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Ma R, Qiao M, Zhou Y, Sun W, Lv Y, Zhou X, Wang Y, Wu X, Yu R. The Relationship Between Knowledge, Psychological Flexibility, Anxiety and Healthy Behaviour in Stroke Patients: A Chain Mediation Model. J Clin Nurs 2025. [PMID: 40329557 DOI: 10.1111/jocn.17820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2025] [Revised: 04/15/2025] [Accepted: 04/23/2025] [Indexed: 05/08/2025]
Abstract
AIMS To explore the mediating effects of psychological flexibility and anxiety between knowledge and health behaviour in stroke patients, and to provide a reference for improving the health behaviour of stroke patients. DESIGN A cross-sectional study. METHODS A convenience sampling method was used to recruit 219 stroke patients from a tertiary hospital in China from July to November 2024. Patients were surveyed using an electronic questionnaire containing demographic questions and validated scales for stroke knowledge, psychological flexibility, anxiety and health behaviour. IBM SPSS v26.0 software and PROCESS Process macro were used for data analysis. RESULTS The health behaviour score of stroke patients was 54.2 ± 3.8, and health behaviour was positively correlated with stroke knowledge and negatively correlated with psychological flexibility and anxiety. There was a significant chain-mediated effect of psychological flexibility and anxiety in the relationship between stroke knowledge and health behaviour. CONCLUSION Stroke knowledge not only directly predicts health behaviour in stroke patients, but also indirectly influences the health behaviour of patients through the chain mediation of psychological flexibility and anxiety. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of caregivers focusing on the interactions between patient knowledge, psychological flexibility, anxiety and health behaviour when caring for stroke patients. Comprehensive interventions aimed at enhancing stroke patients' knowledge, improving patients' psychological flexibility and reducing anxiety have the potential to improve patient health behaviour. PATIENT OR PUBLIC CONTRIBUTION Patients completed questionnaires. REPORTING METHOD The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.
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Affiliation(s)
- Ruili Ma
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengting Qiao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yating Zhou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wenjia Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanyan Lv
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xu Zhou
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaoyu Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ruili Yu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Sakr F, Safwan J, Cherfane M, Salameh P, Sacre H, Haddad C, El Khatib S, Rahal M, Dia M, Harb A, Hosseini H, Iskandar K. Knowledge and Awareness of Stroke among the Elderly Population: Analysis of Data from a Sample of Older Adults in a Developing Country. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2172. [PMID: 38138275 PMCID: PMC10744528 DOI: 10.3390/medicina59122172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Stroke prevention has traditionally concentrated on research to improve knowledge and awareness of the disease in the general population. Since stroke incidents increase with age, there is a need to focus on the elderly, a high-risk group for developing the disease. This study aimed to examine the level of stroke awareness and knowledge, their predictors, and their source of information. Materials and Methods: A prospective cross-sectional study targeted Lebanese senior citizens aged 65 years and above. A total of 513 participants enrolled in the study through a self-administered survey distributed using a snowball sampling technique. Results: Most participants had appropriate baseline knowledge (more than 75% correct answers) of stroke, including risk factors, alarming signs, and preventive measures. Better knowledge of disease risks was significantly associated with having a university degree (ORa = 1.609; p = 0.029). Participants who had previous ischemic attacks showed significantly lower knowledge of the alarming signs (ORa = 0.467; p = 0.036) and prevention measures (ORa = 0.427; p = 0.029). Those suffering from depression had better knowledge of stroke alarming signs (ORa = 2.060.; p = 0.050). Seeking information from pharmacists, physicians, or the internet was not significantly associated with better knowledge of stroke risks, alarming signs, and preventive measures. Conclusions: The present study showed that seniors had fair knowledge of stroke, despite gaps in stroke prevention measures. Healthcare providers could play a leading role in improving public health by educating seniors to enhance awareness about prevention measures, detecting alarming signs, and acting fast to save a life.
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Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Michelle Cherfane
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- College of Health Sciences, Abu Dhabi University, Abu Dhabi 25586, United Arab Emirates
| | - Pascale Salameh
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Hala Sacre
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
| | - Chadia Haddad
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib 1525, Lebanon
- School of Health Sciences, Modern University for Business and Science, Beirut 7501, Lebanon
| | - Sarah El Khatib
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Public Health, Lebanese University, Tripoli 1300, Lebanon
| | - Mohamad Rahal
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Mohammad Dia
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Ahmad Harb
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
| | - Hassan Hosseini
- UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France;
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
- Service de Neurologie, Hôpital Henri Mondor, AP-HP, 94010 Créteil, France
| | - Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut 1105, Lebanon; (J.S.); (M.R.); (M.D.); (A.H.); (K.I.)
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut 1103, Lebanon; (M.C.); (P.S.); (H.S.); (C.H.); (S.E.K.)
- Faculty of Pharmacy, Lebanese University, Beirut 1103, Lebanon
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