| Objective:A cross-sectional survey was conducted to describe the current situation of functional exercise adherence in stroke patients with hemiplegia.Using self-regulation theory and family system theory as a guideline,a structural equation model was used to investigate the pathways between type D personality,family functioning,illness perception and functional exercise adherence of stroke patients with hemiplegia,providing a basis for the development of health guidance and personalized exercise programs for secondary stroke prevention.Methods:The study was a cross-sectional study with a convenience sampling method of stroke hemiplegic patients before discharge from a tertiary hospital in Shanxi Province from June2022 to October 2022,who met the inclusion and exclusion criteria.The general demographic information form,the Type D Personality Scale(DS-14),the Family Assessment Device(FAD-GN),the Brief Illness Perception Questionnaire(B-IPQ)and the Exercise Adherence Questionnaire(EAQ)were selected as the study instruments to survey the patients.Data entry was performed using Excel software,SPSS 24.0 software was used for statistical analysis of the data and AMOS 26.0 software was used to construct structural equation models.General demographic information was described using descriptive statistics,and type D personality,family functioning,illness perception and functional exercise adherence scores were described using means and standard deviations.One-way ANOVA and multiple regression analysis were used to analyze the effects of sociodemographic and disease characteristics on functional exercise adherence in stroke patients with hemiplegia.Pearson correlations were used to analyze the correlation between type D personality,illness perception,family functioning and functional exercise adherence.Model fitting,correction and path analysis were performed using AMOS 26.0 software to construct a mediating effect model for the relationship between type D personality and functional exercise adherence,and the Bootstrap method was used to test the significance of the mediating effect of family functioning and illness perception in the relationship between type D personality and functional exercise adherence.Results:(1)A total of 250 questionnaires were distributed in this study and 234 valid questionnaires were returned,with a valid return rate of 93.6%.(2)Of 234 stroke patients with hemiplegia,76(32.5%)had a type D personality,a family functioning score of(26.75±4.88),a illness perception score of(40.86±5.98),and a functional exercise compliance score of(34.77±4.36).(3)Single-factor analysis showed that functional exercise adherence in stroke patients with hemiplegia was associated with gender,age,work status,marital status,education level,family residence,individual monthly income,primary caregiver,medical payment,side of hemiplegia,stroke times,ADL and regular exercise routine,all of which were statistically different(P<0.05).(4)Pearson correlation analysis showed that type D personality was positively correlated with illness perception(r=0.410,P<0.01),positively correlated with family functioning(r=0.490,P<0.01),and negatively correlated with functional exercise adherence(r=-0.473,P<0.01)in stroke patients with hemiplegia;family functioning was negatively correlated with functional exercise adherence(r=-0.705,P<0.01)and illness perception was negatively correlated with functional exercise adherence(r=-0.557,P<0.01).(5)Multiple linear regression analysis showed that work status,side of hemiplegia,ADL,type D personality,illness perception and family function were predictive of functional exercise compliance and explained 48.2% of the total variance in functional exercise adherence in stroke patients with hemiplegia.(6)The results of the mediation analysis showed that family function and illness perception partially mediated the effect between type D personality and functional exercise adherence,accounting for 21.6% and 23.7% of the total effect,respectively,and that family function and illness perception played a chain mediating effect between type D personality and functional exercise adherence,accounting for 8.4% of the total effect.Conclusion:(1)Stroke patients with hemiplegia had a moderate level of functional exercise compliance,type D personality distribution in line with the Chinese norm,and moderate scores for family functioning and illness perception.(2)Work status,side of hemiplegia,ADL,type D personality,illness perception and family functioning as factors influencing functional exercise adherence in stroke patients with hemiplegia.(3)Family functioning and illness perception in stroke patients with hemiplegia paralysis partially mediated the effect between type D personality and functional exercise adherence,respectively,and there was also a chain mediating effect between family functioning and illness perception. |
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