目的 分析脑卒中患者健康行为的影响因素，并探讨自我效能和电子健康素养在脑卒中患者复发风险感知和健康行为间的链式中介作用，为加强脑卒中患者的健康行为和降低复发风险提供参考依据。 方法 选取2024年3—9月份上海市某三级甲等医院249例脑卒中患者为研究对象，采用一般资料调查表、脑卒中复发风险感知量表、脑卒中健康行为量表、慢性病管理自我效能量表和电子健康素养量表进行问卷调查。采用Pearson相关分析探讨各变量间的相关性，SPSS 26.0软件Process的Model 6进行链式中介模型检验。 结果 脑卒中患者复发风险感知、健康行为、自我效能和电子健康素养得分分别为（42.88 ± 6.48）分、（68.32 ± 14.13）分、（6.87 ± 1.55）分和（27.76 ± 6.06）分，且各变量间均呈正相关（P < 0.01）。中介效应模型显示，自我效能和电子健康素养在脑卒中患者复发风险感知和健康行为间起链式中介作用，效应值为0.488，占总效应的37.22%。 结论 脑卒中患者复发风险感知和健康行为均处于中等水平。未来可通过建立移动管理平台为脑卒中患者提供全程健康管理，进一步探索提升卒中患者自我效能的策略及在线健康教育的渠道，以改善其健康行为。

Objective To analyze the influencing factors of health behaviors in stroke patients， and explore the chain mediating effects of self-efficacy and e-health literacy between the perception of stroke recurrence risk and health behaviors in stroke patients， providing a reference for strengthening the health behavior and reducing recurrence risk in stroke patients. Methods 249 stroke patients were selected as the research objects from March to September 2024 in a tertiary hospital in Shanghai， China. Patients were surveyed using General Information Questionnaire， Stroke Recurrence Risk Perception Scale， Stroke Health Behavior Scale（HBS-SP）， Chronic Disease Self-Efficacy Scale （CDSES）， and the e-health Literacy Scale（e-HEALS）. Pearson correlation analysis was used to explore the correlations among various variables， and SPSS 26.0 software macro program Process Model 6 was used to conduct chain mediation model test. Results The scores of Recurrence Risk Perception， HBS-SP， CDSES and e-HEALS of stroke patients were （42.88 ± 6.48） scores， （68.32 ± 14.13） scores， （6.87 ± 1.55） scores and （27.76 ± 6.06） scores， and all the variables were positively correlated （P < 0.01）. The mediating effect model showed that self-efficacy and e-health literacy played a chain mediating role in the recurrence risk perception and health behavior in stroke patients， with an effect size of 0.488， accounting for 37.22% of the total effect. Conclusions The recurrence risk perception and health behavior of stroke patients are both at a moderate level. In the future， we can establish a mobile management platform to provide comprehensive health management for stroke patients. Further exploration of strategies to enhance stroke patients' self-efficacy and channels for online health education could be pursued to improve their health behaviors.