Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Min Kyeong Kim; Hye Ryun Lee; Ju Yeon Kwon; Hyun Soo Oh

doi:10.7475/JKAN.2013.25.6.610

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Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Min Kyeong Kim¹, Hye Ryun Lee¹, Ju Yeon Kwon², Hyun Soo Oh³

Korean Journal of Adult Nursing 2013;25(6):610-621.
Published online: December 18, 2012

DOI: https://doi.org/10.7475/JKAN.2013.25.6.610

¹Department of Nursing, Inha University, Inha University Hospital, Incheon

²Inha University Hospital, Incheon

³Department of Nursing, Inha University, Incheon, Korea

Corresponding author: Oh, Hyun Soo, Department of Nursing, Inha University, 100 Inha-ro, Nam-gu, Incheon 402-751, Korea. Tel: +82-32-860-8206, Fax: +82-32-874-5880, E-mail: hsoh@inha.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The study was designed to identify influencing and mediating factors of health behaviors of stroke patients based on the hypothetical model constructed in this study.
Methods
Non-experimental correlational research design was used. One hundred and five stroke patients were conveniently selected from one university hospital located in Incheon. Data were collected with survey and analyzed by path analysis to examine the significant influencing and mediating factors of health behaviors in stroke patients.
Results
Age, diagnosis, disability in ADL, knowledge related to health behavior, and self-efficacy had significant direct causal influences on health behavior. And it was shown that knowledge and self-efficacy mediated influence of cohabitation status with family(whether or not living together with family) on health behavior. Self-efficacy also mediated influence of knowledge on health behavior.
Conclusion
From the results, it was proposed that providing knowledge related to health behavior and enhancing self-efficacy by educating skill necessary for health behaviors and promoting health related beliefs might increase health behavior particularly for stroke patients living together with family.
Key Words: Stroke; Health behavior; Causal relationship; Mediating factors

Figure 1.

Hypothetical model for influencing and mediating factors of health behavior of stroke patients.

Figure 2.

Influencing and mediating factors of health behavior of stroke patients.

Table 1.

Descriptive Statistics of Subjects' Characteristics (N=105)

Characteristics	Categories	n (%) or M±SD
Age (year)		60.9±13.85
Age group (year)	＞50	17 (16.2)
	50~59	30 (28.6)
	≤60	58 (55.2)
Gender	Male	58 (55.2)
	Female	47 (54.8)
Living together with family	Yes	91 (86.7)
	No	14 (13.3)
Diagnosis	CI	72 (68.6)
	CH	33 (31.4)
Duration of stroke (year)		1.45±1.55
Comorbidity (diabetes or hypertension)	Yes	68 (64.8)
	No	37 (35.2)
Functional disability		3.01±1.09

CI=cerebral infarction; CH=cerebral hemorrhage.

Table 2.

Parameters Estimates of the Hypothetical Model of Influencing and Mediating Factors of Health Behavior for Stroke Patients

Extrinsic	Intrinsic factors	Coefficient estimates			SMC
Extrinsic	Intrinsic factors	Direct (T-value)	Indirect (T-value)^†	Total (T-value)	SMC
Knowledge related to health	Age	.06 (0.50)	-	.06 (0.50)	.11
	Gender^‡	.02 (0.24)	-	.02 (0.24)
	Living together with family^§	.14 (1.34)	-	.14 (1.34)
	Diagnosis^\|\|	-.26 (-2.59)∗∗	-	-.26 (-2.59)∗∗
	Duration of illness	-.20 (-1.98)∗∗	-	-.20 (-1.98)∗∗
	Comorbidity^¶	.13 (1.21)	-	.13 (1.21)
Self-efficacy	Age	.04 (0.36)	.01 (0.49)	.05 (0.46)	.10
	Gender	.12 (1.19)	.01 (0.24)	.13 (1.21)
	Living together with family	.17 (1.55)	.03 (1.14)	.20 (1.81)∗
	Diagnosis	.10 (0.98)	-.05 (-1.61)	.05 (0.46)
	Duration of diagnosis	-.05 (-0.51)	-.04 (-1.45)	-.09 (-0.91)
	Comorbidity	-.04 (-0.39)	.03 (1.05)	-.01 (-0.14)
	Functional disability	-.05 (-0.52)	-	-.05 (-0.52)
	Knowledge related to health	.21 (2.13)∗∗	-	.21 (2.13)∗∗
Health behavior	Age	.18 (1.89)∗	.03 (0.56)	.21 (1.93)∗	.36
	Gender	.01 (0.03)	.05 (1.11)	.06 (0.57)
	Living together with family	.07 (0.71)	.10 (1.90)∗	.17 (1.61)
	Diagnosis	-.22 (-2.46)∗∗	.02 (0.42)	.20 (2.02)∗∗
	Duration of illness	.08 (0.87)	-.07 (-1.37)	.01 (0.08)
	Comorbidity	.12 (1.30)	.01 (0.28)	.13 (1.29)
	Functional disability	-.22 (-2.58)∗∗	-.02 (-0.52)	-.24 (-2.56)∗∗
	Knowledge related to health	.16 (1.84)∗	.08 (1.95)∗	.24 (2.61)∗∗
	Self-efficacy	.40 (4.79)∗∗	-	.40 (4.79)∗∗

∗T≥1.64, p≤.05; ∗∗T≥1.96, p≤.01).

