Academic Journal of Medicine & Health Sciences, 2026, 7(4); doi: 10.25236/AJMHS.2026.070409.
Shuting Yang1, Xiaolan Guo1,2, Meixia Zhang3
1School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
2School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
3Department of Nursing, the First Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
Stroke is a disease with high disability and mortality rates worldwide, and its rehabilitation process depends not only on the acute treatment, but also on the long-term active health behavior management of patients. Active health behavior covers multiple dimensions such as exercise, diet regulation, medication compliance, psychological adjustment and social participation, which plays a key role in improving functional prognosis, reducing the risk of recurrence and improving the quality of life. Although the current research has clarified the definition and connotation of active health behavior, there are still some deficiencies in the systematic integration of influencing factors, the localized development of assessment tools, and the verification of long-term effects of intervention strategies. This paper systematically reviews the research status of the definition and connotation, influencing factors, assessment tools and intervention strategies of active health behavior in stroke patients. Combined with the latest evidence-based evidence, this paper analyzes the shortcomings of current research and future development directions, so as to provide a theoretical basis for clinical practice and health management.
Stroke, Active health behaviors, Rehabilitation, Self-management
Shuting Yang, Xiaolan Guo, Meixia Zhang. Research status and progress of active health behavior in stroke patients. Academic Journal of Medicine & Health Sciences (2026), Vol. 7, Issue 4: 79-86. https://doi.org/10.25236/AJMHS.2026.070409.
[1] ZHOU Chen-qian, Lin Bei-lei, TANG Shang-feng, et al. Conceptual framework of active health behavior in stroke patients[J]. Chinese Journal of General Practice, 2025, 28(5): 534-540, 547.
[2] LAU S C L, JUDYCKI S, MIX M, et al. Theory-Based Self-Management Interventions for Community-Dwelling Stroke Survivors: A Systematic Review and Meta-Analysis.[J/OL]. The American journal of occupational therapy: Official publication of the American Occupational Therapy Association, 2022, 76 (4).
[3] ALVARENGA M T M, ADA L, PRESTON E, et al. Home-based self-management for sedentary individuals with mild walking disability after stroke: protocol for a randomised pilot study.[J/OL]. BMC neurology, 2023, 23(1): 412.
[4] GUO L, ZHANG M, NAMASSEVAYAM G, et al. Effectiveness of health management among individuals at high risk of stroke: An intervention study based on the health ecology model and self-determination theory (HEM-SDT).[J/OL]. Heliyon, 2023, 9 (11) : e21301.
[5] LEE Y, KIM Y. A Self-Determination Theory-Based Cardiovascular Disease Prevention Program for Community-Dwelling Middle-Aged "Women. [J/OL]. Journal of community health nursing, 2026:1-21.
[6] Yuan Zheng, Guo Xiaoyan, Ye Feng. Stroke patients with hemiplegia home according to the medical behavior and influencing factors of analysis [J/OL]. Health research, 2024, 44 (4) : 386-390.
[7] ZHOU Chen-qian, Lin Bei-lei, TANG Shang-feng, et al. Development and reliability and validity test of active health behavior scale for stroke patients [J/OL]. Military Nursing, 2025, 42(10): 27-30.
[8] Wang M D, Chen M X, et al. Development and reliability and validity test of active health behavior scale for high risk population of stroke [J/OL]. Military Nursing, 2025, 42(8): 55-58.
[9] XU X Q, Xie H B, Wu C Q, et al. Cognition and behavior of chronic disease risk factors among residents in Jinjiazhuang community of Ma 'anshan City [J]. Journal of Bengbu Medical College, 2014(10): 1391-1394.
[10] WEI X, XU M, YANG L, et al. Determinants Influencing Health-Promoting Behaviors in Individuals at High Risk of Stroke: A Cross-Sectional Study.[J/OL]. Health education & behavior : the official publication of the Society for Public Health Education, 2024, 51(3): 457-466.
[11] LI W, LI Q. Breaking the adherence barrier: an information-motivation-behavioral skills model analysis of self-efficacy in stroke survivors’ home-based Exercise. [J/OL]. Frontiers in public health, 2026, 14:1747370.
[12] LIN B, ALLAN L P, CADILHAC D A, et al. Interventions That Support Lifestyle Behavior Change for Secondary Prevention of Stroke: A Scoping Review. [J/OL]. Stroke, 2025, 56 (5) : 1323-1336.
