Correlation Analysis of Disease Perception, Ruminative Rumination, and Psychological Resilience in Elderly Patients with Acute Stroke

Abstract Objective: This study aims to explore the psychological status of elderly patients during the acute phase of stroke and to examine the correlation between Illness perception, rumination, and psychological resilience. Methods: A mixed-method research approach was employed. In the qualitative study, 13 elderly patients with acute stroke were interviewed based on semi-structured interview guides and recordings. The data were transcribed, and thematic content analysis was conducted. In the quantitative study, a cross-sectional survey was conducted on 240 elderly acute stroke patients using paper-based questionnaires, and data analysis was performed using SPSS25.0 and AMOS24.0. Results: From the qualitative analysis, we identified risk factors affecting the psychological status of elderly patients with acute stroke, which can be summarized into four major themes and six categories: lack of stroke-related disease knowledge and cognitive bias, single-source of disease information; significant sequelae, concern about medical expenses; apparent symptoms of anxiety and depression, disease uncertainty, and fear; sense of disease gain. In the quantitative analysis, results indicated that illness perception had a direct effect on psychological resilience (β=-0.34, P<0.01) and rumination (β=0.51, P<0.01). Also, rumination was directly related to psychological resilience (β=-0.24, P<0.01). In addition, illness perception was indirectly related to psychological resilience (β=0.51*-0.24=-0.12, P<0.01) mediated through rumination rumination. Conclusion: Improving the level of rumination in elderly patients with acute stroke can mitigate adverse Illness perception and enhance psychological resilience. This study provides a theoretical basis for developing relevant intervention measures.