Health literacy at the acute stroke phase was significantly associated with post-discharge step count (B = 93.07, p = 0.025) but not with sedentary behavior, light-intensity physical activity, or moderate-to-vigorous physical activity three months after discharge.
Key Findings
Results
Health literacy was significantly associated with post-discharge step count in stroke survivors three months after discharge.
Multiple linear regression analysis found B = 93.07, p = 0.025 for the association between health literacy and step count.
The analysis adjusted for age, sex, stroke severity, walking speed, and modified Rankin Scale score.
Health literacy was assessed using the HLS-EU-Q16 questionnaire during the acute hospitalization phase.
Physical activity was measured three months post-discharge using a triaxial accelerometer.
Results
Health literacy was not significantly associated with sedentary behavior, light-intensity physical activity, or moderate-to-vigorous physical activity at three months post-discharge.
Three physical activity and sedentary behavior outcomes beyond step count were examined but showed no significant association with health literacy.
All analyses were adjusted for age, sex, stroke severity, walking speed, and modified Rankin Scale score.
Measurements were taken using a triaxial accelerometer at three months post-discharge.
Methods
The study was conducted as a prospective cohort study of 61 patients hospitalized with acute stroke.
Sample size was 61 patients.
Health literacy was assessed at discharge using the HLS-EU-Q16 questionnaire.
Physical activity and sedentary behavior outcomes were measured three months post-discharge using a triaxial accelerometer.
Multiple linear regression analyses were used to examine associations between health literacy and each physical activity outcome.
Conclusions
The authors emphasize the need for multidisciplinary collaboration, including nurses, to enhance health literacy from the acute care stage.
The finding that health literacy during acute hospitalization predicts post-discharge step count supports early intervention.
Nurses are specifically identified as part of the multidisciplinary team needed to address health literacy.
The authors suggest targeting health literacy enhancement starting in the acute care phase.
Ashizawa R, Ikeda K, Honda H, Kameyama Y, Yoshimoto Y. (2026). Association between health literacy at discharge and post-discharge step count in stroke survivors: A prospective cohort study.. Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing. https://doi.org/10.1016/j.jvn.2026.01.004