Mechanisms underlying the association between perceived recurrence risk and negative emotions in patients with ischemic stroke: a cross-sectional study.

OBJECTIVE

To examine the relationships among perceived risk of recurrence, attitudes toward seeking professional psychological help, negative emotions, and family care in patients with ischemic stroke, and to test a moderated mediation model. The findings aim to provide a scientific basis for optimizing clinical psychological interventions and family support strategies.

METHODS

A cross-sectional survey was conducted among 311 patients with ischemic stroke recruited from three tertiary hospitals in Sichuan Province, China. Data were collected using validated scales measuring perceived recurrence risk, help-seeking attitudes, negative emotions, and family care. Mediation and moderated mediation analyses were performed using SPSS 27.0 and PROCESS macro (Models 4 and 58), with 5, 000 bootstrap resamples to estimate 95% confidence intervals (CIs).

RESULTS

Perceived recurrence risk was positively associated with negative emotions (β = 0.350, p < 0.001). Attitudes toward seeking professional psychological help partially mediated this association, with a significant indirect effect (effect = 0.131, 95% CI: 0.082-0.192), accounting for 40.68% of the total effect. Family care moderated both paths of the mediation model. In the first stage, family care moderated the association between perceived recurrence risk and help-seeking attitudes (β = 0.043, p = 0.001), such that higher family care weakened the negative association. In the second stage, family care moderated the association between help-seeking attitudes and negative emotions (β = -0.075, p = 0.008), indicating that higher family care strengthened the protective association between help-seeking attitudes and lower negative emotions.

CONCLUSION

Perceived recurrence risk, help-seeking attitudes, and negative emotions are significantly associated in patients with ischemic stroke. Help-seeking attitudes partially explain this association, while family care plays a significant moderating role in both stages. These findings highlight the importance of psychological and family-centered support in stroke rehabilitation. However, causal interpretations should be made cautiously due to the cross-sectional design.