ArticleFrontiers in neurology2026
Distress disclosure and health behaviours in patients with stroke: a theory-informed serial mediation model of social support, self-efficacy, and self-management.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim: To examine the association between distress disclosure and health behaviours among patients with stroke and to test whether social support, self-efficacy and self-management statistically mediate this association independently and in sequence. Methods: A convenience sample of 473 patients with stroke was recruited from the Department of Neurology, Baotou Central Hospital, Inner Mongolia, China, between August 2025 and March 2026. Participants completed a sociodemographic and clinical characteristics form, the Distress Disclosure Index, Social Support Rating Scale, Stroke Self-Efficacy Questionnaire, Stroke Self-Management Scale and Health Behaviour Scale for Stroke Patients. Descriptive statistics, Pearson correlations, hierarchical multiple linear regression and serial mediation analyses were conducted using IBM SPSS Statistics 29.0 and PROCESS macro version 5.0, Model 6. Age, stroke type, modified National Institutes of Health Stroke Scale (modified NIHSS) score and Barthel Index (BI) score were included as covariates. Results: The mean health-behaviour score was 60.65 (SD 12.32), indicating a moderate level. Distress disclosure was positively correlated with health behaviours ( Conclusion: Distress disclosure was strongly associated with health behaviours among patients with stroke, and this association was accompanied by significant indirect statistical associations via social support, self-efficacy and self-management. The findings support an expression-support-efficacy-management framework that may inform the design and prospective evaluation of communication-centred and self-management-oriented nursing interventions.
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