Network analysis of hope, medical coping, and self-deficiency in patients with port-wine stain

Background Port-wine stain (PWS) is a chronic congenital vascular malformation that often causes substantial psychosocial burden due to visible skin lesions. However, the complex interrelationships among hope, medical coping, and self-deficiency in patients with PWS remain unclear. Objective This study aimed to explore the network structure of hope, medical coping styles, and self-deficiency in patients with PWS, identify core and bridge psychological nodes, and examine subgroup differences by socioeconomic status (SES), gender, and treatment experience. Methods A cross-sectional study was conducted among 227 patients with PWS. Hope was assessed using the Herth Hope Index (HHI), coping styles using the Medical Coping Modes Questionnaire (MCMQ), and self-deficiency using the Feeling of Inadequacy Scale (FIS). Network analysis was performed to estimate the psychological interaction structure, evaluate centrality and bridge centrality, identify community structures, and assess network stability. Subgroup network comparisons were further conducted based on gender, SES, and treatment experience. Results The network analysis identified learning ability as the most central node and the most important bridge node. Confrontation and appearance also showed high centrality. The strongest edge was observed between learning ability and confrontation, suggesting a close interaction between perceived competence and active coping. Bridge centrality analysis further highlighted social confidence as an important connector across psychological domains. Community detection identified three interconnected psychological subsystems. Subgroup analyses revealed substantial heterogeneity: males showed stronger associations between hope and self-deficiency, females demonstrated tighter connections among self-esteem, appearance, and social confidence, and patients without treatment experience exhibited denser psychological networks. In addition, low-SES patients had significantly higher network density than high-SES patients, indicating stronger mutual reinforcement among psychological factors. Conclusion The psychological adaptation of patients with PWS exhibits a complex network structure, with learning ability, confrontation, and social confidence serving as key intervention targets. Patients with lower SES may be more psychologically vulnerable due to denser network connectivity. These findings provide a theoretical basis for precision psychological interventions in PWS from a network perspective. Notably, patients with low SES exhibited denser network connectivity, suggesting heightened psychological vulnerability, so future public health strategies should prioritize both node-specific interventions and resources for disadvantaged populations.