Effect of Self-efficacy, Disease Perception, Social Support, Anxiety, and Depression on Self-management in Young Patients With Stroke

J Neurosci Nurs. 2024 Dec 2. doi: 10.1097/JNN.0000000000000813. Online ahead of print.

Abstract

BACKGROUND: Better self-management of chronic diseases may benefit patient functional status, medication effectiveness, lifestyle, and psychosocial health. Self-efficacy, disease perception, social support, anxiety, and depression are determinants of self-management behaviors in individuals with chronic illnesses. There remains a gap in the empirical exploration of the influence of these factors on self-management behaviors in young Chinese stroke survivors. This study examined how these factors affect specific self-management behaviors. METHODS: Validated instruments were used to evaluate patient self-efficacy, disease perception, social support, anxiety, and depression in a cross-sectional study. Structural equation modeling was used to examine the hypothesis. RESULTS: Self-efficacy and social support showed a positive correlation with self-management (0.421 and 0.446, respectively; P < .001). Disease perception, anxiety, and depression were negatively correlated with self-management (-0.158 and -0.336, respectively; P < .05). The structural equation model fit the data very well; social support had a direct positive effect on self-management (t = 3.002, P < .05) and self-efficacy (t = 5.773, P < .001). However, the presence of social support had a positive impact on reducing anxiety and depression (t = -5.046, P < .001). Furthermore, self-efficacy positively affected self-management (t = 1.226, P < .05), whereas anxiety and depression (t = -1.190, P < .05) and disease perception (t = -1.068, P < .05) had adverse effects on self-management. CONCLUSION: Medical staff and caregivers can improve patient self-management by helping them recognize the disease, reducing negative perceptions, communicating more for better understanding and care, intervening in anxiety and depression, and promoting mental health. This is especially important for young stroke patients.