Perceived stress and depression amongst older stroke patients: sense of coherence as a mediator?

Research output: Contribution to journalArticle



  • Li-Na Guo
  • Yan-Jin Liu
  • Jacqueline McCallum
  • Ulrika Soderhamn
  • Xian-Fei Ding
  • Su-Yuan Yv
  • Yi-Ru Zhu
  • Yv-Ru Guo

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Original languageEnglish
Pages (from-to)164-170
Number of pages7
JournalArchives of Gerontology and Geriatrics
Early online date25 Aug 2018
StatePublished - Nov 2018


Objective: This study aimed to explore the relationship between perceived stress, sense of coherence, and depression
among older stroke patients.
Methods: A demographic questionnaire, the Perceived Stress Scale (PSS), the Sense of Coherence Scale (SOC)
and the Center for Epidemiologic Studies Depression Scale (CES-D) were distributed to 3000 older stroke patients
from Neurology wards in six large general hospitals, and 2907 individuals completed the survey. Data
analysis consisted of correlation, multiple linear regression, and structural equation modeling.
Results: The total score of the SOC and perceived stress showed a negative correlation (r=-0.80, P <0.01),
the total SOC of coherence and depression also resulted in a negative correlation (r=-0.77, P <0.01), and the
total score of the perceived stress and depression resulted in a positive correlation (r=0.82, P <0.01). The
results of multiple regression analyses indicated that SOC mediated the association between perceived stress and
depression, and the influence of perceived stress on depression was decreased by 16.0%with in the sense of being
out of control dimension and was decreased by 12.3% within the feeling of tension dimension when sense of
coherence was added to the model. The structural equation model confirmed that the sense of coherence had a
partial mediation effect between perceived stress and depression.
Conclusion: SOC is the mediating variable between perceived stress and depression, and can reduce the influence
of perceived stress on depression.


  • older stroke patients, sense of coherence, perceived stress, depression, mediation effect