Effect of Self-efficacy, Disease Perception, Social Support, Anxiety, and Depression on Self-management in Young Patients With Stroke.

Rongfang Zhang, Xiaojing Li, Huanli Luo, Jiangtao Niu, Huimin Zhang
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Abstract

Abstract: BACKGROUND: Better self-management of chronic diseases may benefit patient functional status, medication effectiveness, lifestyle, and psychosocial health. Self-efficacy, disease perception, social support, anxiety, and depression are determinants of self-management behaviors in individuals with chronic illnesses. There remains a gap in the empirical exploration of the influence of these factors on self-management behaviors in young Chinese stroke survivors. This study examined how these factors affect specific self-management behaviors. METHODS: Validated instruments were used to evaluate patient self-efficacy, disease perception, social support, anxiety, and depression in a cross-sectional study. Structural equation modeling was used to examine the hypothesis. RESULTS: Self-efficacy and social support showed a positive correlation with self-management (0.421 and 0.446, respectively; P < .001). Disease perception, anxiety, and depression were negatively correlated with self-management (-0.158 and -0.336, respectively; P < .05). The structural equation model fit the data very well; social support had a direct positive effect on self-management (t = 3.002, P < .05) and self-efficacy (t = 5.773, P < .001). However, the presence of social support had a positive impact on reducing anxiety and depression (t = -5.046, P < .001). Furthermore, self-efficacy positively affected self-management (t = 1.226, P < .05), whereas anxiety and depression (t = -1.190, P < .05) and disease perception (t = -1.068, P < .05) had adverse effects on self-management. CONCLUSION: Medical staff and caregivers can improve patient self-management by helping them recognize the disease, reducing negative perceptions, communicating more for better understanding and care, intervening in anxiety and depression, and promoting mental health. This is especially important for young stroke patients.

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自我效能感、疾病感知、社会支持、焦虑和抑郁对年轻脑卒中患者自我管理的影响
摘要:背景:更好的慢性疾病自我管理可能有利于患者的功能状态、药物有效性、生活方式和心理健康。自我效能、疾病感知、社会支持、焦虑和抑郁是慢性疾病患者自我管理行为的决定因素。这些因素对中国年轻脑卒中幸存者自我管理行为影响的实证研究仍存在空白。本研究考察了这些因素如何影响具体的自我管理行为。方法:在一项横断面研究中,使用经过验证的工具来评估患者的自我效能感、疾病感知、社会支持、焦虑和抑郁。采用结构方程模型对假设进行检验。结果:自我效能感、社会支持与自我管理呈正相关(分别为0.421、0.446);P < 0.001)。疾病感知、焦虑和抑郁与自我管理呈负相关(分别为-0.158和-0.336;P < 0.05)。结构方程模型能很好地拟合数据;社会支持对自我管理(t = 3.002, P < 0.05)和自我效能感(t = 5.773, P < 0.001)有直接的正向影响。然而,社会支持的存在对减少焦虑和抑郁有积极影响(t = -5.046, P < .001)。自我效能感对自我管理有正向影响(t = 1.226, P < 0.05),而焦虑、抑郁(t = -1.190, P < 0.05)和疾病认知(t = -1.068, P < 0.05)对自我管理有负面影响。结论:医护人员和护理人员可以通过帮助患者认识疾病、减少负面认知、加强沟通以获得更好的理解和护理、干预焦虑和抑郁、促进心理健康来改善患者的自我管理。这对年轻的中风患者尤其重要。
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