiang Xiaolian, Liao Xi, Zhou Lili, Qin Li, Liu Hongying
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, China.
Front Med (Lausanne). 2025 May 20;12:1598945. doi: 10.3389/fmed.2025.1598945. eCollection 2025.
Stroke often leads to functional impairment in patients and carries a risk of recurrence. Therefore, it is crucial for post-stroke patients to proactively pursue self-management behaviors that foster functional recovery and prevent recurrent strokes, such as keeping a balanced diet or exercising. The implementation of self-management behaviors requires the combined influence of internal and external factors, which have not been fully explored. This study aimed to investigate the level of self-management behaviors in post-stroke patients and to explore the impact of chronic illness resources, fear of recurrence, hope, and health locus of control on these behaviors.
A cross-sectional study was conducted among 262 post-stroke patients from a tertiary hospital in Sichuan, China. The scores of the Self-management Behavior Scale for Post-stroke patients, the Chronic Illness Resource Scale, the Fear of Recurrence Inventory Short Form, the Herth Hope Index, and the Multidimensional Health Locus of Control were collected. Multiple linear regression was ultimately used to determine the predictors of self-management behaviors.
The mean score of the Self-management Behavior Scale for Post-stroke patients was 92.23 ± 14.61, with the item mean score of 3.55 ± 0.56. Approximately 56.2% of the variation in self-management behaviors in post-stroke patients could be explained by educational level (β = 0.222, < 0.001), rehabilitation training (β = 0.444, < 0.001), physician/health care team resources (β = 0.139, = 0.007), family and friends resources (β = 0.160, = 0.003), personal resources (β = 0.182, = 0.002), fear of recurrence (β = -0.145, = 0.001), internal locus of control (β = 0.181, < 0.001), and chance health locus of control (β = -0.141, = 0.004).
The self-management of post-stroke patients was moderate, with emotional management and utilization of resources being the weaknesses. Patients' coping abilities, the establishment of a positive psychological locus of control, and the development of a realistic yet constructive recurrence risk perception were beneficial for their self-management. In addition, professional rehabilitation treatment and enhanced support from chronic illness resources such as medical staff and family and friends were also important.
中风常导致患者功能受损，并伴有复发风险。因此，对于中风后患者而言，积极采取促进功能恢复和预防中风复发的自我管理行为至关重要，例如保持均衡饮食或进行锻炼。自我管理行为的实施需要内部和外部因素的共同影响，而这方面尚未得到充分探索。本研究旨在调查中风后患者的自我管理行为水平，并探讨慢性病资源、复发恐惧、希望以及健康控制点对这些行为的影响。
对来自中国四川一家三级医院的262名中风后患者进行了横断面研究。收集了中风后患者自我管理行为量表、慢性病资源量表、复发恐惧简表、赫思希望指数和多维健康控制点的得分。最终采用多元线性回归来确定自我管理行为的预测因素。
中风后患者自我管理行为量表的平均得分为92.23±14.61，项目平均得分为3.55±0.56。中风后患者自我管理行为中约56.2%的变异可由教育程度（β=0.222，<0.001）、康复训练（β=0.444，<0.001）、医生/医疗团队资源（β=0.139，=0.007）、家人和朋友资源（β=0.160，=0.003）、个人资源（β=0.182，=0.002）、复发恐惧（β=-0.145，=0.001）、内控点（β=0.181，<0.001）和机遇健康控制点（β=-0.141，=0.004）来解释。
中风后患者的自我管理处于中等水平，情绪管理和资源利用是薄弱环节。患者的应对能力、建立积极的心理控制点以及形成现实而建设性的复发风险认知对其自我管理有益。此外，专业的康复治疗以及来自医护人员和家人朋友等慢性病资源的强化支持也很重要。
