Research On Self-management Behavior Of High-risk Groups Of Stroke In Community Based On Information-motivation-behavioral Skill Model

Background: With the acceleration of the aging process,the unhealthy lifestyle of residents is widespread,and the risk factors of stroke are generally exposed.The overall incidence of stroke in China is on the rise,and the economic burden of stroke is serious.As an important strategy for primary prevention,self-management is very important for the primary prevention of stroke high-risk groups.The information-motivation-behavioral skills(IMB)model has been widely verified as a theoretical model to explain the behavior of chronic diseases.Therefore,this study takes the IMB model as the theoretical basis and uses Structural Equation Modeling(SEM)for verification and analysis to find out Influencing factors of the self-management behavior of high-risk groups of stroke and analysis of the interaction among various factors,exploring comprehensive intervention measures based on information,motivation,and behavioral skills suitable for the transformation of self-management behavior of high-risk groups of stroke.The level of self-management provides a basis for community medical staff to carry out stroke prevention and management.Objective: This study aims to understand the current situation of self-management of high-risk groups of stroke in the community,use the information-motivation-behavioral skills model,identify the predictors of self-management behaviors of high-risk groups of stroke in the community,and test the relationship between demographic variables,IMB and self-management behavior Relevance,development and validation of a self-management predictive model based on the information-motivation-behavioral skills model in community-based stroke risk populations.Methods:This study adopts a multi-stage sampling method.First,Shushan District and Yaohai District are conveniently selected from the six districts of Hefei City,and then Sanli’an Community Health Service Center and Nangang Community Health Service Center are conveniently selected in Shushan District,and Hongguang Street is conveniently selected in Yaohai District.The Community Health Service Center and Wuhu Road Community Health Service Center were used as the survey sites to carry out questionnaire surveys on community residents who went to community outpatient clinics and contracted for medical examinations and met the inclusion and exclusion criteria.A total of 324 valid questionnaires were collected in this study.SPSS25.0 and AMOS25.0 were used for data analysis.Results(1)The overall reliability of all the scales designed based on the IMB model in this study is above 0.7,the KMO test index is greater than 0.7,the average P of the Bartlett spherical test is less than 0.001,and the cumulative principal factor explains69.637% of the total variation.(2)Among the 324 subjects investigated in this study,there were 149 males(46.00%)and 175 females(54.00%),aged between 36-93 years old,with an average age of(71.74±7.93)years old.The two age groups of 60-69 and 70-79 are the main groups,accounting for 30.80% and 44.30% respectively.The marital status of the research objects is mainly married,accounting for 87.70%,the education level is mainly primary school and below,accounting for 64.80%,and the education level of 75 people is junior high school,accounting for 22.80%.Because the respondents are older,their occupation types are mainly retirees,unemployed and farmers.210 are retirees,accounting for 63.7%,and 77 are unemployed,accounting for 23.80%.From the perspective of per capita monthly household income,53.70% of the households have a per capita monthly income of ≤2,000 yuan,and 46.30% of residents have an income above 2,000 yuan,mainly between 2,001 and 4,000 yuan.(3)In this study,the total score of the information factor part,namely the stroke prevention knowledge scale,ranged from 0 to 27 points,with an average score of16.56±6.33.Motivation is divided into two parts,of which the total score of the individual motivation part,namely stroke prevention attitude scale,ranges from 28 to50 points,with an average score of 40.23±4.66.The total score of the social motivation part,that is,the social support scale,ranges from 21 to 62 points,with an average score of 38.95±6.68,and the total score of the chronic self-efficacy scale corresponding to the behavior skills part ranges from 3 to 10 points,with an average score of 7.36±6.1.22.The total score of self-management behavior of high-risk groups of stroke ranged from 82 to 144 points,with an average score of 113.68±11.95.(4)This study designs an initial model based on the IMB model,and then fits the model according to the fitness index and correction index to obtain the final model.The fitting index is: =3.048,GFI= 0.856,CFI=0.879,RMSEA=0.080.(5)In the final model,the direct effect of information on self-management behavior is0.750;the direct effect of personal motivation on behavioral skills is 0.439,the direct effect of social motivation on behavioral skills is 0.222;the direct effect of behavioral skills on self-management behavior is 0.329.Conclusions(1)All the scales used in this study based on the IMB model were modified and adjusted based on the existing literature scales,combined with the consensus opinions of neurology and other experts,and the scales were found to have good reliability and effectiveness degree,and thus accurately reflect the information that this study seeks to investigate.(2)In the two communities investigated in this study,the self-management behaviors of stroke high-risk groups are relatively good,among which the medication management dimension has the highest score and self-management is good,while other dimension management behaviors still need to be improved.(3)In this study,there are significant differences in the self-management behaviors of high-risk groups of stroke in communities with different genders,education levels,occupation types,and family per capita monthly income.Females,high-educated,high-income,and retirees Facilitating factors of self-management behavior among high-risk groups of stroke in community.(4)In the two communities investigated in this study,the high-risk groups of stroke have a moderate level of stroke-related prevention knowledge,and their knowledge of stroke warning signs is relatively low.(5)In the two communities investigated in this study,the high-risk stroke population has a relatively high level of prevention attitude,and their social support performance is relatively average.(6)In the two communities investigated in this study,the self-efficacy for stroke prevention among high-risk stroke groups is relatively high.(7)Through the test of the structural equation model,the IMB model is suitable for the research on the self-management behavior of high-risk stroke groups in the community.Information directly affects self-management behavior,personal motivation and social motivation directly affect behavioral skills,and indirectly affect self-management through behavioral skills Behavior and behavioral skills directly affect prescription behavior,and the effects are all positive.