The Risk Factors of Self-Management Behavior among Chinese Stroke Patients

Abstract

Background. Stroke is associated with a high number of disability-adjusted life years globally, so long-term care is necessary and important for those survivors, so self-management is becoming a more significant concept in stroke rehabilitation. Methods. Ischemic stroke patients (n = 354) were enrolled from the outpatient department of Neurology in West China Hospital from September 2018 to December 2019. The general demographic and disease-related data of stroke patients were collected. The stroke self-efficacy questionnaire (SSEQ), the brief cognition questionnaire (BIPQ), and the stroke self-management scale (SSMS) were used to collect data on self-efficacy, disease cognition, and self-management behavior separately. The chi-square test, Fisher exact test, independent sample t-test, and Mann–Whitney U test were used for comparison among groups. The logistic regression analysis was used to explore the independent risk factors of the different levels of self-management behavior in stroke patients. Results. The score of self-management among Chinese stroke patients was 151.07 ± 18.53. Multivariate analysis showed that the way of paying medical expenses (OR = 3.215, 95% CI (1.130, 7.769)), self-management efficacy (OR = 2.467, 95% CI (1.534, 3.968)), health education before discharge (OR = 2.354, 95% CI (1.457, 3.802)), age (elder) (OR = 2.060, 95% CI (1.265, 3.355)), educational level (OR = 1.869, 95% CI (1.169, 2.988)), and mRS score (OR = 1.850, 95% CI (1.129, 3.031)) were statistically significant ( P < 0.05 ). Conclusions. The self-management behavior of Chinese stroke patients was at the middle level. Patients with medical insurance, high self-efficiency of management, and better limb function may have better self-management behavior. Besides, patients with a high educational level who accept health education before discharge may also have better self-management behavior. For patients, it is important to know this disease in the right way and set up the faith to take care of themselves independently gradually. For medical staff, it is necessary and important to give all patients health education about self-management before discharge. It is urgent to call for attention to this disease, and the government and all of society should give more support to stroke patients.

Preference for primary care in Chinese homebound patients

“…Regarding the factors associated with preferences for PHC, our research reveals that homebound patients, who had received inpatient care in the past year, in both rural and urban areas, were less likely to opt for PHC. Homebound patients tend to prefer higher-level hospitals with more medical resources, likely due to poor post-discharge self-management behavior and inadequate monitoring after discharge [ 34 – 35 ], resulting in serious health problems, as evidenced by previous studies [ 34 – 35 ]. This finding has significant implications for clinical and policy practices.…”

Factors associated with self-management behaviors among Chinese adults with ischemic stroke: A cross-sectional study

“…In a study of SM in kidney transplant patients, researchers found that SM increased with age (Xie et al, 2019 ). In addition, one study in China found that the SM of stroke patients tended to improve with age (Shuqi et al, 2023 ). Therefore, compared with the previous studies in China, the higher SM score in this study might be due to differences in the ages of the sample population.…”

Individual and health care provider factors influencing stroke self-management behavior: A cross-sectional study

“…Globally, there is a growing tendency for stroke to occur at younger ages, as approximately 30%-50% of all patients with stroke are under 65 years old (Ren et al 2020). The results of the present Owing to the concurrent demands of employment and familial obligations among their peers, the youthful demographic has challenges in committing to extended rehabilitation (Shuqi et al 2023). As young individuals with longevity and life expectancy following a stroke may consider returning to society more, adult patients have better selfmanagement than older ones.…”

“…This behavior consequently poses a heightened risk of experiencing subsequent strokes. The inadequate self-management behavior exhibited by patients with stroke can be attributed to several factors, including individual-related factors, such as age, gender, and residence (Shuqi et al 2023;Sun et al 2022), and health service provider factors, including limited information availability, restricted access to healthcare services, inadequate availability of health facilities (Harfika and Abdullah 2017), and suboptimal collaboration among healthcare professionals (Busari, Moll, and Duits 2017). Health services is defined by the World Health Organization (WHO) as "service delivery systems that are accountable for providing health services to patients, individuals, families, communities, and populations in general, not just patients" (WHO 2023).…”

“…The adoption of self-management behavior has been proposed as a crucial approach that empowers individuals to mitigate their future susceptibility to stroke (Kim et al 2023). A study by Shuqi et al (2023) indicated that self-management behavior in patients with stroke is influenced by internal variables, including insurance, limb function, and self-efficacy. This study aimed to investigate the correlation between external characteristics associated with health service providers and self-management behavior.…”