{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:46:03Z","timestamp":1785735963856,"version":"3.56.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In China, family members typically assume primary caregiving responsibilities for stroke patients after treatment. However, the onset of a first ischemic stroke often occurs abruptly, and caregivers, typically spouses, adult children, or other non-professionals, may assume this responsibility without psychological preparation or caregiving experience. This situation may be associated with higher uncertainty in illness. In turn, caregiving confidence may be reduced, potentially compromising caregiving capacity. Therefore, factors associated with primary caregivers\u2019 caregiving capacity should be examined to inform supportive strategies and reduce caregiver burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Standardized scales were used to assess primary caregivers' uncertainty in illness, psychological adaptation, perceived social support, and caregiving capacity. Correlations were analyzed, and mediation and moderation effects were tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Psychological adaptation (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.708,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) and perceived social support (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.675,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) were both positively correlated with caregiving capacity. Psychological adaptation partially mediated the association between uncertainty in illness and caregiving capacity, accounting for 29.98% of the total effect. Perceived social support significantly moderated the association between uncertainty in illness and psychological adaptation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In the low perceived social support group, uncertainty in illness showed a stronger negative association with psychological adaptation, whereas this association was attenuated in the high perceived social support group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Uncertainty in illness was negatively associated with caregiving capacity both directly and indirectly through psychological adaptation. Perceived social support may mitigate the adverse association between uncertainty in illness and psychological adaptation. Interventions aimed at reducing uncertainty in illness, enhancing psychological adaptation, and strengthening social support may help improve caregiving capacity among primary caregivers of patients with first-time ischemic stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1707967","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:30:51Z","timestamp":1785735051000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The relationship between uncertainty in illness and caregiving capacity in primary caregivers of patients with first-time ischemic stroke: the roles of psychological adaptation and perceived social support"],"prefix":"10.3389","volume":"17","author":[{"given":"Guanrong","family":"Guo","sequence":"first","affiliation":[{"name":"School of Nursing, Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingdong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huili","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"E335","DOI":"10.1097\/NCC.0000000000000773","article-title":"Factors associated with uncertainty in patients scheduled to undergo hematopoietic stem cell transplantation","volume":"43","author":"Adarve","year":"2020","journal-title":"Cancer Nurs."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/bjc.12285","article-title":"Perceived social support, loneliness, and hope during the COVID-19 Pandemic: testing a mediating model in the UK, USA, and Israel","volume":"60","author":"Bareket-Bojmel","year":"2021","journal-title":"Br. J. Clin. Psychol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1016\/j.pec.2013.05.006","article-title":"Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk","volume":"93","author":"Biesecker","year":"2013","journal-title":"Patient Educ. Couns."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"977","DOI":"10.3109\/02770903.2012.721435","article-title":"Factors associated with completion of a behavioral intervention for caregivers of urban children with asthma","volume":"49","author":"Butz","year":"2012","journal-title":"J. Asthma"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/JNN.0000000000000238","article-title":"Caregiving immediately after stroke: a study of uncertainty in caregivers of older adults","volume":"48","author":"Byun","year":"2016","journal-title":"J. Neurosci. Nurs."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"523","DOI":"10.3760\/cma.j.cn113694-20240410-00221","article-title":"Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2023","volume":"57","year":"2024","journal-title":"Chin. J. Neurol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.hrtlng.2018.04.003","article-title":"Home discharge following critical illness: a qualitative analysis of family caregiver experience","volume":"47","author":"Choi","year":"2018","journal-title":"Heart Lung"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1093\/geront\/23.6.637","article-title":"Family caregivers of older adults: improving helping skills","volume":"23","author":"Clark","year":"1983","journal-title":"Gerontologist"},{"key":"ref2002","doi-asserted-by":"publisher","author":"Cohen","year":"1988","DOI":"10.4324\/9780203771587"},{"key":"ref9","volume-title":"A study on the correlation between uncertainty in illness, social support, and coping strategies among family members of chronic disease patients","author":"Cui","year":"2010"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.12102\/j.issn.1009-6493.2018.13.015","article-title":"Evaluation of Perceived Social Support Scale used in study of social support among hospitalized patients in China","volume":"32","author":"Fan","year":"2018","journal-title":"Nurs. Res."},{"key":"ref11","volume-title":"Factor Analysis","author":"Gorsuch","year":"1983"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"8999","DOI":"10.12998\/wjcc.v9.i30.8999","article-title":"Uncertainty in illness and coping styles: moderating and mediating effects of resilience in stroke patients","volume":"9","author":"Han","year":"2021","journal-title":"World J. Clin. Cases"},{"key":"ref13","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: a Regression-Based Approach","author":"Hayes","year":"2013"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"48","DOI":"10.19793\/j.cnki.1006-6411.2021.36.016","article-title":"Study on the impact of uncertainty in illness among caregivers of stroke patients on their caregiving capacity","volume":"28","author":"Jing","year":"2021","journal-title":"Contemp. Nurse"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3452","DOI":"10.1111\/j.1365-2702.2011.03729.x","article-title":"Evaluation of the psychometric properties of a modified Chinese version of the caregiver task inventory\u2014refinement and psychometric testing of the Chinese caregiver task inventory: a confirmatory factor analysis","volume":"20","author":"Lee","year":"2011","journal-title":"J. Clin. Nurs."