Chain mediation effect of psychological resilience and fear of falling on family function and rehabilitation exercise adherence in stroke patients by gender
10.3760/cma.j.cn115682-20240423-02273
- VernacularTitle:心理弹性和跌倒恐惧在不同性别脑卒中患者家庭功能和康复运动依从性间的链式中介作用
- Author:
Qiufang LI
1
;
Rui LI
;
Jie ZHANG
;
Xujing ZHU
;
Lijuan HAN
Author Information
1. 新乡市中心医院康复医学科二，新乡市脑卒中康复护理技术重点实验室，新乡 453000
- Keywords:
Stroke;
Family function;
Psychological resilience;
Fear of falling;
Rehabilitation exercise adherence;
Mediation effect;
Gender
- From:
Chinese Journal of Modern Nursing
2024;30(28):3879-3887
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the chain mediation effects of psychological resilience and fear of falling on family function and rehabilitation exercise adherence among stroke patients of different genders.Methods:Totally 298 stroke patients from Xinxiang Central Hospital between January and December 2023 were selected by convenience sampling. Participants were assessed using the Family Assessment Device (FAD), Connor-Davidson Resilience Scale (CD-RISC), Fear of Falling Questionnaire-Reversed (FFQ-R), and Exercise Adherence Questionnaire (EAQ). The SPSS PROCESS macro was utilized to test the chain mediation effects.Results:Male stroke patients had higher total FAD scores, communication, and family role dimension scores, total CD-RISC scores, resilience and self-reliance dimension scores, and EAQ scores, including adherence to physical exercise and exercise supervision, compared to female patients ( P<0.05). However, female patients scored higher in emotional response and emotional involvement dimensions of FAD, total FFQ-R, and all dimensions of FFQ-R, as well as adherence to seeking timely advice of EAQ ( P<0.05). Mediation analysis showed that in male stroke patients, family function had no significant direct effect on rehabilitation exercise adherence (95% CI: -0.055 - 0.096), with psychological resilience and fear of falling playing a fully mediating role; the total mediation effect was 0.113, accounting for 84.96% of the total effect. In female stroke patients, family function had a significant direct effect on rehabilitation exercise adherence, with an effect of 0.110, accounting for 42.80% of the total effect. In addition, psychological resilience and fear of falling partially mediated the relationship between family function and rehabilitation exercise adherence, with a total mediation effect of 0.147, accounting for 57.20% of the total effect. Conclusions:The levels of family function, psychological resilience, fear of falling, and rehabilitation exercise adherence, as well as the mechanisms linking these factors, differ by gender in stroke patients. In male stroke patients, psychological resilience and fear of falling fully mediate the relationship between family function and rehabilitation exercise adherence. In female stroke patients, family function influences rehabilitation exercise adherence through both direct effects and the partial mediating effects of psychological resilience and fear of falling.
