# The effect of perceived stress on depression in stroke: the chain mediating role of self-acceptance and self-perceived burden

## TL;DR

This study explores how perceived stress contributes to depression in stroke patients, showing that self-acceptance and perceived burden mediate this relationship.

## Contribution

The study identifies a chain mediation model involving self-acceptance and self-perceived burden linking perceived stress to depression in stroke patients.

## Key findings

- 67.12% of stroke patients exhibited depression symptoms.
- Perceived stress significantly correlates with self-perceived burden and depression symptoms.
- Self-acceptance and self-perceived burden act as chain mediators between perceived stress and depression symptoms.

## Abstract

This study aims to investigate the mechanism through which perceived stress affects depression symptoms by assessing the current status of depression symptoms and psychological characteristics in stroke patients.

A total of 222 stroke patients were enrolled through convenience sampling at a tertiary general hospital in Harbin City during 2023–2024. Measurement tools included the patient health questionnaire-9, Chinese version of perceived stress scale, self-perceived burden scale and self-acceptance questionnaire. SPSS software was used for descriptive statistical analysis, t-test, analysis of variance, correlation analysis, multiple stepwise regression analysis and mediation effect test.

In this study, 67.12% of stroke patients had depression symptoms. The results of correlation analysis showed that perceived stress was significantly positively correlated with self-perceived burden and depression symptoms (r = 0.212–0.241, p < 0.01), and significantly negatively correlated with self-acceptance (r = −0.320, p < 0.01). Self-perceived burden was positively correlated with depression symptoms (r = 0.348, p < 0.01), and negatively correlated with self-acceptance (r = −0.255, p < 0.01). Self-acceptance was negatively correlated with depression symptoms (r = −0.304, p < 0.01). Mediation effect analyses showed that self-acceptance mediated significantly (95% CI [0.025, 0.117]); self-perceived burden mediated significantly (95% CI [0.003, 0.098]); and self-acceptance and self-perceived burden mediated significantly the chain of mediation in the relationship between perceived stress and depression symptoms (95% CI [0.005, 0.035]).

Patients with stroke have a relatively high level of depression symptoms. Through a chain path of reducing perceived stress, enhancing self-acceptance, and alleviating perceived burden, the depression symptoms of stroke patients can be effectively alleviated.