Is resourcefulness as a mediator between perceived stress and depression among old Chinese stroke patients?

Abstract

Objective: This study aimed to explore whether resourcefulness can serve as a mediator between perceived stress and depression among old Chinese stroke patients.

Methods: 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.

Results: 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.

Limitations: 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.

Conclusion: 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.

Keywords: Depression symptoms; Mediation analysis; Older people; Resourcefulness; Stroke.