Perceived stress and depression amongst older stroke patients: Sense of coherence as a mediator?

OBJECTIVE: This study aimed to explore the relationship between perceived stress, sense of coherence, and depression among older stroke patients.

METHODS: A demographic questionnaire, the Perceived Stress Scale (PSS), the Sense of Coherence Scale (SOC) and the Center for Epidemiologic Studies Depression Scale (CES-D) were distributed to 3000 older stroke patients from Neurology wards in six large general hospitals, and 2907 individuals completed the survey. Data analysis consisted of correlation, multiple linear regression, and structural equation modeling.

RESULTS: The total score of the SOC and perceived stress showed a negative correlation (r = -0.80, P ＜ 0.01), the total SOC of coherence and depression also resulted in a negative correlation (r = -0.77, P ＜ 0.01), and the total score of the perceived stress and depression resulted in a positive correlation (r = 0.82, P ＜ 0.01). The results of multiple regression analyses indicated that SOC mediated the association between perceived stress and depression, and the influence of perceived stress on depression was decreased by 16.0%with in the sense of being out of control dimension and was decreased by 12.3% within the feeling of tension dimension when sense of coherence was added to the model. The structural equation model confirmed that the sense of coherence had a partial mediation effect between perceived stress and depression.

CONCLUSION: SOC is the mediating variable between perceived stress and depression, and can reduce the influence of perceived stress on depression.