Stroke patients’ knowledge, attitudes, and practices regarding home-based exercise and psychological rehabilitation programs

Abstract

Background: Stroke rehabilitation encompasses crucial components essential for the recovery process. This study aimed to investigate the knowledge, attitudes, and practices (KAP) of stroke patients regarding home-based exercise and psychological rehabilitation programs aimed at enhancing their physical and mental well-being, as well as alleviating depressive symptoms. Methods: This study conducted a cross-sectional survey at 37 institutions from December 2023 to January 2024. The survey gathered demographic data and assessed KAP related to stroke rehabilitation through structured questionnaires. Results: A total of 499 valid questionnaires were included in this study. Of these participants, 312 (62.5%) were male and 252 (50.5%) were aged over 60 years. The median [25.75%] knowledge, attitude, and practice scores were 9.03 (5.04) (possible range: 0–20), 33.19 (3.55) (possible range: 9–45), and 21.43 (4.49) (possible range: 6–30), respectively. Multivariate logistic regression showed that knowledge score (OR = 1.19, 95% CI: [1.13, 1.26], p < 0.001), attitude score (OR = 1.28, 95% CI: [1.19, 1.38], p < 0.001), employed (OR = 2.41, 95% CI: [1.15, 5.04], p = 0.020), retired (OR = 2.20, 95% CI: [1.20, 4.02], p = 0.011), and more than 3 years of duration of stroke (OR = 0.37, 95% CI: [0.16, 0.85], p = 0.019) were independently associated with practice. Structural equation modeling (SEM) showed that knowledge directly affected attitude (β = 0.407, p < 0.001), knowledge (β = 0.390, p < 0.001) and attitude (β = 0.461, p < 0.001) directly affected practice, and knowledge indirectly affected practice through attitude (β = 0.188, p = 0.007). Conclusion: The study highlights that while stroke patients generally exhibit positive attitudes and practices toward home-based exercise and psychological rehabilitation, there remains a gap in their knowledge about these crucial interventions. Clinically, it is imperative to enhance educational strategies targeting stroke survivors, focusing on improving knowledge to further strengthen their rehabilitation outcomes and adherence to prescribed regimens.