脑卒中幸存者坚持功能性运动的影响因素：基于结构方程模型的横断面研究
Influencing factors of functional exercise adherence in stroke survivors: a cross-sectional study based on structural equation modeling.
摘要(中文译文)
卒中后康复锻炼在功能恢复和二级预防中发挥着重要作用。然而，锻炼依从性通常在卒中后6至22周之间出现下降。本研究以能力-机会-动机-行为模型为指导，评估了卒中幸存者的锻炼依从性，考察了潜在的关联路径，并识别了该时期与依从性相关的主要因素。收集了卒中幸存者的一般资料、功能锻炼依从性、健康素养、康复动机和自我效能感数据。采用均数和标准差描述卒中幸存者的功能锻炼依从性。运用独立样本t检验、方差分析、Pearson相关分析和结构方程模型识别影响卒中幸存者功能锻炼依从性的因素。卒中幸存者功能锻炼依从性总分为32.58 ± 7.44。结果显示，健康素养与功能锻炼依从性之间存在显著的直接关联（β = 0.280，95% CI = [0.118, 0.443]，P = 0.001）。健康素养还通过康复动机（β = 0.079，95% CI = [0.035, 0.147]，P = 0.001）和自我效能感（β = 0.107，95% CI = [0.047, 0.190]，P = 0.001）与依从性呈现显著的间接关联。同样，社会支持与功能锻炼依从性直接相关（β = 0.226，95% CI = [0.086, 0.376]，P = 0.003），并通过康复动机（β = 0.078，95% CI = [0.033, 0.143]，P = 0.001）和自我效能感（β = 0.073，95% CI = [0.012, 0.149]，P = 0.019）与依从性呈现间接关联。卒中幸存者的功能锻炼依从性仍不理想，需要进一步改善。本研究表明，康复动机和自我效能感在健康素养、社会支持与功能锻炼依从性之间的关联中发挥显著的中介作用。临床医生和护理人员可实施以健康素养为重点的干预措施，并营造支持性社会环境，以增强卒中幸存者的功能锻炼依从性。
Abstract
Post-stroke rehabilitation exercise plays an important role in functional recovery and secondary prevention. Nevertheless, exercise adherence commonly declines between 6 and 22 weeks after stroke. Guided by the Capability-Opportunity-Motivation-Behavior model, this study assessed exercise adherence among stroke survivors, examined potential pathways of association, and identified major factors linked to adherence during this period. Data on general information, functional exercise adherence, health literacy, rehabilitation motivation, and self-efficacy of stroke survivors were collected. The functional exercise adherence of stroke survivors was described by means and standard deviations. Independent sample t tests, analysis of variance, Pearson's correlation analysis, and structural equation modeling were used to identify the factors influencing functional exercise adherence in stroke survivors. The total score for functional exercise adherence among stroke survivors was 32.58 ± 7.44. The results revealed significant direct associations between health literacy and functional exercise adherence (β = 0.280, 95% CI = [0.118, 0.443], P = 0.001). Health literacy also showed significant indirect associations with adherence via rehabilitation motivation (β = 0.079, 95% CI = [0.035, 0.147], P = 0.001) and self-efficacy (β = 0.107, 95% CI = [0.047, 0.190], P = 0.001). Likewise, social support was directly associated with functional exercise adherence (β = 0.226, 95% CI = [0.086, 0.376], P = 0.003), and presented indirect associations with adherence via rehabilitation motivation (β = 0.078, 95% CI = [0.033, 0.143], P = 0.001) and self-efficacy (β = 0.073, 95% CI = [0.012, 0.149], P = 0.019). Functional exercise adherence among stroke survivors remains suboptimal and requires further improvement. This study demonstrates that rehabilitation motivation and self-efficacy play significant mediating roles in the associations between health literacy, social support, and functional exercise adherence. Clinicians and nursing staff can implement health literacy-focused interventions and foster a supportive social environment to enhance stroke survivors' functional exercise adherence.
如何引用
AMA
Xinyu Wang, Juan Chen, Yingchun Wu, Lian Qiu, Lingli Jiang, Jiaqi Liu, et al. Influencing factors of functional exercise adherence in stroke survivors: a cross-sectional study based on structural equation modeling.. Scientific reports. 2026; doi:10.1038/s41598-026-60730-4.
APA
Xinyu Wang, Juan Chen, Yingchun Wu, Lian Qiu, Lingli Jiang, Jiaqi Liu, et al (2026). Influencing factors of functional exercise adherence in stroke survivors: a cross-sectional study based on structural equation modeling.. Scientific reports. https://doi.org/10.1038/s41598-026-60730-4
GB/T 7714
Xinyu Wang, Juan Chen, Yingchun Wu, Lian Qiu, Lingli Jiang, Jiaqi Liu, et al. Influencing factors of functional exercise adherence in stroke survivors: a cross-sectional study based on structural equation modeling.[J]. Scientific reports, 2026 doi:10.1038/s41598-026-60730-4.
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