健康素养在脑卒中患者积极度与自我管理行为间的中介效应

目的 探讨脑卒中患者健康素养、患者积极度和自我管理行为的现状，明确三个变量间关系，并探讨健康素养在患者积极度与自我管理行为间的中介效应。方法 采用一般资料问卷、慢性病健康素养调查量表、患者积极度量表、脑卒中自我管理行为调查问卷对河南省4所三级甲等医院就诊的223名脑卒中患者进行调查。结果 脑卒中患者健康素养得分为（82.30±15.28）分，自我管理行为得分为（40.89±9.74）分，患者积极度得分为（45.21±11.30）分。脑卒中患者健康素养、自我管理行为与患者积极度三个变量间呈正相关（r值分别为0.622、0.479、0.457，且均P<0.01）；且健康素养在患者积极度与自我管理行为间起显著部分中介效应，中介效应占总效应的53.79%。结论 脑卒中患者健康素养、患者积极度可预测其自我管理行为，且患者积极度既可直接影响自我管理行为，也可通过健康素养间接影响自我管理行为。

Health literacy as a mediator between patient activation and self-management behavior in stroke patients

To explore the current situation of health literacy, patient activation and self-management behavior of stroke patients, and to clarify the relationship between the three variables, so as to explore the mediating effect of health literacy between patient activation and self-management behavior. Methods 223 stroke patients in 4 Grade 3 A hospitals in Henan Province were investigated by general data questionnaire, chronic disease health literacy questionnaire, patient activation measure scale and stroke self-management behavior questionnaire. Results The health literacy score of stroke patients was(82.30±15.28), the self-management behavior score was(40.89±9.74), and the patient activation score was(45.21±11.30). There was a positive correlation between health literacy, self-management behavior and activation of stroke patients( r values were 0.622,0.479,0.457 and P<0.01 respectively).And health literacy has a significant mediating effect between patient activation degree and self-management behavior, which accounts for 53.79% of the total effect.Conclusion The health literacy and patient activation can predict self-management behavior. The patient activation can not only directly affect the self-management behavior but also indirectly affect the self-management behavior through the health literacy.