The Relationship Between Medical Social Support And Cognitive Emotion Regulation And Disability Acceptance In Stroke Patients

Objectives Investigate the current situation of medical social support,cognitive emotion regulation and disability acceptance in stroke patients,explore the influencing factors of cognitive emotion regulation and disability acceptance,and build a structural equation model to clarify the relationship among medical social support,cognitive emotion regulation and disability acceptance,and to provide evidence for improving disability acceptance of stroke patients.Methods Convenience sampling method was used to select 556 stroke patients who were treated in the Department of Neurology,Cangzhou Central Hospital,Hebei Province from September 2020 to August 2021 as the research subjects.The General Information Questionnaire,Medical Social Support Scale,Cognitive Emotion Regulation Questionnaire,Disability Acceptance Scale,Fatigue Severity Scale,Modified Rankin Scale and Self-care Ability Scale were used to investigate the patients.All data were analyzed using SPSS 25.0and AMOS 23.0 statistical software.Statistical methods include statistical description,t-test,analysis of variance,Pearson correlation analysis and structural equation model.Results 1 The medical social support score of stroke patients was(69.55±10.05),which was at an upper-middle level,with the highest practical support score(3.72±0.72)and the lowest mental support score(2.26±0.80).2 The positive cognitive emotion regulation score of stroke patients was(59.09±15.03),the negative cognitive emotion regulation score was(55.91±11.49).The top five strategies with the highest scores are catastrophic(15.75±3.36),self-blame(13.99±3.11),contemplation(13.95±3.23),acceptance(12.24±3.86)and blame others(12.22±2.95).The results of multivariate analysis showed that the age,gender,educational level,marital status,number of onsets,disability,post-stroke fatigue,and personal monthly income had influences on both positive cognitive emotion regulation and negative cognitive emotion regulation.Residence,disease duration and medical payment method were independent influencing factors of positive cognitive emotion regulation.3 The results of Pearson correlation analysis showed that medical social support was positively correlated with disability acceptance(r=0.699,P＜0.001);positive cognitive emotion was positively correlated with disability acceptance(r=0.704,P＜0.001).Negative cognitive emotion regulation was negatively correlated with disability acceptance(r=-0.683,P＜0.001).4 The disability acceptance score of stroke patients was(73.90±14.85),which was at a moderately low level.The results of multivariate analysis showed that the age,education level,marital status,place of residence,number of onsets,duration of disease,fatigue after stroke,personal monthly income,number of comorbidities,degree of disability,frequency of communication with relatives and friends,self-perceived burden,sense of coherence,selfesteem,medical social support,positive cognitive emotion regulation and negative cognitive emotion regulation were the influencing factors of disability acceptance,which could explain 87.3% of the total variance.5 The results of structural equation model showed that the medical social support for stroke patients had positive effects on disability acceptance and positive cognitive emotion regulation(r=0.463,r=0.403,both P＜0.05),had a negative effect on negative cognitive emotion regulation(r=-0.492,P＜0.05).Positive cognitive emotion regulation positively affects disability acceptance(r=0.474,P＜0.05),negative cognitive emotion regulation negatively affects disability acceptance(r=-0.364,P＜0.05),which played a partial mediating role between medical social support and disability acceptance,with the mediating effect values of 0.191 and 0.179,accounting for 22.93% and21.49% of the total effect.Conclusions 1 The medical social support of stroke patients is at an upper-middle level.2The disability acceptance in stroke patients is at a moderately low level.Age,education level,marital status,place of residence,number of onsets,disease duration,post-stroke fatigue,personal monthly income,number of comorbidities,degree of disability,frequency of interactions with relatives and friends,self-perceived burden,sense of coherence,selfesteem,medical social support,positive cognitive emotion regulation and negative cognitive emotion regulation have an impact on disability acceptance.3 Medical social support in stroke patients can directly affect disability acceptance,and it also has indirect effects on disability acceptance through positive cognitive emotion regulation and negative cognitive emotion regulation.Figure1;Table26;Reference 152...