Stroke knowledge and health-promoting behaviors: Mediating effect of patient self-esteem
Abstract
Objective To investigate the levels of and associations between stroke knowledge, self-esteem, and health-promoting behavior (HPB) among stroke patients, and examine the mediating effect of self-esteem in the stroke knowledge-HPB relationship. Methods This descriptive correlational study involved a total of 150 stroke patients. We collected data through questionnaires during outpatient visits at two Korean secondary hospitals, inquiring about general and disease-related characteristics, stroke knowledge, self-esteem, and HPB. Correlation and mediation analyses were performed. Results Stroke knowledge significantly increased patients' self-esteem (β = .53, p = .001) and HPB (β = 1.64, p < .001). Self-esteem mediated the relationship between stroke knowledge and HPB, with the mediating effect coefficient determined to be 1.68 [95 % CI (0.56,-2.46)]. Conclusion Education and intervention programs that increase both self-esteem and stroke knowledge need to be developed and evaluated such that stroke patients are motivated to engage in HPB. Practice implications Stroke patients are often physically and mentally impaired, and low self-esteem can be a barrier to engaging in HPB after diagnosis, negatively affecting their health outcomes. Nursing interventions focused on enhancing self-esteem can empower these patients to effectively engage in HPB. Healthcare professionals should adequately communicate and impart disease-related knowledge to patients with poor disease-related knowledge or education.
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There is a significant predictive causal correlation between higher knowledge and higher health behaviour in stroke patients.
“Similarly, Mun and Shim (Mun and Shim 2024), Parappilly et al. (Parappilly et al. 2019) emphasised that there is a significant predictive causal correlation between higher knowledge and higher health behaviour in stroke patients.”
From The Relationship Between Knowledge, Psychological Flexibility, Anxiety and Healthy Behaviour in Stroke Patients: A Chain Mediation Model. (2026) · cites this paper as Mun and Shim 2024
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Liu, H., Liu, Q., Li, Z., Deng, C., Zhang, X., & Wan, L. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.16909 · Cited by 14 · see citing works
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Ma, R., Qiao, M., Zhou, Y., Sun, W., Lv, Y., Zhou, X., Wang, Y., Wu, X., & Yu, R. (2026) · Journal of Clinical Nursing · doi:10.1111/jocn.17820 · Cited by 3 · see citing works
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A mixed methods study of indigenous perspectives on non-communicable disease health literacy
Usman, S., & Nurmansyah, M. (2026) · International Journal of Health Promotion and Education · doi:10.1080/14635240.2026.2733135
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“Awareness of their warning signs enables individuals to recognize potential symptoms and seek prompt medical care, thereby reducing the risk of severe complications [9,10].”
Li, Y., Li, L., Wang, X., Lin, B., Guo, Z., Tang, Q., & Wang, A. (2026) · Nursing Open · doi:10.1002/nop2.70845
“Stroke-related knowledge may facilitate self-management by helping patients recognize health risks, understand recommended treatments and make informed decisions regarding their health and rehabilitation (Mun and Shim 2024).”
Self-esteem in patients post-percutaneous coronary intervention: a cross-sectional examination
Chen, B., & Lin, Y. (2026) · BMC Cardiovascular Disorders · doi:10.1186/s12872-026-05664-5
“…duration would correlate with lower self-esteem—owing to cumulative physical and psychological burdens, diminished confidence in recovery, and persistent stress-related helplessness [42, 43]— our study identified an unexpected positive association between longer CHD duration and higher self-esteem.”
A latent profile analysis of health behaviors among rural patients with ischemic stroke in China
Li, Y., Fang, X., Ding, S., Wang, Z., Dong, X., & Wang, A.-P. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1838937
Designing an Exo-Suit for Enhanced Mirror Therapy in Stroke Rehabilitation
Abusharar, K. M., Alibrahim, A. N., Alharbi, M., & Alzahrani, S. I. (2025) · 2025 International Conference on Electrical, Communication and Computer Engineering (ICECCE) · doi:10.1109/icecce67514.2025.11257845
“They also disrupt family dynamics and relationships due to the increased caregiving responsibilities and changes in the survivor's abilities and mental states it can cause anxiety, depression, and reduce sense of self-worth [6], [7].”
Knowledge of risk factors and symptoms of stroke in Polish society
Wcisło, S., Bortnowska, A., Sierakowska, A., Morajko, A., Bednarczyk, P., Salamon, A., & Łabuz-Roszak, B. (2025) · Aktualności Neurologiczne · doi:10.15557/an.2024.0020
- Authors
- MUN, G., & SHIM, J.
- Affiliations
- Dongguk University (KR)
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2024-12
- Volume
- 129
- Pages
- 108398
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W4401852332
- Cited by
- 10
- References
- 0
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 1
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation of Korea
- Ministry of Science, ICT and Future Planning (K-2022-A0163-00083, 2022R1A2C2092976)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- stroke knowledge, self-esteem, health-promoting behaviors, stroke patients, mediation, patient education, nursing interventions, disease knowledge
- MeSH terms
- Adult, Aged, Female, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Surveys and Questionnaires, Self Concept, Health Behavior, Stroke, Republic of Korea
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