Path Analysis Of The Influence Factors Of Self-management Level In Young Stroke Patients

BackgroundAccording to the latest survey of World Stroke Organization(WSO),there are 16.9 million stroke patients every year in the world.It is estimated that there will be 23 million first stroke patients and 70 million stroke survivors in the world by 2030.Stroke has become the second leading cause of human death.The incidence rate of stroke in China is the first in the world.The incidence rate of stroke in young people is 4.4% to 15.9%,and the disability rate is about 75%.Young people hold the important responsibilities of individuals,families and society.But after stroke,patients can not live and work normally,and expensive treatment and rehabilitation costs will bring heavy burden to patients themselves,families and society.ObjectiveBy investigating the status quo of self-management of young stroke patients in North Henan province,the influencing factors of self-management of young stroke patients were analyzed,further explore the factors affecting the level of self-management of young stroke patients and their mechanism of action,clarify the path and intensity of influence factors on self-management and provide theoretical basis for clinical targeted intervention.MethodsA cross-sectional study was conducted on 230 young stroke patients who were hospitalized in four Grade III,Class A hospital in northern Henan Province.The self-management level,self-efficacy level,disease perceived degree,social support and anxiety and depression were investigated with The general situation questionnaire,Self-management behavior scale for young stroke patients,General self-efficacy scale,Brief illness perception questionnaire,Social support rating scale and Hospital anxiety and depression scale.All the data were entered into the software Epidata 3.1 and analyzed by SPSS 24.0.The influencing factors of self-management level of young stroke patients were analyzed by univariate analysis of variance and Pearson correlation analysis,and the structural equation model was constructed by R3.6.2 software,further analysis of the impact of self-management level of the variables between the action path and intensity.ResultsIn this study,230 questionnaires were issued and taken back,among which 226 were valid,with an effective rate of 98.26%.The seven main results of the study are as follows:1.The overall score of self-management of young stroke patients was(85.38±15.77)points,with poor self-management level accounting for 28.32%,moderate self-management level accounting for 57.08% and good self-management level accounting for 14.60%.2.The overall score of self-efficacy of young stroke patients was(24.21±6.89),among which the patients with low level self-efficacy accounted for 23.89%,the patients with medium level self-efficacy accounted for 53.98%,and the patients with high level self-efficacy accounted for 22.13%.3.The overall score of disease perception in young stroke patients was(40.13±7.46),with poor disease perception accounting for 32.74%,moderate disease perception accounting for 8.85% and good disease perception accounting for 8.41%.4.The overall score of social support in young stroke patients was(41.95±6.80)points,including(24.12±4.28)points for subjective support,(7.53±1.76)points for utilization of support and(10.30±3.12)points for objective support.5.The average anxiety score and depression score of young stroke patients were(8.49±3.07)points and(8.19±3.18)points respectively.Among the study subjects,137 patients(60.62%)had anxiety and 133 patients(58.84%)had depression.6.One-way ANOVA showed that the self-management level of young stroke patients had statistically significant differences in gender,place of residence,educational level,mode of medical payment,degree of self-care,family history,smoking and drinking history(P < 0.05);Pearson analysis showed that self-efficacy was positively correlated with self-management with a correlation coefficient of 0.421,social support was positively correlated with self-management with a correlation coefficient of 0.446,disease perception was negatively correlated with self-management with a correlation coefficient of-0.158,anxiety and depression were negatively correlated with self-management with a correlation coefficient of-0.336.7.The structural equation model showed that self-efficacy has positive effects on the self management,and the path coefficient was 0.135;and social support has positive effects on the self management of young stroke patients,and the path coefficient was 0.637;disease perception has negative effects on self management,the path coefficient was-0.106;anxiety and depression have negative effects on self management,the path coefficient was-0.165,among which self-efficacy and anxiety and depression have intermediate effects on social support,disease perception and self management.ConclusionsThe level of self-management of young stroke patients is medium,but by raising the patients' social support and self-efficacy,the patient's level of anxiety and depression can be reduced,their self-management level can be improved.