Mechanisms underlying the association between perceived recurrence risk and negative emotions in patients with ischemic stroke: a cross-sectional study.

OBJECTIVE: To examine the relationships among perceived risk of recurrence, attitudes toward seeking professional psychological help, negative emotions, and family care in patients with ischemic stroke, and to test a moderated mediation model. The findings aim to provide a scientific basis for optimizing clinical psychological interventions and family support strategies. METHODS: A cross-sectional survey was conducted among 311 patients with ischemic stroke recruited from three tertiary hospitals in Sichuan Province, China. Data were collected using validated scales measuring perceived recurrence risk, help-seeking attitudes, negative emotions, and family care. Mediation and moderated mediation analyses were performed using SPSS 27.0 and PROCESS macro (Models 4 and 58), with 5, 000 bootstrap resamples to estimate 95% confidence intervals (CIs). RESULTS: Perceived recurrence risk was positively associated with negative emotions (β = 0.350, p < 0.001). Attitudes toward seeking professional psychological help partially mediated this association, with a significant indirect effect (effect = 0.131, 95% CI: 0.082-0.192), accounting for 40.68% of the total effect. Family care moderated both paths of the mediation model. In the first stage, family care moderated the association between perceived recurrence risk and help-seeking attitudes (β = 0.043, p = 0.001), such that higher family care weakened the negative association. In the second stage, family care moderated the association between help-seeking attitudes and negative emotions (β = -0.075, p = 0.008), indicating that higher family care strengthened the protective association between help-seeking attitudes and lower negative emotions. CONCLUSION: Perceived recurrence risk, help-seeking attitudes, and negative emotions are significantly associated in patients with ischemic stroke. Help-seeking attitudes partially explain this association, while family care plays a significant moderating role in both stages. These findings highlight the importance of psychological and family-centered support in stroke rehabilitation. However, causal interpretations should be made cautiously due to the cross-sectional design.