The Relationship Between Knowledge, Psychological Flexibility, Anxiety and Healthy Behaviour in Stroke Patients: A Chain Mediation Model

AIMS: To explore the mediating effects of psychological flexibility and anxiety between knowledge and health behaviour in stroke patients, and to provide a reference for improving the health behaviour of stroke patients. DESIGN: A cross-sectional study. METHODS: A convenience sampling method was used to recruit 219 stroke patients from a tertiary hospital in China from July to November 2024. Patients were surveyed using an electronic questionnaire containing demographic questions and validated scales for stroke knowledge, psychological flexibility, anxiety and health behaviour. IBM SPSS v26.0 software and PROCESS Process macro were used for data analysis. RESULTS: The health behaviour score of stroke patients was 54.2 ± 3.8, and health behaviour was positively correlated with stroke knowledge and negatively correlated with psychological flexibility and anxiety. There was a significant chain-mediated effect of psychological flexibility and anxiety in the relationship between stroke knowledge and health behaviour. CONCLUSION: Stroke knowledge not only directly predicts health behaviour in stroke patients, but also indirectly influences the health behaviour of patients through the chain mediation of psychological flexibility and anxiety. RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of caregivers focusing on the interactions between patient knowledge, psychological flexibility, anxiety and health behaviour when caring for stroke patients. Comprehensive interventions aimed at enhancing stroke patients' knowledge, improving patients' psychological flexibility and reducing anxiety have the potential to improve patient health behaviour. PATIENT OR PUBLIC CONTRIBUTION: Patients completed questionnaires. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.