Abstract
This study aimed to investigate the associations and mediating roles of coping styles and perceived discrimination in the relationship between recurrence risk perception and depression among first-ever stroke patients. Convenience sampling was used to select 382 first-ever stroke patients admitted to our hospital between June 2023 and June 2025. General information questionnaires, the Recurrence Risk Perception Scale, Patient Health Questionnaire-9 (PHQ-9), Medical Coping Modes Questionnaire (MCMQ), and Perceived Discrimination Scale (PDS) were used for assessment. A chain mediation model was constructed and tested. A total of 382 questionnaires were distributed, and 375 valid questionnaires were returned, yielding an effective response rate of 98.17%. The total scores for recurrence risk perception, depression, coping style, and perceived discrimination among the 375 first-ever stroke patients were 35.65 ± 7.37, 5.86 ± 1.39, 43.36 ± 5.12, and 20.77 ± 3.67, respectively. Recurrence risk perception was significantly positively correlated with depression, avoidance, resignation, and perceived discrimination, and significantly negatively correlated with confrontation (P < 0.05). Patients with stronger perceived discrimination had a higher recurrence risk perception, more severe depression, and were more inclined to adopt negative coping styles. The specific indirect effect through coping style was 0.230, accounting for 17.54% of the total effect; the specific indirect effect through perceived discrimination was 0.214, accounting for 16.32% of the total effect; and the chain mediating effect through coping style and perceived discrimination was 0.044, accounting for 3.36% of the total effect. Coping style and perceived discrimination were associated with recurrent risk perception and depression in patients with first-ever stroke. Healthcare professionals should address patients' risk perception of recurrence, focus on guiding them toward adopting positive coping styles, and mitigate the negative psychological impact of perceived discrimination.