[13] CAETANO L C G, PACHECO B D, SAMORA G A R, et al. Self-Efficacy to Engage in Physical Exercise and Walking Ability Best Predicted Exercise Adherence after Stroke.[J/OL]. Stroke research and treatment, 2020, 2020:2957623.
[14] WANG M Y, SHEN M J, WAN L H, et al. Effects of a Comprehensive Reminder System Based on the Health Belief Model for Patients Who Have Had a Stroke on Health Behaviors, Blood Pressure, Disability, and Recurrence From Baseline to 6 Months: A Randomized Controlled Trial.[J/OL]. The Journal of cardiovascular nursing, 2020, 35(2): 156-164
[15] LO S H S, CHAU J P C, CHANG A M. Strategies adopted to manage physical and psychosocial challenges after returning home among people with Stroke: A qualitative study. [J/OL]. Medicine, 2021, 100 (10) : e25026.
[16] FU V, WEATHERALL M, MCPHERSON K, et al. Taking Charge after Stroke: A randomized controlled trial of a person-centered, self-directed rehabilitation intervention.[J/OL]. International journal of stroke: Official journal of the International Stroke Society, 2020, 15 (9) : 954-964.
[17] LI J J, TAN J X, ZHU F Y, et al. Comparisons of Stroke Knowledge and Health Behaviors in Patients With Hypertensive Stroke at Different Recurrence Risk Strata: The Comprehensive Reminder System Based on the Health Belief Model Study.[J/OL]. The Journal of cardiovascular nursing, 2022, 37 (2): 184-191.
[18] ZHANG X P, PAN J H, WAN L H, et al. Factors influencing health behaviour, blood pressure control, and disability in hypertensive ischaemic stroke patients after a comprehensive reminder intervention.[J/OL]. Journal of advanced nursing, 2020, 76(6): 1384-1393.
[19] BROUWER-GOOSSENSEN D, LINGSMA H F, KOUDSTAAL P J, et al. The optimal timing of supporting patients in health-related behavior change after TIA or ischemic stroke: a prospective cohort study to determinants of health-related intention to change over time.[J/OL]. International journal of rehabilitation research, 2021, 44 (1) : 32 - 37.
[20] SWANK C, TRAMMELL M, CALLENDER L, et al. The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial.[J/OL]. Clinical rehabilitation, 2020, 34(4): 504-514.
[21] KIM SH, HWANG S Y, SHIN J H, et al. Self-care and related factors associated with left ventricular systolic function in patients under follow-up after myocardial infarction.[J/OL]. European journal of cardiovascular nursing, 2021, 20(1): 5 - 13.
[22] GUO L, LIU Y, ZHU Y, et al. Identification of health behaviour clusters among people at high risk of stroke: A latent class profile analysis.[J/OL]. Journal of advanced nursing, 2020, 76(11): 3039-3047.
[23] KIM S R, KIM S, CHO B H, et al. Influence of Type D Personality on Health Promoting Behaviours and Quality of Life in Stroke Patients: A Cross-Sectional Study in South Korea.[J/OL]. Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association, 2021, 30(5): 10.
[24] DONG L, BROWN D L, CHERVIN R D, et al. Pre-stroke sleep duration and post-stroke depression.[J/OL]. Sleep medicine, 2021, 77: 325-329
[25] Zhou X X, ZHANG M Y, XIE Y Y, et al. A mixed methods systematic review of influencing factors of health behavior in stroke patients based on active health [J/OL]. Chin J Nursing, 2025, 40(16): 101-106.
[26] WANG M D, Gao W J, Chen M X, et al. Grounded theory based active health behavior model for stroke high-risk population. Chinese Journal of Nursing, 2025, 40(10): 14-19.
[27] HE Jing-jing, CAI Xiu-qun, LIANG Yu-ting, et al. Potential profile analysis and influencing factors of health behavior decision-making in stroke patients [J/OL]. Chinese Journal of Nursing, 2026, 41(4): 106-110.
[28] Zou Yanhui, Xu Xiaopan, Zhao Bingyuan, et al. Qualitative research on driving force of health promotion behavior in stroke patients with hemiplegia [J/OL]. Chinese Journal of Nursing, 2022, 37(23): 32-35. DOI:10.3870/ j.iscn.1001-4152.2022.23.032.
