中风患者的中风知识、健康信息素养与健康自我管理之间的关系：多中心横断面研究

Relationship Between Stroke Knowledge, Health Information Literacy, and Health Self- Management Among Patients with Stroke: Multicenter Cross-Sectional Study.

作者信息

Zeng Mengxue, Liu Yanhua, He Ying, Huang Wenxia

机构信息

West China School of Nursing, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, China.

Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, China, 86 13980589954.

出版信息

JMIR Med Inform. 2025 Jun 23;13:e63956. doi: 10.2196/63956.

DOI:10.2196/63956

PMID:40549967

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12208508/

Abstract

BACKGROUND

The World Health Organization highlights the essential role of effective self-management in the prevention and control of chronic diseases, noting that proper self-management can significantly slow disease progression. Stroke, which ranks as the third leading cause of death worldwide, is often accompanied by inadequate self-management among patients. While health information literacy (HIL) has been shown to influence self-management in conditions such as diabetes and hypertension, its role as a mediating factor linking disease perception and health behavior in patients with stroke remains insufficiently explored. Addressing this research gap is vital for developing targeted interventions.

OBJECTIVE

The aim of this study was to investigate the current status of HIL, stroke knowledge, and self-management abilities among patients with stroke in Southwest China. Additionally, the study analyzed the relationships among these three factors and their mechanisms of action, providing evidence to inform the development of effective health education strategies for enhancing self-management in patients with stroke.

METHODS

A multicenter cross-sectional design was employed, enrolling 514 patients with stroke from the neurology departments of three tertiary general hospitals in Chengdu between September 2022 and March 2023. Data collection used a standardized set of scales: the health information literacy questionnaire for stroke assessed HIL, the stroke prevention questionnaire evaluated knowledge levels, and the stroke self-management assessment scale measured self-management abilities. Regression analysis and bootstrap mediation effect testing were conducted using SPSS software (version 26.0).

RESULTS

Patients with stroke had a mean (SD) score of 17.61 (6.46) for stroke knowledge, 61.17 (13.58) for HIL, and 158.70 (19.07) for self-management skills. Correlation analysis indicated a positive correlation of stroke knowledge with both self-management (r=0.668; P<.001) and HIL (r=0.138; P<.001). The mediation test showed a significant mediating effect of HIL between stroke knowledge and self-management (β=0.543; 95% CI: 0.431-0.663), with an effect share of 82.77%.

CONCLUSIONS

There is a correlation between HIL and self-management; the higher the HIL, the better is the self-management behavior. Furthermore, HIL partially mediates the effect of stroke knowledge on self-management.

摘要

背景

世界卫生组织强调有效自我管理在慢性病预防和控制中的重要作用，指出适当的自我管理可显著减缓疾病进展。中风是全球第三大致死原因，患者往往存在自我管理不足的情况。虽然健康信息素养（HIL）已被证明会影响糖尿病和高血压等疾病的自我管理，但其作为中风患者疾病认知与健康行为之间中介因素的作用仍未得到充分探索。填补这一研究空白对于制定针对性干预措施至关重要。

目的

本研究旨在调查中国西南部中风患者的健康信息素养、中风知识和自我管理能力现状。此外，该研究分析了这三个因素之间的关系及其作用机制，为制定有效的健康教育策略以增强中风患者自我管理提供依据。

方法

采用多中心横断面设计，于2022年9月至2023年3月从成都三家三级综合医院神经内科招募514例中风患者。数据收集使用一套标准化量表：中风健康信息素养问卷评估健康信息素养，中风预防问卷评估知识水平，中风自我管理评估量表测量自我管理能力。使用SPSS软件（版本26.0）进行回归分析和Bootstrap中介效应检验。

结果

中风患者的中风知识平均（标准差）得分为17.61（6.46），健康信息素养得分为61.17（13.58），自我管理技能得分为158.70（19.07）。相关性分析表明，中风知识与自我管理（r = 0.668；P <.001）和健康信息素养（r = 0.138；P <.001）均呈正相关。中介检验显示，健康信息素养在中风知识和自我管理之间具有显著中介效应（β = 0.543；95%CI：0.431 - 0.663），效应占比为82.77%。