Relationship between perceptions of recurrence risk and depression state among first-episode ischemic stroke patients in rural areas: The mediating role of coping style

Relationships Between Quality of Discharge Teaching, Readiness for Hospital Discharge, Self-Efficacy and Self-Management in Patients With First-Episode Stroke: A Cross-Sectional Study

AIMS

The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates.

DESIGN

Cross-sectional study.

METHODS

A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables.

RESULTS

The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376-0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ2/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05).

CONCLUSION

QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community.

RELEVANCE TO CLINICAL PRACTICE

Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.

Recurrence Risk Perception, Fear of Progression, and Health Behaviors Among Patients With Ischemic Stroke

BACKGROUND

The relationship between recurrence risk perception, fear of progression, and health behaviors in patients with ischemic stroke is unclear.

OBJECTIVE

To explore the effect of accuracy and level of recurrence risk perception on health behaviors and the mediating role of fear of progression.

METHODS

We conducted a 2-wave survey. Patients with ischemic stroke (N = 261) were recruited from 2 hospitals in Guangzhou, China. Before discharge, demographic information, objective recurrence risk, perceived recurrence risk, fear of progression, and health behaviors were investigated. After 1 month, the patient's health behaviors were followed up.

RESULTS

The median (quartiles 1-3) scores for recurrence risk perception and fear of progression were 43.0 (39.0-46.0) and 22.0 (18.0-28.0), respectively. Only 22.2% of the patients correctly perceived the risk of recurrence, 23.0% underestimated the risk, and 30.7% overestimated the risk. Patients who overestimated the risk of recurrence (β = 0.421, P = .002) or had a higher perceived level of recurrence risk (β = 0.446, P < .001) had a higher fear of progression, which contributed to better health behaviors at 1 month (β = 0.197, P = .001). Fear of progression played a partial and full mediating role, respectively. Patients who underestimated the recurrence risk had worse health behaviors than those who accurately perceived it (β = -0.296, P = .033).

CONCLUSION

Both accuracy and level of recurrence risk perception were independent predictors of future health behaviors, and fear of progression was mediating. Health care professionals should develop individualized risk education programs to help stroke patients properly understand and cope with the risk of recurrence.

Relationship between perceptions of recurrence risk and depression state among first-episode ischemic stroke patients in rural areas: The mediating role of coping style

AIMS

To investigate the relationship between stroke survivors' perceptions of recurrence risk, coping styles and depression state, and the role coping styles play in mediating that relationship.

DESIGN

A cross-sectional descriptive study.

METHODS

From one hospital in Huaxian, China, 320 stroke survivors were randomly selected as a convenience sample. In this research, the Simplified Coping Style Questionnaire, the Patient Health Questionnaire-9 and the Stroke Recurrence Risk Perception Scale were all used. Structural equation modelling and correlation analysis were used to analyse the data. This research followed the EQUATOR and STROBE checklists.

RESULTS

There were 278 valid survey responses. There were mild to severe depressive symptoms in 84.8% of stroke survivors. In stroke survivors, there was a significant negative relationship (p < 0.01) between the positive coping of perceptions of recurrence risk and their depression state. Recurrence risk perception's impact on depression state was partly mediated, according to mediation studies, by coping style, with the mediation effect accounting for 44.92% of the overall effect.

CONCLUSIONS

The connection between perceptions of recurrence risk and depression state was mediated by the coping mechanisms of stroke survivors. A lower degree of depression state among survivors was connected with positive coping to the beliefs of recurrence risk.