Associations Among Health Literacy, Decision Self-Efficacy, and Decisional Conflict in Stroke Survivor–Caregiver Dyads
Ya-Ting LIU, Si-Xun ZHANG, Mei-Sin CHONG, Ying-Chen DUAN, Yi-Nan SHI, Zhen-Xiang ZHANG, Wen-Na WANG, Xin LI, Bei-Lei LIN, Nuo SHI, Kwan Ching WONG, Yong-Xia MEIBackground:
The cognitive and physical impairments often experienced by stroke survivors make health care decisions challenging for both survivors and their caregivers. Although poststroke care decision-making involves complex factors such as health literacy and decision self-efficacy, research on the interactions among health literacy, decision self-efficacy, and decisional conflict within stroke survivor–caregiver dyads remains limited.
Purpose:
This study was designed to explore the inter-relationships among health literacy, decision self-efficacy, and decisional conflict in stroke survivor–caregiver dyads.
Methods:
This cross-sectional study, conducted from September 2023 to April 2024, included 305 pairs of Chinese stroke survivor–caregiver dyads. The All Aspects of Health Literacy Scale, Decision Self-Efficacy Scale, and Decisional Conflict Scale were used to collect data from both stroke survivors and their caregivers. A dyadic analysis was conducted using the actor–partner interdependent mediation model.
Results:
In terms of actor effects, decision self-efficacy was found to respectively mediate health literacy and decisional conflict in stroke survivors (β = −0.511,
Conclusions:
The results of this study indicate that, in stroke survivors, higher health literacy has a direct reducing effect on perceived decisional conflict. In light of this, dyadic-based intervention strategies should be developed. Examples include joint workshops designed to improve stroke survivor–caregiver shared information interpretation and comprehension, and the development of dyadic-oriented decision aids to help both dyad partners achieve information symmetry and consensus in their health care decision-making.