Mediating effect of social support in the relationship of symptom burden and fear of disease progression in stroke patients

Aims: To investigate the current status and influencing factors of fear of disease progression in stroke patients, and to analyze the mediating effect of social support between symptom burden and the fear of disease progression.

Methods: A cross-sectional study recruited 235 stroke patients in a convenience sample from the neurology department of a tertiary hospital in China. The general information questionnaire, social support rating scale, stroke symptom experience scale, and fear of progression questionnaire short form were utilized for the survey. This study adheres to STROBE reporting guidelines.

Results: The fear of disease progression score in stroke patients was 29.11 (6.72). Results from the multivariable analysis indicated that patients without a family history of stroke (β = -0.09, 95% CI (-2.37, -0.15)), elderly patients (≥ 65) (β = -0.26, 95% CI (-4.88, -2.32)), hypertensive patients (β = 0.10, 95% CI (0.40, 2.63)), and patients with balanced budgets (β = -0.13, 95% CI (-3.58, -0.28)) exhibited lower levels of fear of disease progression. Unemployment (β = 0.21, 95% CI (1.72, 4.54)), patients experiencing heavy symptom burden (β = 0.56, 95% CI (4.86, 6.67)), and those with low social support (β = -0.28, 95% CI (-0.42, -0.22)) had a higher level of fear of disease progression. Social support (β = 0.14, 95% CI (0.08, 0.20)) mediated the correlation between symptom burden and fear of disease progression.

Conclusions: Stroke patients have moderate to low levels of fear of disease progression. Nursing staff should provide more social support to patients with heavier symptom burdens to reduce their fear of disease progression.

Impact: Healthcare providers and caregivers can reduce the fear of disease progression in stroke patients with high symptom burden by increasing their level of social support. This study can help promote the mental health of stroke patients.

Patient or public contribution: No patient or public contribution.