The association between social support and quality of life in patients with severe stroke: a chain mediation analysis of resilience and self-efficacy.

Authors

Yun Li, Yuru Liu, Dan Liu, Hongmei Pang, Rongrong Hao, Juan Du, Xiaonan Liu, Yining Shi

Published in

Frontiers in psychiatry. Volume 17. Pages 1851981. Epub Jul 16, 2026.

Abstract

To explore the chain mediating effects of resilience and self-efficacy on the association between social support and quality of life (QoL) among patients with severe stroke.
This cross-sectional study enrolled 272 inpatients between June 2023 and June 2025. Validated instruments were used to assess social support (SSRS), resilience (CD-RISC), self-efficacy (GSES), and quality of life (QoL) (SS-QOL). PROCESS Model 6 with 5,000 bias-corrected bootstrap samples was used to test sequential mediation while adjusting for key covariates.
Mean scores indicated moderate levels of social support, resilience, self-efficacy, and QoL. Quality of life scores were significantly higher among patients aged <60 years compared to those aged ≥60 years (54.62 ± 14.07 vs. 49.34 ± 13.12), among patients with higher education levels (college or above: 54.73 ± 14.27 vs. primary school or below: 47.26 ± 11.38), among patients covered by Employee Health Insurance compared to self-funded patients (53.26 ± 13.42 vs. 42.36 ± 11.25), and among patients with lower NIHSS scores (10-14 points: 56.38 ± 13.45 vs. 15-24 points: 46.44 ± 12.41). All comparisons were statistically significant at P < 0.05. All main variables were positively correlated. The direct association between social support and QoL was significant (adjusted unstandardized β = 0.88, 95% CI [0.790, 0.975]), accounting for 53.5% of the total association. The three indirect associations were: (1) SSRS - CD-RISC - SS-QOL: β = 0.255, 95% CI [0.192, 0.329]; (2) SSRS - GSES - SS-QOL: β = 0.126, 95% CI [0.020, 0.208]; and (3) SSRS - CD-RISC - GSES - SS-QOL: β = 0.385, 95% CI [0.289, 0.510],supporting the hypothesized chain mediation model.
Social support was strongly associated with QoL, both directly and indirectly through resilience and self-efficacy and their sequential pathways. These findings highlight potential intervention targets, although causal inferences are limited by the study's cross-sectional design. Strengthening social support and related psychological resources may improve rehabilitation outcomes in patients with severe strokes.

PMID:
42534726
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.