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e0211313","DOI":"10.1371\/journal.pone.0211313","article-title":"Illness uncertainty, social support, and coping mode in hospitalized patients with systemic lupus erythematosus in a hospital in Shaanxi, China","volume":"14","author":"Li","year":"2019","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.2147\/PPA.S463562","article-title":"Relationship between illness uncertainty and family resilience among caregivers of stroke patients in Chinese nuclear families: the mediating role of perceived stress","volume":"18","author":"Li","year":"2024","journal-title":"Patient Prefer. Adherence"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1111\/jocn.16290","article-title":"Family function, self-efficacy, care hours per day, closeness and benefit finding among stroke caregivers in China: a moderated mediation model","volume":"32","author":"Mei","year":"2023","journal-title":"J. Clin. Nurs."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3761\/j.issn.0254-1769.2021.01.026","article-title":"Psychometric testing of the Chinese version of Psychological Adaptation Scale for caregivers of children with cancer","volume":"56","author":"Mengjia","year":"2021","journal-title":"Chin. J. Nurs."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"268","DOI":"10.3969\/j.issn.2096-5516.2024.04.005","article-title":"Analysis of factors affecting cognitive function in patients with acute ischemic stroke","volume":"7","author":"Miao","year":"2024","journal-title":"J. Alzheimer's Dis. Relat. Disord."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1177\/019394598300500408","article-title":"Adjusting the fit: development of uncertainty scales for specific clinical populations","volume":"5","author":"Mishel","year":"1983","journal-title":"West. J. Nurs. Res."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/j.1547-5069.1988.tb00082.x","article-title":"Uncertainty in illness","volume":"20","author":"Mishel","year":"1988","journal-title":"Image: J. Nurs. Scholarsh."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"70","DOI":"10.4103\/jehp.jehp_1776_23","article-title":"Multifaceted support for caregivers of stroke patients to meet the dynamic needs of patients: a qualitative study","volume":"14","author":"Noorian","year":"2025","journal-title":"J. Educ. Health Promot."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12888-018-1616-z","article-title":"Resilience and burden in caregivers of older adults: moderating and mediating effects of perceived social support","volume":"18","author":"Ong","year":"2018","journal-title":"BMC Psychiatry"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.3390\/ijerph191711116","article-title":"Addressing uncertainty in informal familial caregivers of stroke survivors: a systematic meta-ethnography","volume":"19","author":"Ponzini","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref26","first-page":"41","article-title":"Perceived social support scale","volume":"10","author":"Qianjin","year":"2001","journal-title":"Chin. Behav. Med. Scie."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1002\/msc.46","article-title":"Control perceptions in patients with rheumatoid arthritis: the role of social support","volume":"1","author":"Ryan","year":"2003","journal-title":"Musculoskeletal Care"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.1212\/WNL.0000000000012781","article-title":"Global epidemiology of stroke and access to acute ischemic stroke interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1002\/pon.5551","article-title":"The impact of ovarian cancer on individuals and their caregivers: a qualitative analysis","volume":"30","author":"Tan","year":"2021","journal-title":"Psychooncology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e231455","DOI":"10.1001\/jamanetworkopen.2023.1455","article-title":"Estimated burden of stroke in China in 2020","volume":"6","author":"Tu","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"788737","DOI":"10.3389\/fpsyt.2022.788737","article-title":"Resilience and caregiving ability among caregivers of people with stroke: the mediating role of uncertainty in illness","volume":"13","author":"Wang","year":"2022","journal-title":"Front. Psych."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"296","DOI":"10.3969\/j.issn.1009-5551.2024.02.025","article-title":"Current status and influencing factors of care ability of caregivers of 182 children with primary nephrotic syndrome","volume":"47","author":"Wanjun","year":"2024","journal-title":"J. Xinjiang Med. Univ."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12904-024-01559-4","article-title":"Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study","volume":"23","author":"Xu","year":"2024","journal-title":"BMC Palliat. Care"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1544692","DOI":"10.3389\/fpsyt.2025.1544692","article-title":"Social alienation and influencing factors among caregivers of stroke patients in China: a cross-sectional study","volume":"16","author":"Xu","year":"2025","journal-title":"Front. Psych."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.12102\/j.issn.1009-6493.2024.08.006","article-title":"The psychological adaptation level and influencing factors of spouse caregivers for stroke patients in the transition period after discharge","volume":"38","author":"Yan","year":"2024","journal-title":"Nurs. Res."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1188\/17.ONF.645-649","article-title":"Uncertainty in illness: theory review, application, and extension","volume":"44","author":"Zhang","year":"2017","journal-title":"Oncol. Nurs. Forum"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1319848","DOI":"10.3389\/fpsyt.2024.1319848","article-title":"Non-adaptive cognitive emotion regulation mediates the relationship between disease uncertainty and acute stress disorder in patients with ischaemic stroke","volume":"15","author":"Zhou","year":"2024","journal-title":"Front. Psych."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1207\/s15327752jpa5503&4_17","article-title":"Psychometric characteristics of the multidimensional scale of perceived social support","volume":"55","author":"Zimet","year":"1990","journal-title":"J. Pers. Assess."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1707967\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:31:01Z","timestamp":1785735061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1707967\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":39,"alternative-id":["10.3389\/fpsyg.2026.1707967"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1707967","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"article-number":"1707967"}}