1.Developing a Chain Mediation Model of Recurrence Risk Perception and Health Behavior Among Patients With Stroke: A Cross-sectional Study
Yujia JIN ; Zhenxiang ZHANG ; Dominique A. CADILHAC ; Yunjing QIU ; Weihong ZHANG ; Yongxia MEI ; Zhiguang PING ; Lanlan ZHANG ; Beilei LIN
Asian Nursing Research 2024;18(4):384-392
Purpose:
To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior.
Methods:
A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables.
Results:
Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01).
Conclusion
Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.
2.Developing a Chain Mediation Model of Recurrence Risk Perception and Health Behavior Among Patients With Stroke: A Cross-sectional Study
Yujia JIN ; Zhenxiang ZHANG ; Dominique A. CADILHAC ; Yunjing QIU ; Weihong ZHANG ; Yongxia MEI ; Zhiguang PING ; Lanlan ZHANG ; Beilei LIN
Asian Nursing Research 2024;18(4):384-392
Purpose:
To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior.
Methods:
A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables.
Results:
Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01).
Conclusion
Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.
3.Developing a Chain Mediation Model of Recurrence Risk Perception and Health Behavior Among Patients With Stroke: A Cross-sectional Study
Yujia JIN ; Zhenxiang ZHANG ; Dominique A. CADILHAC ; Yunjing QIU ; Weihong ZHANG ; Yongxia MEI ; Zhiguang PING ; Lanlan ZHANG ; Beilei LIN
Asian Nursing Research 2024;18(4):384-392
Purpose:
To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior.
Methods:
A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables.
Results:
Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01).
Conclusion
Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.
4.Effect of the Coronavirus Disease 2019 Pandemic on the Quality of Stroke Care in Stroke Units and Alternative Wards: A National Comparative Analysis
Dominique A. CADILHAC ; Joosup KIM ; Geoffrey CLOUD ; Craig S. ANDERSON ; Emma K. TOD ; Sibilah J. BREEN ; Steven FAUX ; Timothy KLEINIG ; Helen CASTLEY ; Richard I. LINDLEY ; Sandy MIDDLETON ; Bernard YAN ; Kelvin HILL ; Brett JONES ; Darshan SHAH ; Katherine JAQUES ; Benjamin CLISSOLD ; Bruce CAMPBELL ; Natasha A. LANNIN ;
Journal of Stroke 2022;24(1):79-87
Background:
and Purpose Changes to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to patients’ treatment setting (stroke unit or alternate ward).
Methods:
We conducted a retrospective cohort study of patients admitted with stroke or transient ischemic attack between January 2019 and June 2020 in the Australian Stroke Clinical Registry (AuSCR). The AuSCR monitors patients’ treatment setting, provision of allied health and nursing interventions, prescription of secondary prevention medications, and discharge destination. Weekly trends in the quality of care before and during the pandemic period were assessed using interrupted time series analyses.
Results:
In total, 18,662 patients in 2019 and 8,850 patients in 2020 were included. Overall, 75% were treated in stroke units. Before the pandemic, treatment in a stroke unit was superior to alternate wards for the provision of all evidence-based therapies assessed. During the pandemic period, the proportion of patients receiving a swallow screen or assessment, being discharged to rehabilitation, and being prescribed secondary prevention medications decreased by 0.58% to 1.08% per week in patients treated in other ward settings relative to patients treated in stroke units. This change represented a 9% to 17% increase in the care gap between these treatment settings during the period of the pandemic that was evaluated (16 weeks).
Conclusions
During the first 6 months of the pandemic, widening care disparities between stroke units and alternate wards have occurred.