Physical dependence, self-efficacy, and resilience in stroke patients: a double-moderated mediation model of healthcare group and pre-stroke employment.

Authors

Hsiu-Ling Hsieh, Chia-Pang Shih, Wen-Yuan Lee, Ching-Hua Chu, Sung-Yuan Sung, Huey-Fen Wang

Published in

Topics in stroke rehabilitation. Pages 1-15. Sep 14, 2026. Epub Sep 14, 2026.

Abstract

To examine the concurrent relationships between physical dependence, self-efficacy, and resilience among stroke patients, and to explore whether the healthcare intervention group and pre-stroke employment status jointly moderate this mediated relationship.
A cross-sectional study using moderated mediation analysis.
A total of 123 participants were recruited from a neurology ward in a hospital. Instruments included the Chinese version of the Resilience Scale, the Stroke Self-Efficacy Questionnaire, and the Modified Rankin Scale. Descriptive statistics, correlation analyses, and independent samples t-tests were performed. PROCESS macro (Model 21) with 5,000 bootstrap samples was applied to examine the hypothesized double-moderated mediation model.
Self-efficacy mediated the concurrent relationship between physical dependence and resilience. The healthcare intervention group moderated the relationship between physical dependence (operationalized as a binary threshold [mRS ≤ 3 vs. mRS = 4]) and self-efficacy, whereas pre-stroke employment status moderated the relationship between self-efficacy and resilience. Crucially, the conditional indirect pathway was statistically significant exclusively within the routine care group among patients who were unemployed prior to stroke onset.
Greater physical dependence is concurrently associated with lower resilience, a concurrent relationship where lower self-efficacy serves as a partial mediator. This conditional indirect pathway is particularly pronounced among individuals who receive standard routine care and concurrently lack pre-stroke occupational engagement. For patients who were employed before stroke, the concurrent link between self-efficacy and resilience is absent, suggesting that their psychological adaptation is characterized by distinct environmental or vocational factors.
Routine assessment of physical dependence is crucial for evaluating current functional status and adjusting care plans accordingly. Incorporating social role context and employment history into rehabilitation strategies may further support psychosocial adaptation in stroke patients.

PMID:
42735210
Bibliographic data and abstract were imported from PubMed on 15 Sep 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.