Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2021; 9(30): 8999-9010
Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.8999
Uncertainty in illness and coping styles: Moderating and mediating effects of resilience in stroke patients
Zi-Ting Han, Hui-Min Zhang, Yi-Ming Wang, Shan-Shan Zhu, Dong-Yang Wang
Zi-Ting Han, Hui-Min Zhang, Shan-Shan Zhu, School of Nursing, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
Yi-Ming Wang, School of International Education, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
Dong-Yang Wang, Department of Nursing, School of Pharmacy, Changzhou University, Changzhou 213000, Jiangsu Province, China
Dong-Yang Wang, Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
Author contributions: Han ZT and Zhang HM contributed equally to this work; Wang DY and Zhang HM designed the research study; Han ZT, Zhang HM, Wang YM, and Wang DY performed the research; Han ZT and Zhang HM contributed new reagents and analytic tools; Han ZT, Zhu SS, and Wang DY analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by The Humanities and Social Sciences Research Program of the Henan Province Education Department in 2017, No. 2017-ZZJH-439.
Institutional review board statement: This study was approved by the Academic Ethics Committee of Xinxiang Medical University (No. 20190201001).
Informed consent statement: Written informed consent was obtained from all participants, and the researchers kept the research data confidential.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
STROBE statement: The manuscript was checked according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Yang Wang, PhD, Academic Research, Department of Nursing, School of Pharmacy, Changzhou University, No. 21 Gehu Road, Wujin District, Changzhou 213000, Jiangsu Province, China. wangdongyang1994@gmail.com
Received: April 12, 2021
Peer-review started: April 12, 2021
First decision: May 11, 2021
Revised: May 19, 2021
Accepted: September 2, 2021
Article in press: September 2, 2021
Published online: October 26, 2021
Processing time: 191 Days and 18 Hours
Abstract
BACKGROUND

Stroke has a great influence on the patient’s mental health, and reasonable psychological adjustment and disease perception can promote the recovery of mental health.

AIM

To explore the relationships among resilience, coping style, and uncertainty in illness of stroke patients.

METHODS

A retrospective study was used to investigate 154 stroke patients who were diagnosed and treated at eight medical institutes in Henan province, China from October to December 2019. We used the Mishel Uncertainty in Illness Scale, the Connor-Davidson Resilience Scale, and the Medical Coping Modes Questionnaire to test the uncertainty in illness, resilience, and coping style, respectively.

RESULTS

Resilience had a significant moderating role in the correlation between coping style and unpredictability and information deficiency for uncertainty in illness (P < 0.05). Further, the tenacity and strength dimensions of resilience mediated the correlation between the confrontation coping style and complexity, respectively (P < 0.05). The strength dimension of resilience mediated the correlation between an avoidance coping style and the unpredictability of uncertainty in illness (P < 0.05), as well as correlated with resignation, complexity, and unpredictability (P < 0.05).

CONCLUSION

Resilience has moderating and mediating roles in the associations between coping style and uncertainty in illness, indicating that it is vital to improve resilience and consider positive coping styles for stroke patients in the prevention and control of uncertainty in illness.

Keywords: Stroke; Resilience, Psychological; Coping styles; Uncertainty in illness

Core Tip: This study aimed to examine the association between uncertainty in illness and coping styles, as moderated and mediated by resilience, in stroke patients. We believe that our study makes a significant contribution to the literature because, to the best of our knowledge, it is the first to explore this association. Further, in our sample of 154 stroke inpatients in China, we found evidence to support the significant mediating role that resilience plays in the correlation between uncertainty in illness and patients’ coping styles. We believe that these findings can have clinical and practical implications, and can be used to inform interventions to increase the resilience of stroke patients.