[29] Lin Haiju, Liu Ping, Zhou Lin, et al. Effect of home visit nursing on secondary prevention of stroke [J/OL]. Chinadialmed, 2011, 30(5): 138, 140. (in Chinese)
[30] SPRINGER M V, CONLEY K M, SANCHEZ B N, et al. Process Evaluation of a Faith-Based Multicomponent Behavioral Intervention to Reduce Stroke Risk in Mexican Americans in a Catholic Church Setting: The SHARE (Stroke Health and Risk Education) Project.[J/OL]. Journal of religion and health, 2021, 60(6): 3915-3930.
[31] Chen X, YUAN Y P., et al. Application of stage change model in behavior change of stroke patients [J/OL]. The Chinese modern nursing journal, 2009, 15 (26): 2673-2675.
[32] DYMM B L, KWICKLIS M, MEURER W J, et al. Recurrent stroke arrival time.[J/OL]. Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association, 2023, 32(6): 10.
[33] PENG Hui-jiao, Wan Lihong, HUANG Yue-you, et al. Investigation on health belief and health behavior of stroke patients [J/OL]. Chin J Nursing, 2012, 47(1): 10-13.
[34] Liu Xian, Wan Liyuan, Yan Tong, et al. Current status of health belief and health behavior in elderly patients with stroke [J/OL]. Hainan Medicine, 2019, 30(3): 370-373.
[35] LIU Y, WEI M, GUO L, et al. Association between illness perception and health behaviour among stroke patients: The mediation effect of coping style.[J/OL]. Journal of advanced nursing, 2021, 77(5): 2307-2318.
[36] LINDBLOM S, FLINK M, SJOSTRAND C, et al. Perceived Quality of Care Transitions between Hospital and the Home in People with Stroke.[J/OL]. Journal of the American Medical Directors Association, 2020, 21 (12) : 1885-1892.
[37] TAYLOR C A, BOULDIN E D, GREENLUND K J, et al. Comorbid Chronic Conditions Among Older Adults with Subjective Cognitive Decline, United States, The 2015-2017. [J/OL]. Innovation in aging, 2020, 4 (1) : igz045.
[38] SINGH P, JAYAKARAN P, MANI R, et al. The experiences of Indian people living in New Zealand with stroke.[J/OL]. Disability and rehabilitation, 2022, 44(14): 3641-3649
[39] COSTER S, LI Y, NORMAN I J. Cochrane reviews of educational and self-management interventions to guide nursing practice: A review. [J/OL]. International journal of nursing studies, 2020, 110:103698.
[40] SAYWELL N L, VANDAL A C, MUDGE S, et al. Telerehabilitation After Stroke Using Readily Available Technology: A Randomized Controlled Trial.[J/OL]. Neurorehabilitation and neural repair, 2021, 35(1): 88-97.
[41] BURKE J, PALMER R, HARRISON M. What are the factors that may influence the implementation of self-managed computer therapy for people with long term aphasia following stroke? A qualitative study of speech and language therapists’ experiences in the Big CACTUS trial.[J/OL]. Disability and Rehabilitation, 2022, 44 (14) : 3577-3589.
[42] BANCHANI E, TENKORANG E Y, SARFO-KANTAKA O, et al. Social Support Systems and the Self-Management of Non-Communicable Diseases (NCDs) in Ghana.[J/OL]. Journal of health Care for the poor and underserved, 2020, 31 (3) : 1191-1212.
[43] STILL C H, BURANT C, MOORE S, et al. The Targeted Management (TEAM) Intervention for Reducing Stroke Risk in African American Men: Rationale and Study Design of a Prospective Randomized Controlled Trial.[J/OL]. Journal of multidisciplinary healthcare, 2021, 14:513-522.
[44] GUO Lina, GUO Yuan-li, ZHANG Meng-Yu, et al. Stroke patients health behaviors latent class and its prediction factors [J/OL]. Chinese behavioral medicine and brain science journal, 2024, 33 (1) : 21-26. DOI: 10.3760 / cma. J.c. n371468-20230320-00132.
[45] VERBERNE D P J, KROESE M E AL, STAALS J, et al. Nurse-led stroke aftercare addressing long-term psychosocial outcome: a comparison to care-as-usual.[J/OL]. Disability and rehabilitation, 2022, 44(12): 2849-2857
[46] MASRI J E, AFYOUNI A, GHAZI M, et al. Stem cell transplantation in cerebrovascular accidents: A global bibliometric analysis (2000-2023).[J/OL]. World journal of stem cells, 2024, 16(9): 832-841.
[47] LAXY M, BECKER J, KAHM K, et al. Utility Decrements Associated With Diabetes and Related Complications: Estimates From a Population-Based Study in Germany.[J/OL]. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2021, 24(2): 274-280.