^†Mediating effect SMC=squared multiple correlation;

^‡1) male, 2) female;

^§1) no (living alone), 2) yes (living together with family);

^||1) cerebral infarction, 2) cerebral hemorrhage;

^¶1) no (without history of hypertension or diabetes mellitus), 2) yes (with history of hypertension or diabetes mellitus).

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Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Korean J Adult Nurs. 2013;25(6):610-621. Published online December 31, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.6.610

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Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Korean J Adult Nurs. 2013;25(6):610-621. Published online December 31, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.6.610

Figure

Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Figure 1. Hypothetical model for influencing and mediating factors of health behavior of stroke patients.

Figure 2. Influencing and mediating factors of health behavior of stroke patients.

Figure 1.

Figure 2.

Influencing and Mediating Factors in Health Behaviors among Stroke Patients

Table 1.

Descriptive Statistics of Subjects' Characteristics (N=105)

Characteristics	Categories	n (%) or M±SD
Age (year)		60.9±13.85
Age group (year)	＞50	17 (16.2)
	50~59	30 (28.6)
	≤60	58 (55.2)
Gender	Male	58 (55.2)
	Female	47 (54.8)
Living together with family	Yes	91 (86.7)
	No	14 (13.3)
Diagnosis	CI	72 (68.6)
	CH	33 (31.4)
Duration of stroke (year)		1.45±1.55
Comorbidity (diabetes or hypertension)	Yes	68 (64.8)
	No	37 (35.2)
Functional disability		3.01±1.09

CI=cerebral infarction; CH=cerebral hemorrhage.

Table 2.

Parameters Estimates of the Hypothetical Model of Influencing and Mediating Factors of Health Behavior for Stroke Patients

Extrinsic	Intrinsic factors	Coefficient estimates			SMC
Extrinsic	Intrinsic factors	Direct (T-value)	Indirect (T-value)^†	Total (T-value)	SMC
Knowledge related to health	Age	.06 (0.50)	-	.06 (0.50)	.11
	Gender^‡	.02 (0.24)	-	.02 (0.24)
	Living together with family^§	.14 (1.34)	-	.14 (1.34)
	Diagnosis^\|\|	-.26 (-2.59)∗∗	-	-.26 (-2.59)∗∗
	Duration of illness	-.20 (-1.98)∗∗	-	-.20 (-1.98)∗∗
	Comorbidity^¶	.13 (1.21)	-	.13 (1.21)
Self-efficacy	Age	.04 (0.36)	.01 (0.49)	.05 (0.46)	.10
	Gender	.12 (1.19)	.01 (0.24)	.13 (1.21)
	Living together with family	.17 (1.55)	.03 (1.14)	.20 (1.81)∗
	Diagnosis	.10 (0.98)	-.05 (-1.61)	.05 (0.46)
	Duration of diagnosis	-.05 (-0.51)	-.04 (-1.45)	-.09 (-0.91)
	Comorbidity	-.04 (-0.39)	.03 (1.05)	-.01 (-0.14)
	Functional disability	-.05 (-0.52)	-	-.05 (-0.52)
	Knowledge related to health	.21 (2.13)∗∗	-	.21 (2.13)∗∗
Health behavior	Age	.18 (1.89)∗	.03 (0.56)	.21 (1.93)∗	.36
	Gender	.01 (0.03)	.05 (1.11)	.06 (0.57)
	Living together with family	.07 (0.71)	.10 (1.90)∗	.17 (1.61)
	Diagnosis	-.22 (-2.46)∗∗	.02 (0.42)	.20 (2.02)∗∗
	Duration of illness	.08 (0.87)	-.07 (-1.37)	.01 (0.08)
	Comorbidity	.12 (1.30)	.01 (0.28)	.13 (1.29)
	Functional disability	-.22 (-2.58)∗∗	-.02 (-0.52)	-.24 (-2.56)∗∗
	Knowledge related to health	.16 (1.84)∗	.08 (1.95)∗	.24 (2.61)∗∗
	Self-efficacy	.40 (4.79)∗∗	-	.40 (4.79)∗∗

∗T≥1.64, p≤.05; ∗∗T≥1.96, p≤.01).

^†Mediating effect SMC=squared multiple correlation;

^‡1) male, 2) female;

^§1) no (living alone), 2) yes (living together with family);

^||1) cerebral infarction, 2) cerebral hemorrhage;

^¶1) no (without history of hypertension or diabetes mellitus), 2) yes (with history of hypertension or diabetes mellitus).

Table 1. Descriptive Statistics of Subjects' Characteristics (N=105)

CI=cerebral infarction; CH=cerebral hemorrhage.

Table 2. Parameters Estimates of the Hypothetical Model of Influencing and Mediating Factors of Health Behavior for Stroke Patients

∗T≥1.64, p≤.05; ∗∗T≥1.96, p≤.01).

†

Mediating effect SMC=squared multiple correlation;

‡

1) male, 2) female;

1) no (living alone), 2) yes (living together with family);

1) cerebral infarction, 2) cerebral hemorrhage;

1) no (without history of hypertension or diabetes mellitus), 2) yes (with history of hypertension or diabetes mellitus).

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