ORIGINAL RESEARCH article
Front. Neurol.
Sec. Cognitive and Behavioral Neurology
This article is part of the Research TopicAnosognosia in Neurological and Psychiatric DisordersView all 8 articles
The Mediating Role of Coping Style in the Relationship Between Optimism and Cognitive Impairment Among Patients with Stroke
Provisionally accepted
- 1Shenyang Medical College, Shenyang, China
- 2Shenyang Medical College Affiliated Second Hospital, shenyang, China
- 3Shenyang Third People's Hospital, shenyang, China
- 4Beijing Health Vocational College, Beijing, China
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Background: Stroke may bring psychological and cognitive challenges. Previous research revealed that several mediators, such as coping style and optimism, might be associated with cognitive impairment in patients with stroke. Objective: This study aims to establish a structural equation model of the relationships among optimism, coping style, and cognitive impairment and to explore the mediating role of coping style in the association between optimism on cognitive impairment.Methods: Using a cross-sectional survey, 1000 hospitalized patients with stroke from China were studied. Collected data were analyzed using correlation analyses, structural equation modeling, and regression analyses.SPSS 26.0 was used to construct logistic regression and decision tree models, and the area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the two models. Structural equation modeling was used to examine the links among dispositional optimism, coping style, and cognitive impairment. The robustness of the model was verified by the bootstrap method. Results:The average scores of positive coping,negative coping, optimism, and cognitive impairment in patients with stroke were 19.26±9.68, 10.49±7.24,23.22±4.58, and 0.87±1.69, respectively. The analysis of the receiver operating characteristic (ROC) curve showed that the predictive performance of logistic regression was slightly better than that of the decision tree model.SEM findings indicated that coping style serves as a significant mediator of the association between optimism and cognitive impairment. Conclusion:Both coping style and optimism were found to be significantly associated with cognitive impairment in patients with stroke, with coping style serving as a mediator of the association between optimism and cognitive impairment in this patient population. These cross-sectional findings suggest that, for inpatients with stroke, medical staff could consider paying attention to their cognitive function and assessing their psychological health status, including their optimism and coping strategies, which may help inform the selection of supportive interventions that could be beneficial for cognitive health.
Keywords: Cognitive impairment1, Coping style3, Optimism2, Stroke4, structural equation modeling5
Received: 16 Aug 2025; Accepted: 05 Dec 2025.
Copyright: © 2025 Gu, Liu, Su and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li Zhao
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