# The mediating role of coping style in the relationship between optimism and cognitive impairment in patients with stroke

## TL;DR

This study explores how coping style influences the link between optimism and cognitive impairment in stroke patients.

## Contribution

It identifies coping style as a mediator between optimism and cognitive impairment in stroke patients.

## Key findings

- Coping style significantly mediates the relationship between optimism and cognitive impairment in stroke patients.
- Logistic regression showed slightly better predictive performance than decision tree models in this context.
- Both optimism and coping style are significantly associated with cognitive impairment in stroke patients.

## Abstract

Stroke may bring psychological and cognitive challenges. Previous research revealed that several mediators, such as coping style and optimism, might be associated with cognitive impairment in patients with stroke.

This study aims to establish a structural equation model of the relationships among optimism, coping style, and cognitive impairment, and to explore the mediating role of coping style in the association between optimism on cognitive impairment.

Using a cross-sectional survey, 1,000 hospitalized patients with stroke from China were studied. The collected data were analyzed using correlation analyses, structural equation modeling, and regression analyses. SPSS 26.0 was used to construct logistic regression and decision tree models, and the area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the two models. Structural equation modeling was used to examine the links among dispositional optimism, coping style, and cognitive impairment. The robustness of the model was verified using the bootstrap method.

The average scores of positive coping, negative coping, optimism, and cognitive impairment in patients with stroke were 19.26 ± 9.68, 10.49 ± 7.24, 23.22 ± 4.58, and 0.87 ± 1.69, respectively. The analysis of the receiver operating characteristic (ROC) curve showed that the predictive performance of logistic regression was slightly better than that of the decision tree model. SEM findings indicated that coping style serves as a significant mediator in the association between optimism and cognitive impairment.

Both coping style and optimism were found to be significantly associated with cognitive impairment in patients with stroke, with coping style serving as a mediator of the association between optimism and cognitive impairment in this patient population. These cross-sectional findings suggest that, for inpatients with stroke, medical staff should consider paying attention to their cognitive function and assessing their psychological health status, such as their optimism and coping strategies, which may help inform the selection of supportive interventions that may benefit cognitive health.