Psychological distress in stroke patients: latent class analysis and influencing factors

Psychological distress is common in stroke patients and adversely affects rehabilitation and quality of life. However, the heterogeneity of this distress remains underexplored.

This study aimed to explore the latent categories of psychological distress in patients with stroke and analyze its influencing factors.

A cross-sectional study was conducted using a convenience sample of 417 patients with stroke in a tertiary hospital in Zunyi from July to November 2024. Socio-demographic information and psychological distress of participants were obtained using a general information questionnaire and the SCL-90 scale. Latent class analysis was used to analyze the latent categories of psychological distress in patients with stroke. In the multiple logistic regression analysis, the latent categories of psychological distress derived from latent class analysis were used as the dependent variable to identify factors influencing these categories.

Psychological distress in patients with stroke was classified into three groups: High Paranoid Ideation and Hostility group (Class 1, 17.99%), Generalized Psychological Distress group (Class 2, 25.18%), and Low Psychological Distress group (Class 3, 56.83%). Multiple logistic regression demonstrated that, compared with Class 3 (reference), health literacy was significantly associated with membership in Class 1 (OR = 1.019, 95% CI: 1.003-1.036) and Class 2 (OR = 1.057, 95% CI: 1.039-1.075), while interoceptive sensibility was significantly associated with membership in Class 1 (OR = 0.988, 95% CI: 0.980-0.997) and Class 2 (OR = 0.974, 95% CI: 0.965-0.983). Male patients and those with a stroke duration of less than one year were significantly more likely to belong to Class 2 (OR = 9.281, 95% CI: 4.347-19.815; OR = 23.594, 95% CI: 2.592-214.62).

Among stroke patients, psychological distress manifests in three distinct profiles: the High Paranoid Ideation and Hostility group, the generalized psychological distress group, and the low psychological distress group. Tailored intervention measures are implemented based on the unique demographic characteristics of each group to enhance their mental health outcomes.