Effect of Self-efficacy, Disease Perception, Social Support, Anxiety, and Depression on Self-management in Young Patients With Stroke

“Improved self-efficacy and self-management capacity exhibit bidirectional positive reinforcement [31,32], thereby contributing to sustainable health behavior establishment.”

“In the absence of coordinated, developmentally responsive care, YASS frequently assumed responsibility for navigating care pathways and coordinating support services (Bright et al., 2024; Kvigne et al., 2014; Zhang et al., 2025).”

“15,16 However, most existing studies have examined these psychosocial factors in isolation, and the potential relationships through which cognitive appraisal, internal psychological resources, and external social resources jointly contribute to self-management remain insufficiently understood.”

“32 Patients with higher self-efficacy typically tend to have greater confidence when facing challenges, which may help them to correct maladaptive behaviours and maintain healthy lifestyles.”

“In haemodialysis settings, higher self-efficacy has been associated with better adherence to fluid restrictions, improved self-management behaviors, and more effective control of fluid intake (Alikari et al., 2022; L. Zhang et al., 2025).”

“These findings align with previous studies highlighting social support as a critical protective factor for health behavior, as it addresses both the practical and psychological dimensions of behavior change [30].”

“This approach is consistent with the recommendations of Zhang et al. 25 , who conducted a systematic review of dyadic psychosocial interventions and found that interventions targeting both patients and caregivers were most effective when addressing self-efficacy as a key mechanism of change.”

“Conversely, depression can adversely affect self-management behaviors (e.g., medication adherence), amplify somatic symptoms, and dysregulate physiological systems, thereby worsening CMD progression and outcomes [12–14].”

“Additionally, self-efficacy can be situation-specific and may reflect optimism about certain tasks rather than a broader psychological resilience (Liu et al., 2023; Zhang et al., 2025).”