The Self-management Status And Risk Factors Of High Risk Population Of Stroke In Community

Objectives:To explore the related factors of influencing self-management behavior in high-risk population of stroke by describing the status of self-management of high-risk population..The aim of this study is to provide scientific basis for further development of comprehensive intervention program for high-risk groups of stroke in community,so as to improve their self-management level,prevent stroke,save medical resources,and reduce the economic burden of society and familyMethod:From March to September 2017,617cases who have joined the National Health Commission’s Brain Prevention Committee’s Stroke High-risk Population Screening and Intervention Project,were screened in 2 communities of Liaocheng Economic and Technological Development Zone,using the method of convenience sampling.Face-to-face survey was conducted in strict accordance.At last collected 448 valid questionnaires,involving general situation questionnaire,self-management behavior rating scale for high-risk stroke patients,the stroke prevention knowledge,the chronic disease self-efficacy energy scale,the social support rating scale.Excel database and SPSS 26.0 were used for statistical analysis of the obtained data.For gender,age,occupation,marital status,education level and other statistical data,frequency and composition ratio were used to express.The measurement data of self-management behavior,stroke prevention knowledge,self-efficacy and social support score were statistically described by percentage,mean and standard deviation The influencing factors of self-management behavior were analyzed by univariate analysis,pearson analysis and multiple linear regression analysisResults1.The score of each index in high-risk population of strokeThe total average score of self-management behavior of 448 community stroke high-risk groups was(132.07 ± 16.520),the index score rate was 60.03%,and the level of self-management behavior was in the middle.52.9%(237people)of community stroke high-risk population had poor self-management behavior,45.8%(205people)of community stroke high-risk population had moderate self-management behavior,and only 1.34%(6 people)of community stroke high-risk population had good self-management behavior.The score rate of the six dimensions of self-management behavior from high to low was:safe medication management(75.67%),emotional management(75.64%),daily life management(64.70%),social interpersonal management(62.86%),diet management(60.53%)and disease management(40.48%).2.Analysis of risk factors of self-management behavior in high-risk population of strokeThe results of single factor analysis showed that the total score of self-management behavior in community stroke high-risk population was statistically significant in different occupational status,medical payment mode and family per capita monthly income(P<0.05).Pearson correlation analysis showed that self-management behavior of high risk groups of stroke was positively correlated with stroke knowledge(r=0.550,P<0.001),self-efficacy(r=0.152,P<0.01),social support(r=0.176,P<0.001).The results show that the higher the knowledge,self-efficacy and social support level,the better the self-management behavior is.The results of multiple regression analysis showed that the knowledge of stroke prevention and treatment had the greatest contribution to the self-management behavior of high-risk group of stroke in community.The higher the knowledge,the better the self-management behavior and the management level of each dimension(β=0.213-0.517,P<0.001);the higher the self-efficacy of disease symptom management,the better the disease management behavior of high-risk group of stroke in community(β=0.119,P<0.05);the higher the self-efficacy of disease common management,the better the disease management behavior(β=0.109,P<0.005),and the worse the social interpersonal management behavior(β=0.123,P<0.05);the higher the level of subjective support,the better the self-management behavior(β=0.105,P<0.05)and social interpersonal management behavior(β=0.252,P<0.001)of community stroke high-risk population;The higher the objective support level was,the worse the self-management behavior level(β=-0.128,P<0.01),disease management behavior level(β=-0.146,P<0.01),daily life management behavior level(β=-0.165,P<0.01),emotional management behavior level(β=-0.135,P<0.01)and social interpersonal management behavior level(β=-0.134,P<0.01)of community stroke high-risk population were;the higher the utilization of support was Good,the better the diet management behavior level of community stroke high-risk group(β=0.035,P<0.01);among the risk factors of stroke,the self-management behavior(β=0.093,P<0.05)and diet management behavior(β=0.146,P<0.01)of dyslipidemia community stroke high-risk group were better,the disease management behavior of hypertension community stroke high-risk group was better(β=0.219,P<0.001)Life management behavior was poor(β=-0.096,P<0.05),emotion management behavior was better in high-risk group of community stroke with atrial fibrillation or heart valve(β=0.125,P<0.01),disease management behavior(β=0.089,P<0.05)and social interpersonal management behavior(β=0.100,P<0.05)were better in high-risk group of community stroke without exercise;The life management behavior(β=0.124,P<0.05)and emotion management behavior(β=0.135,P<0.01)of community stroke high-risk population aged over 60 were better;the self-management behavior(β=-0.090,P<0.05),daily life management behavior(β=-0.127,P<0.05),emotional management behavior(β=-0.149,P<0.01)and social interpersonal management behavior(β=-0.118,P<0.05)of community stroke high-risk population whose occupation was agricultural workers were worse.Conclusions1.The overall score of self-management behavior of high-risk groups of stroke is in the middle level,especially in the Social function and interpersonal management,diet management and disease management.2.Stroke prevention and treatment knowledge,social support,self-efficacy,occupation and dyslipidemia are the main factors influencing the self-management behavior of the community at high risk of stroke.Among them,stroke prevention and treatment knowledge has the most significant impact on self-management behavior.The higher the level of stroke prevention knowledge,self-efficacy,and subjective support,the better the self-management behavior;the better the objective support,the worse the self-management behavior,and the poorer disease management,daily life management,emotional management,and social and interpersonal management.The high-risk population of stroke in communities whose occupations are agricultural workers have poor self-management behaviors,and poor daily life management,emotional management,and social interpersonal management.3.Age,hypertension,atrial fibrillation or valvular heart disease,and lack of exercise have a certain impact on the self-management behavior of the community at high risk of stroke.Community stroke high-risk populations≥60 years old have better daily life management and emotional management;community high-risk stroke populations with hypertension have better daily life management;community high-risk stroke populations with atrial fibrillation or valvular heart disease,Emotional management is better;the community at high risk of stroke who lacks exercise has better social interpersonal management.