Int J Nurs Pract. 2026;32(4):e70162. doi: 10.1111/ijn.70162.
ABSTRACT
BACKGROUND: Health literacy and fear of disease progression can predict quality of life, yet the underlying mechanisms among these three factors remain poorly understood.
AIM: This study aimed to investigate the hypothesis that health literacy among patients with ischemic stroke is associated with fear of disease progression and both directly and indirectly influence quality of life through the mediating role of fear of disease progression.
METHODS: Between December 2023 and June 2024, questionnaires were distributed to 300 in-patients with ischemic stroke selected by convenience sampling from the neurology departments of three tertiary general hospitals in the Xiangxi region of Hunan Province. Assessments were conducted using the General Information Questionnaire, the Medical Outcomes Study Short Form 36 (SF-36), Health Literacy Management Scale (HeLMS) and Fear of Progression Questionnaire-Short Form (FoP-Q-SF). Pearson correlation analysis was employed to examine the correlations between variables; AMOS 24.0 statistical analysis software was used to explore the pathways and effect sizes of fear of disease progression and health literacy on quality of life.
RESULTS: Health literacy was positively correlated with quality of life (r = 0.412, p < 0.01), while fear of disease progression was negatively correlated with quality of life (r = -0.445, p < 0.01). Fear of disease progression partially mediated the relationship between health literacy and quality of life, accounting for 41.3% of the total effect.
CONCLUSIONS: Findings support the development of targeted psychosocial intervention strategies aimed at enhancing patients' health literacy to effectively alleviate disease-related fear, ultimately improving quality of life and optimizing care outcomes for stroke patients.
PMID:42385192 | DOI:10.1111/ijn.70162