Evaluation of the Effect of Psychological Resilience on Anxiety in Patients with Diabetic Retinopathy Through the Mediating Effect of Perceived Stress: A Moderated Mediation Model

Yanqiu Cui,1,2,* Yonghua Mao,2,* Mengjiao Tang,1 Jie Zhu,1 Huiyu Yao2 1Department of Ophthalmology, Changzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, People’s Republic of China; 2Nursing department, Changzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Huiyu Yao, Email [email protected]: To investigate the anxiety status of Chinese patients with diabetic retinopathy (DR) and its relationship with psychological resilience and perceived stress.Methods: A sampling method was used to select 606 DR patients, and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Perceived Stress Scale short-form (PSS-10), and General Anxiety Disorder-7 (GAD-7) were used for the survey. We used SPSS 26.0 to analyse the data and employed PROCESS v4.1 for the mediating effect test.Results: The incidence of anxiety in DR patients was approximately 53.63%, with psychological resilience (CD-RISC-10 average=27.51± 8.32) and perceived stress (PSS-10 average=15.97± 6.54). Anxiety was negatively correlated with psychological resilience (r=− 0.569, P< 0.01) and positively correlated with perceived stress (r=0.638, P< 0.01). Additionally, psychological resilience was negatively correlated with perceived stress (r=− 0.681, P< 0.01). Perceived stress had a positive predictive effect on anxiety (total effect = − 0.327, 95% bootstrap CI = − 0.363 to − 0.291), and it played a mediating role in the relationship between psychological resilience and anxiety, with a mediating effect size of 54.13%.Conclusion: Psychological resilience and perceived stress directly or indirectly affect anxiety, Perceived stress moderates the relationship between psychological resilience and anxiety as a mediating variable. By analyzing this psychological mechanism, this study provides a new perspective for applying psychology to chronic diseases and a scientific basis for medical staff to develop targeted psychological intervention measures.Keywords: diabetic retinopathy, perceived stress, psychological resilience, mediating effect