Relationship between family functioning and psychological distress among young and middle-aged patients with stroke: a moderated mediation model

This study explores the association between family functioning and psychological distress among young and middle-aged stroke patients, investigating the mediating role of hope and the moderating role of perceived social support. From February 2022 to March 2023, participants were recruited from six hospitals in five areas of Tianjin, China using a convenience sampling method. A total of 643 participants completed the measures of psychological distress, family functioning, hope, and perceived social support. We used the PROCESS macro for SPSS to establish a mediation model with regulations. The results revealed good family functioning was negatively associated with psychological distress in young and middle-aged stroke patients, and hope served as a partial mediator in the relationship between family functioning and psychological distress. Perceived social support moderated the strength of the indirect association between family functioning and psychological distress via hope. Among young and middle-aged stroke patients with high perceived social support scores, the indirect effect between family functioning and psychological distress through hope was stronger. These findings highlight a moderated mediation model, whereby the association between family functioning and psychological distress is mediated by hope, and this indirect association is contingent upon the level of perceived social support.