Multiple Mediation Effects of Health Locus of Control and Hope on the Relationship between Stroke Patients’ Social Support and Self-Management
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Abstract Objective This study aimed to identify the mediation effects of health locus of control (HLC) and hope between stroke patients’ social support and self-management. Methods A cross-sectional study was conducted. A total of 300 Chinese stroke patients were recruited by convenient sampling from the acupuncture department of two Chinese Traditional Medical Hospitals in Tianjin Province from June to September 2018. The self-report questionnaires include Social Support Assessment Scale, Herth Hope Index, Mental Health Locus of Control Scale, Stroke Self-management Behavior Scale, and personal information questionnaires. All the survey data were entered in Excel and analyzed using the SPSS 24.0 program. Mediation was tested with Bootstrapping in AMOS 23.0 program. Results The result showed that internal health locus of control (IHLC), chance health locus of control (CHLC) and hope were the mediators between social support and self-management. The direct, indirect, and total effects of social support on self-management behavior were 0.306 P < 0.01), 0.109 ( P < 0.01), and 0.415 ( P < 0.01), respectively. Conclusions Social support can directly influence self-management, and it can also indirectly influence self-management through IHLC, CHLC, and hope.
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Locus of control may influence the recovery process, moderate the relationship between stroke impact and depressive symptoms, and mediate between social support and self-management.
“LOC may influence the recovery process [24], moderate the relationship between the impact of stroke and depressive symptoms [25], as well as mediate between social support and self-management [26].”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [26]
Cites
Hu, L., & Bentler, P. M. (1999) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705519909540118 · Cited by 108,788 · see citing works
Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., Abraham, J., Adair, T., Aggarwal, R., Ahn, S. Y., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61728-0 · Cited by 14,070 · see citing works
Self-management education: History, definition, outcomes, and mechanisms
Lorig, K. R., & Holman, H. R. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2601_01 · Cited by 4,094 · see citing works
Kim, H.-Y. (2013) · Restorative Dentistry & Endodontics · doi:10.5395/rde.2013.38.1.52 · Cited by 4,035 · see citing works
TARGET ARTICLE: Hope Theory: Rainbows in the Mind
Snyder, C. R. (2002) · Psychological Inquiry · doi:10.1207/s15327965pli1304_01 · Cited by 3,737 · see citing works
Development of the multidimensional health locus of control (MHLC) scales
Wallston, K. A., Strudler Wallston, B., & DeVellis, R. (1978) · Health Education Monographs · doi:10.1177/109019817800600107 · Cited by 3,373 · see citing works
Self-management approaches for people with chronic conditions: a review
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00032-0 · Cited by 2,800 · see citing works
Emotion, cognition, and behavior
Dolan, R. J. (2002) · Science · doi:10.1126/science.1076358 · Cited by 1,979 · see citing works
Preventing stroke: saving lives around the world
Strong, K., Mathers, C. D., & Bonita, R. (2007) · The Lancet Neurology · doi:10.1016/s1474-4422(07)70031-5 · Cited by 1,498 · see citing works
The Validity of the Multidimensional Health Locus of Control Scales
Wallston, K. A. (2005) · Journal of Health Psychology · doi:10.1177/1359105305055304 · Cited by 430 · see citing works
Development and refinement of an instrument to measure hope.
Herth, K. (1991) · PubMed · Cited by 376 · see citing works
Steptoe, A., & Wardle, J. (2001) · British Journal of Psychology · doi:10.1348/000712601162400 · Cited by 298 · see citing works
The experience of living with stroke: a qualitative meta-synthesis
Salter, K. L., Hellings, C., Foley, N., & Teasell, R. W. (2008) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0238 · Cited by 288 · see citing works
Stroke Trends in the WHO MONICA Project
Thorvaldsen, P., Kuulasmaa, K., Rajakangas, A.-M., Rastenytė, D., Sarti, C., & Wilhelmsen, L. (1997) · Stroke · doi:10.1161/01.str.28.3.500 · Cited by 217 · see citing works
Multidimensional Health Locus of Control: Comments on the Construct and its Measurement
Łuszczyńska, A., & Schwarzer, R. (2005) · Journal of Health Psychology · doi:10.1177/1359105305055307 · Cited by 207 · see citing works
Langenbrunner, J. C., Marquez, P. V., & Wang, S. (2011) · Cited by 162 · see citing works
Karimy, M., Koohestani, H. R., & Araban, M. (2018) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-018-0386-6 · Cited by 136 · see citing works
Rajati, F., Mohebi, S., Parham, M., Sharifirad, G., Gharlipour, Z., & Mohammadbeigi, A. (2018) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_73_17 · Cited by 124 · see citing works
Changes in locus of control as a function of life crisis resolution.
Smith, R. E. (1970) · Journal of Abnormal Psychology · doi:10.1037/h0029336 · Cited by 88 · see citing works
Ashby, J. S., Dickinson, W. L., Gnilka, P. B., & Noble, C. L. (2011) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2011.tb00070.x · Cited by 76 · see citing works
Lin, C., & Tsai, H. (2004) · Psycho-Oncology · doi:10.1002/pon.854 · Cited by 66 · see citing works
Boger, E. J., Demain, S. H., & Latter, S. M. (2014) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2014.05.006 · Cited by 64 · see citing works
Feldman, D. B., Davidson, O. B., Ben‐Naim, S., Maza, E., & Margalit, M. (2016) · Learning Disabilities Research and Practice · doi:10.1111/ldrp.12094 · Cited by 64 · see citing works
Perrin, V. A. (2013) · Health Affairs · doi:10.1377/hlthaff.2013.1102 · Cited by 64 · see citing works
Lawrence, M., Kerr, S., McVey, C., & Godwin, J. (2012) · International Journal of Stroke · doi:10.1111/j.1747-4949.2012.00771.x · Cited by 60 · see citing works
Relationships among hope, coping style and social support for breast cancer patients.
