Mediating role of rehabilitation self-efficacy in the relationship between stress perception and depression among Chinese patients with stroke during the recovery period

To explore the relationship between perceived stress and depression and examine the mediating role of rehabilitation self-efficacy in this relationship among patients with stroke during the recovery period. A convenience sampling method was used to select 316 patients with stroke in the recovery period who were admitted to our hospital between August 2022 and August 2025 as the study participants. A general information questionnaire, the Perceived Stress Scale (PSS), Geriatric Depression Scale (GDS), and Rehabilitation Self-Efficacy Scale (RSES) were administered. A mediation model was constructed and verified using the PROCESS macro (Model 4) in SPSS to test the mediating effect. There were statistically significant differences in perceived stress scores among patients with different educational levels and comorbid chronic diseases (P < 0.05), statistically significant differences in depression scores among patients of different genders, ages, and family histories of stroke (P < 0.05), and statistically significant differences in rehabilitation self-efficacy scores among patients of different ages, educational levels, and per capita monthly family income (P < 0.05). Among the 310 patients with stroke in the recovery period, the total perceived stress score was (25.65 ± 4.37), the total depression score was (20.86 ± 4.39), and the total rehabilitation self-efficacy score was (50.36 ± 8.12). Perceived stress was positively correlated with depression (P < 0.05) and negatively correlated with rehabilitation self-efficacy (P < 0.05), while depression was negatively correlated with rehabilitation self-efficacy (P < 0.05). Rehabilitation self-efficacy played a mediating role between perceived stress and depression (mediating effect = 0.450), accounting for 47.77% of the total effect (95% CI: 0.161-0.842). The confidence interval did not include 0, indicating a significant mediating effect. The direct effect of perceived stress on depression was 0.493 (95% CI: 0.412-0.574), which was significant and accounted for 52.23% of the total effect. Rehabilitation self-efficacy partially mediates the relationship between perceived stress and depression among stroke patients during recovery. Improving patients' rehabilitation self-efficacy may indirectly reduce depression levels.