Factors Influencing Adherence to Home-Based Exercise Rehabilitation in Stroke Patients from a Temporal Perspective: An Explanatory Sequential Mixed-Methods Study

从时间角度探讨影响中风患者居家康复锻炼依从性的因素:一项解释性序贯混合方法研究

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Abstract

PURPOSE: This study aimed to examine the factors influencing the adherence of stroke patients to home-based exercise rehabilitation and to elucidate the potential driving mechanisms of temporal perspective on rehabilitation adherence. PATIENTS AND METHODS: This study employed a sequential, explanatory, and mixed-methods design. In the quantitative phase, a questionnaire survey was conducted among 289 stroke patients from January 2025 to May 2025 using convenience sampling. In the qualitative phase, 16 stroke patients were selected from the quantitative sample through purposive and maximum variation sampling to explain and supplement the quantitative findings using semi-structured interviews. RESULTS: Quantitative analysis demonstrated a significant positive correlation between temporal perspective and rehabilitation adherence, with rehabilitation intention partially mediating this relationship. Behavioral advantage exerted a negative moderating effect on the intention-adherence pathway, whereas the moderating effect of self-regulation ability did not reach statistical significance. Qualitative analysis identified four main themes: consistency belief, time-bound potency, behavioral advantage, and self-regulation ability. CONCLUSION: Temporal perspective is an important driver of adherence to home-based rehabilitation among stroke patients. As rehabilitation habits develop, behavioral patterns gradually shift from being "intention-driven" to becoming "automatic habits", thereby weakening the direct driving effect of intention. Given the potential presence of latent executive dysfunction in stroke patients, targeted assessment tools and intervention strategies should be developed to bridge the gap between intention and behavior.

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