The Relationship Between Stigmaand Loneliness Among Young And Middle-aged Stroke Patients And The Mediating Moderating Effect

ObjectivesThe purpose of this study is to examine the current situation of stigma,psychological resilience,interpersonal sensitivity,and loneliness among young and middle-aged stroke survivors and how they vary across different demographic attributes;the correlation among these four constructs;the influencing factors of loneliness;the role of interpersonal sensitivity and psychological resilience between stigma and loneliness among young and middle-aged stroke survivors,with a view to offering novel insights for clinical caregivers to alleviate the loneliness experienced by this group,and providing guidance for facilitating their holistic rehabilitation.MethodsThis study employed methods such as literature review,questionnaire survey,and statistical analysis,and used convenience sampling to administer questionnaires to 330 young and middle-aged stroke survivors from three tertiary hospitals in Zhengzhou and Kaifeng,Henan province.The research instruments mainly comprised a general demographic questionnaire,stigma scale,interpersonal sensitivity scale,Connor-Davidson resilience scale,and UCLA loneliness scale.Data analysis methods included descriptive statistics,single factor analysis,Pearson correlation,multiple linear regression,and moderated mediation test.Results(1)Descriptive analysis.The total score of the stigma of young and middle-aged stroke patients was(47.71 ± 7.27).Among the average scores of the four dimensions,the highest score was self-perception(3.75 ± 0.73),and the lowest score was discrimination experience(2.74 ± 0.85);The total score of psychological resilience was(75.20 ± 10.77).Among the average scores of the three dimensions,the highest score was strength(3.51 ± 0.70),and the lowest was tenacity(3.17 ± 0.64);The total score of interpersonal sensitivity was(48.25 ±7.56).Among the average scores of the five dimensions,the highest score was identification needs(2.73 ± 0.48),and the lowest score was separation anxiety(2.33 ± 0.64);The total score of loneliness was(36.23 ± 8.19),and the average score of items was(2.01 ± 0.45).(2)Single factor analysis.There were significant differences in the scores of the sense of stigma among different genders,residences,marital status,occupational types and duration of illness(p<0.05);There were significant differences in psychological resilience scores among different education levels,occupational types,per capita monthly income of families and whether or not to drink alcohol(p<0.05);There were significant differences in scores of interpersonal sensitivity between gender,family economic support before illness and illness time(p<0.05);Age,residence,education level,per capita monthly income,whether it was the main economic pillar of the family before illness,and the duration of illness had significant differences in loneliness scores(p<0.05)(3)Pearson correlation analysis.There was a significant negative correlation between the stigma and psychological resilience in young and middle-aged stroke patients(r=-0.254),and a positive correlation with interpersonal sensitivity and loneliness,with correlation coefficients of 0.553 and 0.489,respectively;The correlation coefficient between psychological resilience and interpersonal sensitivity was-0.157,and the correlation coefficient between psychological resilience and loneliness was-0.211,both of which were negatively correlated;The correlation coefficient between interpersonal sensitivity and loneliness was 0.682,showing a positive correlation.(4)Multivariate linear regression analysis.Somatic symptom disorder,discrimination experience,social interaction,self-perception,separation anxiety,tenacity,strength,optimism,age and duration of illness and other variables have significant effects on loneliness in young and middle-aged stroke patients(p<0.05).(5)Moderated mediation test.Interpersonal sensitivity plays a part of mediating role between the stigma and the loneliness in young and middle-aged stroke patients,of which the mediating role accounts for 63.27%.In addition,for young and middle-aged stroke patients with low psychological resilience,their sense of stigma has a significant positive predictive effect on interpersonal sensitivity(β= 0.699,t=17.865,p<0.001);For young and middle-aged stroke patients with high resilience,compared with the former,their sense of stigma has no significant positive predictive effect on loneliness(β= 0.035,t=0.841,p=0.402)。ConclusionsIn this study,middle-aged and young stroke patients had moderate levels of stigma,psychological resilience,interpersonal sensitivity and loneliness,and there were significant correlations between all variables.In addition,the loneliness of middle-aged and young stroke patients was influenced by multiple factors.Interpersonal sensitivity played a partial mediating role between stigma and loneliness in middle-aged and young stroke patients.The process of stigma affecting loneliness through interpersonal sensitivity was negatively moderated by psychological resilience.Therefore,clinical care workers should pay attention to reducing the stigma and interpersonal sensitivity of middle-aged and young stroke patients,improving their psychological resilience,and ultimately reducing their loneliness level.