Factors influencing health behaviour, blood pressure control, and disability in hypertensive ischaemic stroke patients after a comprehensive reminder intervention

Abstract

Aims:To test prospective pathways of a Comprehensive Reminder System based on the Health Belief Model (CRS-HBM), stroke knowledge, health belief in health behaviour, blood pressure (BP) control, and disability in hypertensive ischaemic stroke patients at 6-month postdischarge.Design: A nested cohort study design. Methods: Data were derived from a randomized controlled trial evaluating the effects of the intervention (N = 174, performed during February 2015 -March 2016). Data were collected by questionnaires and analysed in structural equation modelling in Mplus software. Results: The proposed model provided a good fit to the data. This model accounted for 51.5% of the variance in health behaviour, 34.1% in BP control, and 5.7% in modified Rankin Scale score at 6-month postdischarge. The CRS-HBM had: (a) direct positive effect (β = .391, p < .001) and indirect positive effects (β = .186, p = .002) on health behaviour; (b) direct positive effect (β = .356, p < .001) and indirect positive effects (β = .183, p = .009) on BP control; and (c) indirect negative effect (β = −.146, p = .008) on disability. Being female was linked to better health behaviour. Higher education predicted higher level of stroke knowledge and health belief. Conclusions:The CRS-HBM can not only directly but also indirectly improve patients' health behaviours by improving their health knowledge or health belief. Better health behaviour can improve patients' BP control and reduce disability. Therefore, nurses need to pay more attention to not only patients' health knowledge but also their health belief when providing education. Impact:The CRS-HBM intervention accounted for 51.5% of variance in health behaviour, 34.1% in BP control, and 5.7% in modified Rankin Scale score at 6-month postdischarge. This research can help nurses improve health education strategies in postdischarge and community contexts to achieve better health results. | 1385ZHANG et Al.

Association between chronic illness resources and health behaviors in hypertensive stroke patients at 6 months after discharge: a cross-sectional study

“…In this study, patients with a high-school education or higher had better health behaviors than those with an elementary-school education. Our results are consistent with the findings of a previous study on stroke patients (24). A high level of education helps people to increase their health knowledge and master more health skills, and thus promotes healthy behaviors (25).…”

Determinants influencing health-promoting behaviors in individuals at high risks of stroke: a cross-sectional study

“…In addition, health beliefs were directly associated with health behavior. The finding is consistent with previous studies ( 55 , 56 ). According to the health beliefs model (HBM), one of the well-known theories of health behavior, beliefs in health risk predict the likelihood of engaging in health behavior ( 57 , 58 ).…”

Effectiveness of health management among individuals at high risk of stroke: An intervention study based on the health ecology model and self-determination theory (HEM-SDT)

“…Health belief is the driving force for healthy behavior change and the most direct influencing factor for health behavior improvement [ 34 ]. The intervention group's health management motivation was continuously generated and strengthened, and their health beliefs were greatly improved, which was consistent with the result of other researchers [ 35 , 36 ]. Compared to the results of the Meng Yao Wang's study [ 37 ], health behaviors of high-risk for stroke groups have been greatly improved after the intervention in this study.…”