Patient activation and health behavior decision-making in stroke patients

A longitudinal mediation mechanism of family function and risk perception

Bibliographic Data

ID22087205
AuthorsHui Li (0000-0001-9355-1116, Guangdong Academy of Medical Sciences), Haixia Li (0000-0002-4818-4107, Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University), Xiaoshan Chen (0000-0001-9739-5851, Guangdong Academy of Medical Sciences), Xiu Zheng (Guangdong Academy of Medical Sciences), Zhangying Li (Guangdong Academy of Medical Sciences, corresponding author)
Year2026
Volume14
Pages1725303-1725303
Publication date2026-05-08
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1725303
PMID42180463
OpenAlexW7160521137
LanguageEN
References cited36

Objective To explore the chain mediating effect of family function and recurrence risk perception between activation and health behavior decision-making in stroke patients within 6 months after stroke. Methods A total of 254 stroke patients were investigated using the Family APGAR Index, Risk of Recurrence Perception Scale, Activation Scale, and Stroke Behavior Decision Scale before discharge (T1), 3 months after stroke (T2), and 6 months after stroke (T3). Equivalence testing and cross-lag model analysis were employed to analyze the data. Results A total of 232 valid questionnaires were collected. Equivalence test results: All variables met the equivalence requirements, indicating that the measurement tools were inter-temporal comparable in dynamic tracking. Cross-lagged model path analysis: T1 activation could significantly predict T2 family function ( β = 0.28, p < 0.01), T2 recurrence risk perception ( β = 0.20, p < 0.01), and T2 health behavior decision ( β = 0.23, p < 0.01). T1 family function could significantly predict T2 recurrence risk perception ( β = 0.21, p < 0.01) and T2 health behavior decision-making ( β = 0.29, p < 0.01); T2 activation significantly positively predicted T3 recurrence risk perception ( β = 0.19, p < 0.01), T2 family function could significantly positively predict T3 recurrence risk perception ( β = 0.20, p < 0.01), and could significantly positively predict T3 health behavior decision ( β = 0.26, p < 0.01). Recurrence risk perception at T2 significantly positively predicted T3 health behavior decision ( β = 0.17, p < 0.01), and health behavior decision at T2 significantly positively predicted T3 activation ( β = 0.12, p < 0.01). Bootstrap analysis showed that T2 family function ( β = 0.073, p < 0.01) and T2 recurrence risk perception ( β = 0.034, p < 0.01) had significant indirect effects on T1 activation in the prediction of T3 health behavior decision. Conclusion Within 6 months after a stroke, there is a mutual predictive relationship between activation and health behavior decision-making in stroke patients. Family function and perceived risk of recurrence have a longitudinal mediating effect on the mechanism of activation’s influence on health behavior decision-making

Behavior change · Health behavior · Health belief model · Mediation · Perception · Risk perception · Dementia and Cognitive Impairment Research · Stroke Rehabilitation and Recovery · Traumatic Brain Injury Research

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