| ObjectivesTo analyze the adherence level of physical activity for community-dwelling stroke survivors and its influencing factors.MethodsThe Cross-sectional descriptive study was conducted on208convenient selected stroke survivors being resided in Zhengzhou with minor limb dysfunction caused by stroke in March to December2011. Three community health centers included eleven health service stations. The questionnaire of exercise adherence, questionnaire of stroke-related knowledge and attitude, self-efficacy scale for chronic, social support scale were used to measure stroke survivors’adherence, knowledge level, attitude, self-efficacy and social support. SPSS (version13.0) was used for statistic description, one-factor analysis and regression analysis, but AMOS (version7.0) software was used to perform the path analysis. Results1. Totally210patients meeting the inclusion criteria were investigated, only208questionnaires were collected, so the effective collect rate was99.10%.2. The average score of exercise adherence of community-dwelling stroke survivors was (34.71±8.45). The mean exercise adherence rate was61.98%, totally in midlevel, in which20.19%at a high level. According adherence rate, the better was physical activity adherence and the lowest dimension was initiatively seeking advice adherence.3. The mean score of knowledge questionnaire was (14.06±5.81), and the mean correct rate was51.9%. According to score index to sort, the recurrence-related knowledge had the highest correct rate, and the lowest correct rate went to physical activity-related knowledge and stroke elementary-related knowledge. Used same method to analyze the attitude score, and the results showed that the stroke survivors had a good attitude to control of risk factors and exercise related attitude, but their health responsibility attitude was lowest.4. The mean score of self-efficacy was (3.46±1.71), generally was in medium and low level. There were two dimensions including sympotom management self-efficay which’s score was (2.26±1.17) and disease common management self-efficacy which’s score was (1.19±0.59). Most of the stroke survivors’ self-efficacy was low level (75.48%) and24.52%were medium level, only0%was at high level.5. The mean score of social support was (29.67±6.65), it was lower than health person’s (34.56±3.73)(t=0.616, P<0.01) and stroke survivors who were in hospital (t=-3.129,P<0.01).6. Used the functional exercise adherence’score as dependent variable, and age, character, knowledge, attitude, self efficacy and social support as independent variables for multiple linear regressions. Multivariate linear regression analysis revealed that seven major influencing factors for community dwelling stroke survivors. The regression model included7predictor variables accounting for75.7% of the variance in the total physical activity adherence.7. According to the theory, literature review and investigation database, used the maximum likelihood estimation to fit path analysis model including knowledge, attitude, self-efficacy, social support and adherence. Goodness-of-fit indicated that tf value was2.201, P value was0.138; X/df value was2.201, showed the model was fitted very well. Path analysis revealed that self efficacy was a decisive factor influencing adherence, not only had a direct effect on adherence, also a intermediary variable. Based upon our analysis, it was concluded that attitude and social support can be the cause on self-efficacy to affect or directly affect exercise of adherence for community-dwelling stroke survivors. But knowledge only had an indirect influencing on exercise adherence. Conclusions1. The exercise adherence rate generally at a midlevel and the adherence of seeking advice initiatively at a low level.2. The disease-related knowledge level of community-dwelling stroke survivors is low, expecially stroke elementary-related knowledge and physical activity-related knowledge. But they have an active attitude to stroke, expecially they have a good recogonization to the relationship between stroke and risk factors like hypertention, emotional factors, smoking, drinking, and also have a good attitude to exercise.3. The self-efficacy level of research objects is mid even low level and needs to be improved. Also the social support of community-dwelling stroke survivors is lower than normal health person and they have had during in hospital.4. The Influencing factors are physical activity-related knowledge, attitude to control of risk factors, attitude to insistence on taking exercise, self-efficacy, and utilization of social support, self-care ability, and community rehabilitation. Also other predictive factors included physical status, caregiver, age and income, et cetera. Self-efficacy turned out to be a consequence of knowledge, attitude and social support but originator on exercise of adherence. Social support and attitude have both direct and indrect effect on adherence, while knowledge is an indirect factor through influence self-efficacy to affect adherence. |
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