Research On Self-management Status And Influencing Factors Of First-episode Stroke Patients

ObjectiveThe purpose of this study was to investigate the status of self-management behavior,stroke knowledge,anxiety,depression,self-efficacy,and social support in patients with first-episode stroke,and explore related factors that affect the self-management behavior of patients with stroke.MethodsThis study used a convenient sampling method,and selected 243 patients with first-episode stroke who were seen at a certain top-three hospital in Beijing from October 2016 to September 2017.The demographic questionnaire,self-management behavior scale,stroke knowledge questionnaire,self-rating anxiety scale(SAS),self-rating depression scale(SDS),chronic self-efficacy scale and social support rating questionnaire were used to investigate.To compare the self-management behaviors of first-episode stroke patients with different demographic characteristics by T-Test and ANOVA,the relation of self management behaviors with the level of knowledge,anxiety,depression,and self efficacy scale and social support was analyzed by Pearson correlation,and the influencing factors model of self-management behaviors was structured by multiple linear regression analysis.Results1.The status of index scores in first-episode stroke patients(1)Current status of self-management behaviors in first-episode stroke patientsThe total score of self-manaement behaviors was 164.38±24.45,and with index score of 65.75%.The dimension of emotional,social function and interpersonal management and safe medication management had better scores,on the contrary,the dimension of rehabilitation exercise and disease management had lower scores.From the distribution of grades,there were 17 cases of good self-management behavior,162 cases of moderate and 64 cases of poor.(2)Status of the knowledge in first-episode stroke patientsThe score of stroke knowledge was 27.08±7.68,and with index score of 75.22%,which was at a moderate level.All dimensions of knowledge are ranked from high to low were diet,daily life,exercise,blood pressure monitoring,risk factors,stroke symptoms,medication and stroke treatment.(3)Status of anxiety and depression in first-episode stroke patientsThe average score of anxiety in 243 patients was 44.20±9.74,and there were 62 patients with different degree of anxiety,accouned for 25.5%,the average score of depression was 48.59±10.80,and 89 patients have different degrees of depression,accounted for 36.6%.(4)Self-efficacy of first-episode stroke patientsThe results of this study showed that the average score of the self-efficacy items of 243 stroke patients was 7.31±2.21,and the average score of symptoms management self-efficacy was 7.29±2.35,the general management self-efficacy was 7.34± 2.39.According to the division standard,147 cases were in the high level,61 were in the middle level,and 35 cases were at the low level.(5)Social support status of first-episode stroke patientsThe total score of social support was 41.10± 7.63,the objective support dimension was 9.12±3.00,the subjective support dimension was 24.57±5.14,and the utilization of the support was 7.41±2.20.Thereinto,the subjective support dimension was slightly higher than the domestic norm,and the other two dimensions were lower than domestic norm,and the difference was statistically significant(P<0.05).2.Influencing factors of self management behavior in first-episode stroke patients.The results of univariate analysis showed that there were significant differences in the self-management behaviors of patients in different cultural levels,occupations,family average monthly income,smoking status,and place of residence(P<0.05).Pearson correlation analysis showed that the self-management behavior of stroke patients was positively correlated with stroke knowledge,self-efficacy,and social support,and was negatively correlated with anxiety and depression.Multiple linear regression analysis showed that stroke knowledge,depression,self-efficacy,smoking status,and place of residence were the main influencing factors of first-episode stroke self-management behavior.Conclusions1.The majority of patients with first-episode stroke have a moderate level of self-management behavior and still need to be further improved.2.Stroke knowledge,depression,self-efficacy,smoking behavior,and place of residence are all factors influencing self-management behavior.The higher the level of knowledge and self-efficacy,the better the self-management behavior,and the presence of depression,rural living or smoking patients,the self-management behavior was relatively poor.3.It is suggest that medical personnel should pay attention to the different features of patients,and provide targeted interventions for first-episode stroke patients to help them develop good health behaviors so as to promote disease recovery and reduce recurrence.