{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:29:54Z","timestamp":1789140594917,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke keeps on the rise in young and middle-aged individuals. This group may experience positive psychological changes, such as posttraumatic growth (PTG), which facilitates recovery. However, PTG in young and middle-aged stroke patients is not yet fully understood in China. This study aims to examine the associations between uncertainty in illness and PTG among young and middle-aged patients with stroke, and to explore whether coping styles and rumination are associated with this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted from September 2022 to February 2023 in a tertiary hospital in Guangzhou, China, enrolling 204 stroke patients aged 18 to 59 years. Sociodemographic and clinical data were obtained via interviews and medical records. Data on PTG, uncertainty in illness, coping styles, and rumination were collected via the Posttraumatic Growth Inventory (PTGI), Mishel Uncertainty in Illness Scale for Adults (MUIS-A), Simplified Coping Style Questionnaire (SCSQ), and Event-Related Rumination Inventory (ERRI). Data were analyzed using Pearson correlation and path analysis in SPSS 26.0 and Mplus 8.3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Totally 204 participants were included. The mean score for PTG was $52.27\u2009\u00b1\u200912.06. Uncertainty in illness was negatively correlated with PTG (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22120.61,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Path analysis revealed that positive coping styles (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      = \u22120.21,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and deliberate rumination (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009-0.12,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002) were significantly associated with the relationship between uncertainty in illness and PTG. These variables accounted for 44.7% and 25.9% of the total effect, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Uncertainty in illness is significantly associated with PTG among young and middle-aged stroke patients, such association was mediated by positive coping styles and deliberate rumination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135261445651","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:33:47Z","timestamp":1778074427000},"page":"63-73","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Uncertainty in Illness and Posttraumatic Growth among Young and Middle-Aged Stroke Patients: A Mediation Model of Coping Styles and Rumination"],"prefix":"10.1177","volume":"59","author":[{"given":"Xinyi","family":"Chen","sequence":"first","affiliation":[{"name":"School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong Province, China"},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Xingyi People's Hospital, Xingyi, Guizhou Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Cao","sequence":"additional","affiliation":[{"name":"School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2016.1141242"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10615806.2010.529901"},{"issue":"9","key":"e_1_3_3_4_1","first-page":"4","article-title":"Reliability and validity of the simplified Chinese version of event related rumination inventory among accidentally injured patients","volume":"48","author":"Dong C.","year":"2013","unstructured":"Dong C., Gong S., Liu X. 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