Effect of health knowledge and social support on health behaviors in patients with ischemic stroke: the dual mediating effects of health belief and depression
10.3760/cma.j.cn371468-20250329-00120
- VernacularTitle:健康知识和社会支持对缺血性脑卒中患者健康行为的影响：健康信念和抑郁的双重中介作用
- Author:
Yuying GUO
1
;
Mengyu ZHANG
;
Xinxin ZHOU
;
Yuying XIE
;
Peng ZHAO
;
Juanjuan WANG
;
Caixia YANG
;
Yuanli GUO
;
Ao YUAN
;
Qinyang LI
;
Shuo DU
;
Yanjin LIU
;
Lina GUO
Author Information
1. 郑州大学第一附属医院，郑州 450052
- Publication Type:Journal Article
- Keywords:
Ischemic stroke;
Health behavior;
Capacity, Opportunity, Motivation-Behavior model;
Social support;
Health belief;
Health knowledge;
Depression
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2025;34(11):1018-1024
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.
