# The Relationship between Type D Personality and Depression Symptoms in Stroke Patients: The Chain Mediating Effect of Self‐Efficacy and Participation Preferences

## TL;DR

This study explores how Type D personality affects depression symptoms in stroke patients through self-efficacy and participation preferences in discharge planning.

## Contribution

The study identifies a chain mediating effect of self-efficacy and discharge planning participation preferences linking Type D personality to depression symptoms in stroke patients.

## Key findings

- Type D personality, self-efficacy, participation preferences, and depression symptoms are significantly correlated.
- Self-efficacy and participation preferences mediate the relationship between Type D personality and depression symptoms.
- The chain indirect effect accounts for 7.23% of the total effect on depression symptoms.

## Abstract

Stroke significantly impacts population health, and post‐stroke depressive symptoms are highly prevalent. Although depression symptoms are linked to Type D personality, self‐efficacy, and participation preferences in discharge planning, the mechanisms underlying these interactions remain unclear. This study aimed to examine the chain mediation effects of self‐efficacy and discharge planning participation preferences on the relationship between Type D personality and depression symptoms in stroke patients.

This study used a convenience sampling method to recruit 318 stroke patients from the Department of Neurology at the First People's Hospital of Changzhou. Participants were assessed using the Type D personality scale (DS14), stroke self‐efficacy questionnaire (SSEQ), patient participation preferences assessment (PPPA), and self‐rating depression scale (SDS). Statistical analyses included descriptive analysis, Spearman's rank correlation analysis, and chain mediation analysis; these analyses were performed using SPSS 25.0 and PROCESS v3.5 (Model 6).

A total of 311 stroke patients were included in this study. Type D personality, self‐efficacy, participation preferences, and depression symptoms are significantly correlated with each other (all P < 0.001). Self‐efficacy and participation preferences acted as significant mediators between Type D personality and depression symptoms. The total indirect effect accounted for 46.51% of the total effect, and the chain pathway contributed 7.23% (chain indirect effect = 0.030, 95% CI 0.014–0.050).

Type D personality indirectly influences depression symptoms through the chain mediation effects of self‐efficacy and participation preferences in stroke patients. This study demonstrates the intrinsic mechanisms by which Type D personality contributes to depression symptoms, providing insights for healthcare professionals to prevent and clinically intervene in stroke patients with depression.

Type D personality is associated with depression symptoms in stroke patients. In 311 inpatients, a chain mediation model identified a significant chain mediating effect of self‐efficacy and discharge planning participation preferences on this association. The total indirect effect accounted for 46.51% of the total effect, and the chain pathway contributed 7.23% (chain indirect effect = 0.030, 95% CI 0.014‐0.050). Enhancing self‐efficacy and discharge engagement may help reduce depression symptoms.