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已发表论文
面向主动康复：基于 BCW 指导的首次中风患者健康行为促进护理干预方案
Authors Zhou X , Zhang M, Xie Y, Zhao P, Chang A, Lian X, Guo Y, Wang J, Guo L , Liu Y
Received 23 September 2025
Accepted for publication 1 December 2025
Published 26 December 2025 Volume 2025:19 Pages 4257—4270
DOI https://doi.org/10.2147/PPA.S555255
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Xinxin Zhou,1 Mengyu Zhang,2 Yuying Xie,3 Peng Zhao,1 Anni Chang,1 Xiuyu Lian,1 Yuying Guo,2 Juanjuan Wang,2 Lina Guo,2 Yanjin Liu4
1School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Departement of Nursing, Henan Cancer Hospital, Zhengzhou, Henan, People’s Republic of China; 4Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
Correspondence: Lina Guo, Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Email guolina09@126.com Yanjin Liu, Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China, Email liu-yanjin@126.com
Background: Stroke is a disease with high incidence, disability, recurrence, mortality, and economic burden, and its occurrence and progression are closely associated with unhealthy lifestyle behaviors. For first-episode stroke patients, the post-stroke period is not only critical for physical recovery but also a key window for initiating behavioral modifications to improve long-term outcomes. Current health behavior intervention programs predominantly target stroke survivors in the acute or subacute phase, while insufficiently addressing long-term rehabilitation and the establishment of sustainable health behavior habits.
Purpose: This study aims to investigate the efficacy and sustainable impact of a 6-month proactive health behavior guidance intervention on proactive health behavior ability, medication compliance, physical exercise, coping with psychological stress, and anxiety and depression.
Methods: The guidance will last for 6 months with four sections from hospitalization to 6 months post-discharge. The data will be measured at six time points: baseline, 3 months after discharge, intervention ends, 1 month post-intervention, 3 months post-intervention, and 6 months post-intervention. Outcomes including proactive health behavior, prevention knowledge, health belief, social support, depression, and anxiety were measured at 6 time points. Data were analyzed with SPSS 26.0, GEE models, and Bonferroni correction (P< 0.01).
Discussion: This protocol, developed within the BCW framework, effectively integrates behavioral guidance, psychological support, and family involvement to address poor adherence and unhealthy lifestyles among stroke survivors. Covering the acute, transitional, and long-term phases, it combines hospital-based education with home-based follow-up through face-to-face, digital, and video modalities. This multi-modal and family-centered approach enhances accessibility, continuity, and sustainability of health behavior changes, thereby improving functional recovery, reducing recurrence risk, and supporting the long-term integration of proactive health behaviors.
Trial Registration: ChiCTR2400090433 (Date of registration: September 29, 2024).
Keywords: proactive health behavior, stroke, first-episode, randomized controlled trial
1School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Departement of Nursing, Henan Cancer Hospital, Zhengzhou, Henan, People’s Republic of China; 4Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
Correspondence: Lina Guo, Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Email guolina09@126.com Yanjin Liu, Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China, Email liu-yanjin@126.com
Background: Stroke is a disease with high incidence, disability, recurrence, mortality, and economic burden, and its occurrence and progression are closely associated with unhealthy lifestyle behaviors. For first-episode stroke patients, the post-stroke period is not only critical for physical recovery but also a key window for initiating behavioral modifications to improve long-term outcomes. Current health behavior intervention programs predominantly target stroke survivors in the acute or subacute phase, while insufficiently addressing long-term rehabilitation and the establishment of sustainable health behavior habits.
Purpose: This study aims to investigate the efficacy and sustainable impact of a 6-month proactive health behavior guidance intervention on proactive health behavior ability, medication compliance, physical exercise, coping with psychological stress, and anxiety and depression.
Methods: The guidance will last for 6 months with four sections from hospitalization to 6 months post-discharge. The data will be measured at six time points: baseline, 3 months after discharge, intervention ends, 1 month post-intervention, 3 months post-intervention, and 6 months post-intervention. Outcomes including proactive health behavior, prevention knowledge, health belief, social support, depression, and anxiety were measured at 6 time points. Data were analyzed with SPSS 26.0, GEE models, and Bonferroni correction (P< 0.01).
Discussion: This protocol, developed within the BCW framework, effectively integrates behavioral guidance, psychological support, and family involvement to address poor adherence and unhealthy lifestyles among stroke survivors. Covering the acute, transitional, and long-term phases, it combines hospital-based education with home-based follow-up through face-to-face, digital, and video modalities. This multi-modal and family-centered approach enhances accessibility, continuity, and sustainability of health behavior changes, thereby improving functional recovery, reducing recurrence risk, and supporting the long-term integration of proactive health behaviors.
Trial Registration: ChiCTR2400090433 (Date of registration: September 29, 2024).
Keywords: proactive health behavior, stroke, first-episode, randomized controlled trial