Factors Influencing Self-management Behaviors among Ischemic Stroke Patients

Main Article Content

Wanwisa Srirung
Wimolrat Puwarawuttipanit
Sarunya Koositamongkol

Abstract

Purpose: To study the influence of hope, rehabilitation motivation, family support, and fatigue on self-management behavior among ischemic stroke patients.


Design: Correlational predictive research.


Methods: The sample was comprised of 128 ischemic stroke patients, both males and females, aged 18 years or older who came for a follow-up appointment after discharge at the out-patient department, Prasat Neurological Institute between March and May, 2020. The questionnaires included the demographic characteristics, the Herth Hope Index, Stroke Rehabilitation Motivation Scale, Family Support Questionnaires, Fatigue Severity Scale, and Self-management Behavior questionnaire. Data were analyzed by using descriptive statistics and multiple regression analysis.


Main findings: An average age of the sample was 62.58 years old (SD = 9.14), and 97.7% of them had self-management behaviors at a high level (gif.latex?\bar{X} = 92.76, SD = 6.37). All of the independent variables explained 44.4% of the variance in self-management behavior (R2 = .44). The factors significantly influencing self-management behavior were motivation for rehabilitation, family support, and hope (gif.latex?\beta = .41, p < .001, gif.latex?\beta = .24, p < .01 and gif.latex?\beta = .19, p < .05) respectively. Even though fatigue did not demonstrate the prediction, the significant correlation with self-management behavior was found.


Conclusion and recommendations: Hope, motivation for rehabilitation, and family support could affect self-management behavior. Thus, it is recommended that healthcare team should be aware of the importance of building hope and motivation for rehabilitation. Families should be engaged in a program development and encouragement for promoting self-management behavior of the patients, consequently leading to good quality of life after ischemic stroke.

Article Details

How to Cite
Srirung, W., Puwarawuttipanit, W. ., & Koositamongkol, S. (2022). Factors Influencing Self-management Behaviors among Ischemic Stroke Patients. Nursing Science Journal of Thailand, 40(2), 108–123. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/249113
Section
Research Papers

References

World Health Organization. Global health estimates 2016: disease burden by cause, age, sex, by country and by region, 2006-2016 [Internet]. Geneva, Switzerland; WHO; 2018 [cited 2019 Sep 7]. Available from: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.

Venketasubramanian N, Yoon BW, Pandian J, Navarro JC. Stroke epidemiology in South, East, and South-East Asia: a review. J Stroke. 2017;19(3):286-94. doi: 10.5853/jos.2017.00234.

Coupland AP, Thapar A, Qureshi MI, Jenkins H, Davies AH. The definition of stroke. J R Soc Med. 2017;110(1):9-12. doi: 10.1177/0141076816680121.

Joice S. Self-management following stroke. Nurs Stand. 2012;26(22):39-46. doi: 10.7748/ns2012.02.26.22.39.c8919.

Sadler E, Wolfe CDA, Jones F, McKevitt C. Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK. BMJ Open. 2017;7(3):e011631. doi: 10.1136/bmjopen-2016-011631.

Guan F-G, Wang M, Lian X-Q. The status quo and influence of self-management behaviors in convalescent stroke patients. Front Nurs. 2018;5(2):119-25. doi: 10.2478/fon-2018-0016.

Nantharaksa C, Phuthikhamin N. Hope in patients with cerebrovascular disease during rehabilitation phase. North-Eastern Thai Journal of Neuroscience. 2013;8(2):35-55. (in Thai).

Kortte KB, Stevenson JE, Hosey MM, Castillo R, Wegener ST. Hope predicts positive functional role outcomes in acute rehabilitation populations. Rehabil Psychol. 2012;57(3):248-55. doi: 10.1037/a0029004.

Chen Y, Fu G, Liang F, Wei J, He J, Bai J. Symptoms, hope, self-management behaviors, and quality of life among Chinese preoperative patient with symptomatic valvular heart diseases. J Transcult Nurs. 2020;31(3):284-93. doi: 10.1177/1043659619864157.

Wang L-Y, Chang P-C, Shih F-J, Sun C-C, Jeng C. Self-care behavior, hope, and social support in Taiwanese patients awaiting heart transplantation. J Psychosom Res. 2006;61(4):485-91. doi: 10.1016/j.jpsychores.2004.11.013.

Maclean N, Pound P, Wolfe C, Rudd A. Qualitative analysis of stroke patients' motivation for rehabilitation. BMJ. 2000;321(7268):1051-4. doi: 10.1136/bmj.321.7268.1051.

Rapoliene J, Endzelyte E, Jaseviciene I, Savickas R. Stroke patients motivation influence on the effectiveness of occupational therapy. Rehabil Res Pract. 2018;2018:9367942. doi: 10.1155/2018/9367942.

Rosland A-M, Heisler M, Choi H-J, Silveira MJ, Piette JD. Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chronic Illn. 2010;6(1):22-33. doi: 10.1177/1742395309354608.

Park AS, Ko E, Kang HS. Comparison of motivation for rehabilitation, family support and adherence to rehabilitation between depressive and non-depressive stroke patients. Korean J Rehabil Nurs. 2016;19(2):138-47. doi: 10.7587/kjrehn.2016.138.

Acciarresi M, Bogousslavsky J, Paciaroni M. Post-stroke fatigue: epidemiology, clinical characteristics and treatment. Eur Neurol. 2014;72(5-6):255-61. doi: 10.1159/000363763.

MacIntosh BJ, Edwards JD, Kang M, Cogo-Moreira H, Chen JL, Mochizuki G, et al. Post-stroke fatigue and depressive symptoms are differentially related to mobility and cognitive performance. Front Aging Neurosci. 2017;9:343. doi: 10.3389/fnagi.2017.00343.

Flinn NA, Stube JE. Post-stroke fatigue: qualitative study of three focus groups. Occup Ther Int. 2010;17(2):81-91. doi: 10.1002/oti.286.

Grey M, Schulman-Green D, Knafl K, Reynolds NR. A revised self- and family management framework. Nurs Outlook. 2015;63(2):162-70. doi: 10.1016/j.outlook.2014.10.003.

Jodnok K, Panomai N. Factors affecting self-care behaviors of stroke patients in Bungkan hospital, Bungkan District, Bungkan Province. North-Eastern Thai Journal of Neuroscience. 2018;13(2):38-55. (in Thai).

Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs. 1992;17(10):1251-9. doi: 10.1111/j.1365-2648.1992.tb01843.x.

White GN, Cordato D, O’Rourke F, Mendis RL, Ghia DK, Chan DKY. Validation of the stroke rehabilitation motivation scale: a pilot study. Asian J Gerontol Geriatr. 2012;7(2):80-7.

Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022.

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485.

Yan H, Liu B, Meng G, Shang B, Jie Q, Wei Y, et al. The influence of individual socioeconomic status on the clinical outcomes in ischemic stroke patients with different neighborhood status in Shanghai, China. Int J Med Sci. 2017;14(1):86-96. doi: 10.7150/ijms.17241.

Lei T-T, Han H-M, Liu X-J. Multiple mediation effects of health locus of control and hope on the relationship between stroke patients’ social support and self-management. Front Nurs. 2020;7(1):49-57. doi: 10.2478/fon-2020-0005.

Muina-Lopez R, Guidon M. Impact of post-stroke fatigue on self-efficacy and functional ability. Eur J Physiother. 2013;15(2):86-92. doi: 10.3109/21679169.2013.792868.