Zhang, J., Gao, W., Wang, P., & Wu, Z.-H. (2010) · PubMed · Cited by 59 · see citing works
The Role of Hope in Engaging in Healthy Behaviors Among College Students
Berg, C. J. (2011) · American Journal of Health Behavior · doi:10.5993/ajhb.35.4.3 · Cited by 58 · see citing works
Marr, J., & Wilcox, S. (2015) · American Journal of Health Education · doi:10.1080/19325037.2015.1023477 · Cited by 50 · see citing works
Self-care behavior, hope, and social support in Taiwanese patients awaiting heart transplantation
Wang, L.-Y., Chang, P., Shih, F., Sun, C.-C., & Jeng, C. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2004.11.013 · Cited by 46 · see citing works
Moshki, M., & Cheravi, K. (2015) · International Journal of Social Psychiatry · doi:10.1177/0020764015612119 · Cited by 46 · see citing works
Evaluation of chronic disease self-management programme (CDSMP) for older adults in Hong Kong
Chan, W. L. S., Hui, E., Chan, C. W. H., Cheung, D. S. T., Wong, S. Y. S., Wong, R., Li, S., & Woo, J. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0257-9 · Cited by 45 · see citing works
Social Support and Hope among Egyptian Women with Breast Cancer after Mastectomy
Denewer, A. T., Farouk, O., Mostafa, W., & Elshamy, K. (2011) · Breast Cancer Basic and Clinical Research · doi:10.4137/bcbcr.s6655 · Cited by 41 · see citing works
Shin, E. S., Hwang, S. Y., Jeong, M. H., & Lee, E. S. (2013) · Asian Nursing Research · doi:10.1016/j.anr.2013.10.003 · Cited by 39 · see citing works
Broomfield, N., Scoular, A., Welsh, P., Walters, M., & Evans, J. (2015) · International Journal of Stroke · doi:10.1111/ijs.12109 · Cited by 37 · see citing works
Health locus of control and self-care behaviors in diabetic foot patients.
Abredari, H., Bolourchifard, F., Rassouli, M., Nasiri, N., Taher, M., & Abedi, A. (2015) · PubMed Central · Cited by 35 · see citing works
The concept of hope in nursing 4: hope and gerontological nursing
Henh, K. A., & Cutcliffe, J. R. (2002) · British Journal of Nursing · doi:10.12968/bjon.2002.11.17.1148 · Cited by 29 · see citing works
The Chinese version of the multidimensional health locus of control scale form C in pregnancy
Ip, W. Y., & Martin, C. R. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.08.011 · Cited by 16 · see citing works
Fan, J., Kong, Y., Shi, S., & Cheng, R. Y.-H. (2016) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2016.02.002 · Cited by 8 · see citing works
Mohebi, S., Azadbakhat, L., feyzi, A., sharifirad, G., Hozoori, M., & Sherbafchi, M. (2013) · Majallah-i ghudad-i darūn/rīz va mitābulīsm-i Īrān./Majallah-i ghudad-i darūn/rīz va mitābulīsm-i Īrān. · Cited by 7 · see citing works
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Parviniannasab, A. M., Dehghani, F., & Hosseini, S. A. (2024) · BMC Nephrology · doi:10.1186/s12882-024-03558-2 · Cited by 28 · see citing works
Zhang, D., Zhang, N., Chang, H., Shi, Y., Tao, Z., Zhang, X., Miao, Q., & Li, X. (2022) · Clinical Nursing Research · doi:10.1177/10547738221078897 · Cited by 29 · see citing works
Błaszcz, M., Prucnal, N., Wrześniewski, K., Pasiut, S., Mika, P., Kucia, M., Stach, B., Woźniak, M., & Mirek, E. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11247260 · Cited by 12 · see citing works
Fitzgerald, S., Gracey, F., & Broomfield, N. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.2002439 · Cited by 9 · see citing works
Shourabi, E., & Vagharseyyedin, S. A. (2025) · BMC Psychology · doi:10.1186/s40359-025-02848-0 · Cited by 7 · see citing works
- Authors
- Lei, T.-T., Han, H.-M., & Liu, X.-J.
- Affiliations
- Tianjin University of Traditional Chinese Medicine (CN)
- School of Nursing , The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine , Tianjin 300382 , China
- Venue
- Frontiers of Nursing
- Publisher
- Walter de Gruyter GmbH
- Published
- 2020-03-01
- Volume
- 7
- Issue
- 1
- Pages
- 49-57
- ISSN
- 2544-8994 (ISSN-L)
- OpenAlex
- W3015076877
- Cited by
- 5
- References
- 40
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 2 · 2021: 1
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Frontiers of Nursing (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Wellbeing Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Keywords
- stroke, social support, self-management, health locus of control, hope, internal health locus of control, mediating effect, Chinese stroke patients, traditional Chinese medicine
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