Influence of recurrence risk perception on depressive mood in first-time stroke patients and the mediating effect of coping styles and perceived discrimination

This study aimed to investigate the associations and mediating roles of coping styles and perceived discrimination in the relationship between recurrence risk perception and depression among first-ever stroke patients. Convenience sampling was used to select 382 first-ever stroke patients admitted to our hospital between June 2023 and June 2025. General information questionnaires, the Recurrence Risk Perception Scale, Patient Health Questionnaire-9 (PHQ-9), Medical Coping Modes Questionnaire (MCMQ), and Perceived Discrimination Scale (PDS) were used for assessment. A chain mediation model was constructed and tested. A total of 382 questionnaires were distributed, and 375 valid questionnaires were returned, yielding an effective response rate of 98.17%. The total scores for recurrence risk perception, depression, coping style, and perceived discrimination among the 375 first-ever stroke patients were 35.65 ± 7.37, 5.86 ± 1.39, 43.36 ± 5.12, and 20.77 ± 3.67, respectively. Recurrence risk perception was significantly positively correlated with depression, avoidance, resignation, and perceived discrimination, and significantly negatively correlated with confrontation (P < 0.05). Patients with stronger perceived discrimination had a higher recurrence risk perception, more severe depression, and were more inclined to adopt negative coping styles. The specific indirect effect through coping style was 0.230, accounting for 17.54% of the total effect; the specific indirect effect through perceived discrimination was 0.214, accounting for 16.32% of the total effect; and the chain mediating effect through coping style and perceived discrimination was 0.044, accounting for 3.36% of the total effect. Coping style and perceived discrimination were associated with recurrent risk perception and depression in patients with first-ever stroke. Healthcare professionals should address patients' risk perception of recurrence, focus on guiding them toward adopting positive coping styles, and mitigate the negative psychological impact of perceived discrimination.