Guan Xuechun, Zhu Qinyuan, Qian Hailan
School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Top Stroke Rehabil. 2025 Jul;32(5):544-552. doi: 10.1080/10749357.2024.2417646. Epub 2024 Oct 22.
Fear of progression (FoP) among stroke patients is closely associated with post-traumatic stress disorder (PTSD), perceived social support, and coping styles. However, there is still limited research on the mechanism of interaction among these four factors. The purpose of this study was to investigate the mediating role of coping styles and perceived social support in the relationship between FoP and PTSD among stroke patients.
The study included 240 stroke patients and utilized a cross-sectional design. Data was collected using a general data questionnaire, the Fear of Progression-Questionnaire-Short Form (FoP-Q-SF), the Perceived Social Support Scale (PSSS), Medical Coping Modes Questionnaire (MCMQ), and the Post-traumatic Stress Disorder Check-list-Civilian Version (PCL-C). Structural equation modeling was used to assess the mediating relationship between PSSS and MCMQ between FoP and PTSD.
A total of 112 (46.7%) patients exhibited mental dysfunction with FoP scores ≥34, and 89 (37.1%) patients presented with a PTSD score of at least 38 had certain PTSD symptoms. FoP was negatively correlated with PSSS and facing coping styles, and positively correlated with PTSD and yielding coping styles. PSSS, facing coping styles, and yielding coping styles partially mediated the relationship between FoP and PTSD, accounting for 42.69% of the total effect.
PTSD can impact FoP directly or indirectly through perceived social support, confrontation, and submissive coping styles. Therefore, it is important to urge patients to reasonably use social support and coping styles to increase well-being, and strive to mitigate the ongoing impact of PTSD symptoms, and reduce the risk of FoP.
中风患者的病情进展恐惧(FoP)与创伤后应激障碍(PTSD)、感知社会支持及应对方式密切相关。然而,关于这四个因素之间相互作用机制的研究仍然有限。本研究旨在探讨应对方式和感知社会支持在中风患者FoP与PTSD关系中的中介作用。
本研究纳入240例中风患者,采用横断面设计。使用一般资料问卷、病情进展恐惧简式问卷(FoP-Q-SF)、感知社会支持量表(PSSS)、医学应对方式问卷(MCMQ)和创伤后应激障碍检查表平民版(PCL-C)收集数据。采用结构方程模型评估PSSS和MCMQ在FoP与PTSD之间的中介关系。
共有112例(46.7%)患者FoP评分≥34,表现出心理功能障碍,89例(37.1%)患者PTSD评分至少为38,有一定的PTSD症状。FoP与PSSS及面对应对方式呈负相关,与PTSD及屈服应对方式呈正相关。PSSS、面对应对方式和屈服应对方式部分中介了FoP与PTSD之间的关系,占总效应的42.69%。
PTSD可通过感知社会支持、对抗和顺从应对方式直接或间接影响FoP。因此,促使患者合理利用社会支持和应对方式以提高幸福感、努力减轻PTSD症状的持续影响并降低FoP风险非常重要。