Predictors and barriers to family planning access through pharmacies and drug shops among young women (15-24 Years) in Debre Tabor Town: A Convergent Parallel Mixed-Method study.

Ischemic stroke, an acute cerebrovascular disease, is the most prevalent subtype of stroke worldwide, accounting for approximately 70%–80% of all stroke cases (). Its high rates of disability and recurrence impose substantial social and economic burdens, making it a major public health concern globally, particularly in China. According to the China Stroke Surveillance Report 2021 (), the 5-year recurrence rate of ischemic stroke in China is approximately 41%, with a 1-year recurrence rate of about 17%, which is comparable to global estimates. Notably, patients with recurrent stroke exhibit significantly greater neurological deficits and higher mortality rates than those experiencing a first-ever stroke. With the growing adoption of the biopsychosocial medical model, psychological health issues in stroke patients have become a research priority. Negative emotions, primarily anxiety and depression, affect approximately 30%–50% of patients with ischemic stroke (). Previous studies have suggested that perceived recurrence risk may indirectly influence emotional outcomes by affecting individuals’ psychological coping processes, and it is also associated with treatment adherence and quality of life (). However, the underlying psychological mechanisms remain insufficiently clarified. It is important to note that the present study focuses on the pathways through which perceived recurrence risk affects negative emotions in patients with ischemic stroke. This focus aligns with the emerging trend of integrated physical–psychological interventions in global stroke rehabilitation research highlighting the importance of elucidating the internal mechanisms linking these key variables (). Therefore, this study aims to examine the underlying pathways through which perceived recurrence risk influences negative emotions in patients with ischemic stroke, from the perspectives of psychological coping and social support, thereby providing theoretical evidence for clinical psychological interventions. Perceived recurrence risk refers to patients’ subjective perception of the likelihood of disease recurrence. Within the Stress and Coping Theory framework (), it is considered an important cognitive stressor that influences psychological outcomes in individuals with chronic diseases. Previous studies have demonstrated a significant positive association between perceived recurrence risk and negative emotions in patients with ischemic stroke (, ). However, several limitations remain. First, most studies have focused on the direct relationship between these variables, while the underlying mechanisms through which perceived recurrence risk influences negative emotions remain insufficiently explored, and potentially modifiable psychological pathways are still unclear (). Second, existing evidence is largely based on heterogeneous stroke populations, whereas research specifically targeting ischemic stroke—a subtype accounting for more than 80% of all stroke cases—remains limited, reducing the specificity and clinical applicability of existing findings (). These gaps hinder the development of precision-based psychological interventions and are not fully aligned with current rehabilitation demands under the precision medicine framework.