Use and Dynamic Adjustment of Self-Control Strategies in Physical Activity Engagement Among Young and Middle-Aged Stroke Patients: A Qualitative Study.

BACKGROUND: Young and middle-aged stroke patients often have poor self-control due to brain injury and limited experience in disease management, leading to conflicts between intentions to engage in physical activity (PA) and temptations. However, little is known about PA participation from a self-control perspective. This study therefore investigated how these patients use self-control to manage such conflicts. METHODS: This descriptive qualitative study employed purposive sampling to recruit 16 stroke patients (10 ischemic, 6 hemorrhagic) aged 18-59 years with relatively mild disability, all of whom were living independently in the community. The majority were married and resided in urban areas. Thematic analysis was employed for data analysis. This report follows the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS: Three themes were identified: (1) conflict between PA intentions and temptations, (2) adaptive self-control strategies in PA contexts, and (3) temporal and contextual dynamics of self-control motivation in PA. Participants' PA intentions were driven by health cognitions and identity roles. However, knowledge gaps and symptom interpretation biases led them to rationalize temptations. Participants adopted various adaptive self-control strategies (eg, self-motivation, establishing external supervision, and daily habits). Furthermore, self-control motivation varied across different stages and contexts of PA, and was primarily influenced by anticipated and actual fatigue, as well as body image concerns. CONCLUSION: This study offers insight into how young and middle-aged stroke patients navigate the conflict between PA intentions and temptations from a self-control perspective. Healthcare professionals may consider offering motivational interviewing and guidance on PA safety to reduce stroke patients' tendency to rationalize temptations. Furthermore, attention should be paid to patients' psychological resources and external environmental support, in order to deliver individualized self-control strategies that promote PA participation and long-term adherence.