The Impact of Self-Perceived Burden on Loneliness in Stroke Patients: The Mediating Role of Rumination
Xinxin Zhou,1 Lina Guo,2 Yuanli Guo,2 Genoosha Namassevayam,3 Peng Zhao,1 Mengyu Zhang,1 Yuying Xie,1 Yanjin Liu4 1School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 2Department of Neurology, National Advanced Stroke Center, the First Affiliate...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-07-01
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| Series: | Patient Related Outcome Measures |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-impact-of-self-perceived-burden-on-loneliness-in-stroke-patients-t-peer-reviewed-fulltext-article-PROM |
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| Summary: | Xinxin Zhou,1 Lina Guo,2 Yuanli Guo,2 Genoosha Namassevayam,3 Peng Zhao,1 Mengyu Zhang,1 Yuying Xie,1 Yanjin Liu4 1School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 2Department of Neurology, National Advanced Stroke Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 3Department of Supplementary Health Sciences, Faculty of Health-Care Sciences, Eastern University, Chenkalady, Sri Lanka; 4Department of Nursing, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of ChinaCorrespondence: Yanjin Liu, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China, Email liu-yanjin@126.com Lina Guo, Department of Neurology, National Advanced Stroke Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China, Email guolina09@126.comBackground: Stroke outcomes are often measured through objective scales, which may neglect subtle cognitive changes and fail to capture patients’ subjective experiences of recovery and quality of life. This study aimed to examine the interrelations among self-perceived burden, loneliness, and rumination in stroke survivors through the patient-reported outcomes and to provide theoretical insights and intervention strategies for improving psychological well-being and quality of life in stroke patients.Methodology: Data from 1024 stroke patients who aged 18 years and above were prospectively collected in September 2022 in Zhengzhou, China. PROs included Self-Perceived Burden Scale, UCLA‐Loneliness Scale, and Event-Related Rumination Inventory. Statistical methods employed included correlation analysis and mediation effect analysis.Results: A total of 1024 participants completed this survey (90.9%), with 56.2% males and a mean age of 62.22 (SD = 13.60) years. Approximately 84.28% of stroke patients felt moderate loneliness. Self-perceived burden was positively correlated with rumination (r = 0.516, 95% CI [0.460, 0.574]) and loneliness (r = 0.370, 95% CI [0.307, 0.431]). Rumination was also positively associated with loneliness (r = 0.493, 95% CI [0.443, 0.541]). Both intrusive and deliberate rumination served as mediators in the relationship between SPB and loneliness (b = 0.119, 55.09%, b = 0.031, 14.35%, respectively).Conclusion: Intrusive and deliberate rumination mediated the relationship between self-perceived burden and loneliness in stroke patients. Rumination in stroke patients should be emphasized as a modifiable factor to reduce loneliness and improve quality of life.Plain Language Summary: Understanding how stroke patients’ self-perceived burden (SPB) contributes to loneliness and the influencing of rumination between them could help improve their well-being and reduce negative outcomes. The focus was on exploring whether two types of rumination—intrusive and deliberate rumination—connect self-perceived burden to loneliness. Key findings showed that both intrusive and deliberate rumination played a role in connecting self-perceived burden with loneliness. Meanwhile, intrusive rumination has a stronger effect. This suggested that reducing repetitive negative thoughts, especially intrusive ones, and addressing more mental patterns in care plans might help lessen loneliness in stroke patients and improve their quality of life after stroke.Keywords: stroke, self-perceived burden, loneliness, rumination, mediating effect |
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| ISSN: | 1179-271X |