Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2023; 13(12): 1096-1105
Published online Dec 19, 2023. doi: 10.5498/wjp.v13.i12.1096
Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients
Chang-Yue Luo, Peng Jiao, Shu-Min Tu, Lin Shen, Yong-Mei Sun
Chang-Yue Luo, Peng Jiao, Shu-Min Tu, Lin Shen, Yong-Mei Sun, Department of Emergency, The First People’s Hospital of Shangqiu, Shangqiu 476000, Henan Province, China
Author contributions: Luo CY, Shen L, and Sun YM designed this study; Jiao P organized the literature; Luo CY wrote the manuscript; Tu SM reviewed the manuscript.
Institutional review board statement: The study procedures were approved by the First People’s Hospital of Shangqiu (2021-125-29).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Yue Luo, MM, Attending Doctor, Department of Emergency, The First People’s Hospital of Shangqiu, No. 292 Kai Road, Suiyang District, Shangqiu 476000, Henan Province, China. 15090647313@163.com
Received: September 13, 2023
Peer-review started: September 13, 2023
First decision: September 28, 2023
Revised: October 10, 2023
Accepted: October 29, 2023
Article in press: October 29, 2023
Published online: December 19, 2023
Processing time: 97 Days and 4.8 Hours
Abstract
BACKGROUND

Stroke patients often experience psychological distress, which can impact their intimate relationships with spouses, subsequently influencing their treatment and recovery. Physical activity is considered a key rehabilitation method for stroke patients. This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.

AIM

To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.

METHODS

A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study. The participants completed questionnaires, including the Kessler Psychological Distress Scale (K10), the Quality of Relationship Index (QRI), International Physical Activity Questionnaire, and a general information questionnaire. Data analysis were performed using SPSS 23.0. The Harman test was employed to detect common method deviations, and Spearman correlation was used for correlation analysis. The mediating effect was assessed using Process 3.4.1, with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method (5000 iterations, 95% confidence interval). Statistical significance was set at P < 0.05.

RESULTS

The results showed that patients scored an average of 21.61 ± 6.44 points on the K10, 32.40 ± 6.19 points on the QRI; the median physical activity level according to the International Physical Activity Questionnaire was 1861 (566, 2846) MET·min/w. The level of physical activity (the physical activity intensity of the patients reflected by the International Physical Activity Questionnaire-Long Form scale) negatively correlated with psychological distress and intimacy (P < 0.05), and positively correlated with each other (P < 0.05), with the correlation stronger at lower physical activity levels compared to higher ones. The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%. Bootstrap analysis further validated the results. The mediating effect of psychological distress on intimate relationships through physical activity level was -0.284, with a confidence interval of -0.409 to -0.163, excluding 0, confirming a significant mediating effect of psychological distress on intimate relationships.

CONCLUSION

Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients. Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

Keywords: Stroke; Cross-sectional study; Psychological distress; Intimate relationship; Mediating effect; Physical activity level

Core Tip: Psychological distress is prevalent among stroke patients and can significantly impact their intimate relationships with spouses. Physical activity plays a crucial role in stroke prevention and rehabilitation. This study successfully identified a mediating effect of physical activity on psychological distress and intimate relationships, among stroke patients, confirmed through the Bootstrap test. These findings provide a robust foundation for promoting stroke patient rehabilitation and addressing relationship challenges between spouses.