Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Frances Payne Bolton School of Nursing, Case Western Reserve University. Euclid Avenue Cleveland, Ohio, USA.
J Affect Disord. 2019 Jun 15;253:44-50. doi: 10.1016/j.jad.2019.04.083. Epub 2019 Apr 22.
This study aimed to explore whether resourcefulness can serve as a mediator between perceived stress and depression among old Chinese stroke patients.
A cross-sectional study was conducted in six hospitals during July 2016 to July 2017, from five cities of Henan Province, China. A demographic questionnaire, the Perceived Stress Scale (PSS), the Resourcefulness Scale (RS) and the Center for Epidemiologic Studies Depression Scale (CES-D) were distributed among 3000 old stroke patients, and 2907 of them completed this survey. Correlation analysis, multiple linear regression and structural equation model (SEM) were used for statistical analysis of the study.
The total scores of the resourcefulness were negatively correlated with perceived stress (r= -0.795, P<0.01) and depression (r= -0.772, P<0.01); It indicated positive correlation of the total scores of perceived stress and depression (r = 0.820, P<0.01). Multiple regression analyses showed that resourcefulness mediated the relationship between perceived stress and depression, which reduced the effect of perceived stress on depression by 16.3% (from 0.464 to 0.301) on the subscale "sense of being out of control" and by 20.3% (from 0.411 to 0.208) on the subscale "feeling of tension" when resourcefulness was included in the model. Structural equation model validated these findings, and further confirmed that resourcefulness had a partial mediation effect (39.4% of total effect) between perceived stress and depression.
This cross-sectional study does not allow for examination of the relationship between pre-stroke resourcefulness and post-stroke depression, or the potential intervening role of perceived stress.
Resourcefulness was found to be a mediator between perceived stress and depression, suggesting the potential benefit of an intervention to teach resourcefulness skills to decrease depression in highly stressed older Chinese stroke patients.
本研究旨在探讨资源感是否可以作为中国老年脑卒中患者感知压力和抑郁之间的中介。
本研究采用横断面研究，于 2016 年 7 月至 2017 年 7 月在河南省五个城市的六所医院进行。共发放 3000 份一般资料问卷、感知压力量表（PSS）、资源量表（RS）和流行病学研究中心抑郁量表（CES-D）给老年脑卒中患者，其中 2907 人完成了该调查。采用相关性分析、多元线性回归和结构方程模型（SEM）对研究进行统计分析。
资源感总分与感知压力（r=-0.795，P<0.01）和抑郁（r=-0.772，P<0.01）呈负相关；感知压力总分与抑郁呈正相关（r=0.820，P<0.01）。多元回归分析表明，资源感在感知压力和抑郁之间起中介作用，当纳入模型时，资源感将感知压力对抑郁的影响降低了 16.3%（从 0.464 到 0.301），在“失控感”亚量表上降低了 20.3%（从 0.411 到 0.208）。结构方程模型验证了这些发现，并进一步证实资源感在感知压力和抑郁之间具有部分中介效应（总效应的 39.4%）。
本横断面研究不能检验脑卒中前的资源感与脑卒中后的抑郁之间的关系，也不能检验感知压力的潜在干预作用。
资源感是感知压力和抑郁之间的中介，提示通过干预教授资源感技能可能会降低高度应激的中国老年脑卒中患者的抑郁。
