Nonlinear association between perceived social support and fear of disease progression in stroke patients: a cross-sectional study
- 1School of Nursing, Ningxia Medical University
- 2General Hospital of Ningxia Medical University
Abstract
Objectives: To explore the nonlinear association between perceived social support and fear of disease progression in stroke patients.
Methods: In this cross-sectional study, 300 patients with stroke completed a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Modified Barthel Index (MBI). Independent-samples t tests, one-way analysis of variance, hierarchical linear regression, and restricted cubic spline (RCS) analysis were used.
Results: The mean FoP score was 30.34 ± 8.56. In the hierarchical regression model, higher PSS was associated with lower FoP ( B = −0.223, P < 0.001). Compared with employed participants, unemployed participants had lower FoP scores ( B = −3.188, P = 0.008), and severe ADL dependence was associated with higher FoP compared with independence ( B = 4.921, P = 0.035). The restricted cubic spline analysis indicated evidence of nonlinearity ( P foroverall < 0.001; P for nonlinear = 0.023). Exploratory piecewise linear regression identified an estimated change point at a PSS score of 67 ( P = 0.011). Below 67, each one-point increase in PSS was associated with a 0.319-point lower FoP score ( B = −0.319, 95% CI −0.396 to −0.241; P < 0.001). At PSS scores ≥ 67, the slope was not statistically significant and was imprecisely estimated ( B = 0.304, 95% CI −0.142 to 0.751; P = 0.182).
Conclusions: This study suggested a nonlinear association between perceived social support and fear of disease progression, with a change point at a perceived social support score of 67. However, this change point requires validation in larger multicenter and prospective studies. In addition, unemployed and severely dependent were independently associated with fear of disease progression. These findings may help guide more comprehensive psychosocial assessment for stroke patients at risk of fear of disease progression.
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BibTeX
@article{qi2026nonlinear,
title = {{Nonlinear association between perceived social support and fear of disease progression in stroke patients: a cross-sectional study}},
author = {Yijia Qi and Yuyan Yang and Xiaohui Liu and Xiaoping Yang and Shailing Ma and Yingjie Zheng and Jing Li and Jiajia Lai},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1954246},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1954246/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Nonlinear association between perceived social support and fear of disease progression in stroke patients: a cross-sectional study
AU - Yijia Qi
AU - Yuyan Yang
AU - Xiaohui Liu
AU - Xiaoping Yang
AU - Shailing Ma
AU - Yingjie Zheng
AU - Jing Li
AU - Jiajia Lai
PY - 2026
DA - 2026/10/13
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1954246
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1954246/full
AB - Objectives: To explore the nonlinear association between perceived social support and fear of disease progression in stroke patients. Methods: In this cross-sectional study, 300 patients with stroke completed a general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Modified Barthel Index (MBI). Independent-samples t tests, one-way analysis of variance, hierarchical linear regression, and restricted cubic spline (RCS) analysis were used. Results: The mean FoP score was 30.34 ± 8.56. In the hierarchical regression model, higher PSS was associated with lower FoP ( B = −0.223, P < 0.001). Compared with employed participants, unemployed participants had lower FoP scores ( B = −3.188, P = 0.008), and severe ADL dependence was associated with higher FoP compared with independence ( B = 4.921, P = 0.035). The restricted cubic spline analysis indicated evidence of nonlinearity ( P foroverall < 0.001; P for nonlinear = 0.023). Exploratory piecewise linear regression identified an estimated change point at a PSS score of 67 ( P = 0.011). Below 67, each one-point increase in PSS was associated with a 0.319-point lower FoP score ( B = −0.319, 95% CI −0.396 to −0.241; P < 0.001). At PSS scores ≥ 67, the slope was not statistically significant and was imprecisely estimated ( B = 0.304, 95% CI −0.142 to 0.751; P = 0.182). Conclusions: This study suggested a nonlinear association between perceived social support and fear of disease progression, with a change point at a perceived social support score of 67. However, this change point requires validation in larger multicenter and prospective studies. In addition, unemployed and severely dependent were independently associated with fear of disease progression. These findings may help guide more comprehensive psychosocial assessment for stroke patients at risk of fear of disease progression.
SN - 2296-2565
ER -