目的 探讨脑卒中患者心理弹性在复发恐惧与功能锻炼依从性间的中介效应，为指导临床提高其功能锻炼依从性提供参考。方法 2023年11月至2024年2月，采取便利抽样法选取郑州市3所社区卫生服务中心管辖范围内的脑卒中患者202例为研究对象，采用脑卒中患者功能锻炼依从性量表、心理弹性量表、恐惧疾病进展简化量表等对其调查。结果 脑卒中患者功能锻炼依从性、复发恐惧、心理弹性得分分别为（38.77±11.50）分、（32.16±9.78）分、（59.56±17.24）分。脑卒中患者功能锻炼依从性在不同年龄、家庭人均月收入、自理程度间的差异均有统计学意义（均P＜0.05）；复发恐惧与心理弹性、功能锻炼依从性均呈负相关（r=-0.674,-0.544；均P＜0.01），心理弹性与功能锻炼依从性呈正相关（r=0.574,P＜0.01）。心理弹性在复发恐惧对功能锻炼依从性的影响中存在部分中介效应(β=-0.268,P＜0.05)，中介效应占比45.5%。结论 脑卒中患者复发恐惧既可直接影响功能锻炼依从性，也可通过心理弹性间接影响功能锻炼依从性。

Objective To explore the mediating effect of mental resilience between fear of recurrence and functional exercise compliance in stroke patients.Methods From November 2023 to February 2024,a total of 202 stroke patients were selected from three community health service centers in Zhengzhou City by convenience sampling method.A survey was conducted with the questionnaire of exercise adherence,the Connor-Davidson resilience scale and the fear of progression questionnaire-short form.Results The total scores of functional exercise compliance,fear of recurrence and mental resilience of stroke patients were(38.77±11.50),(32.16±9.78) and(59.56±17.24),respectively.There were statistically significant differences in functional exercise compliance among stroke patients at different ages,per capita monthly family income and self-care degree(all P＜0.05).The fear of recurrence in stroke patients was negatively correlated with mental resilience and compliance with functional exercise(r=-0.674,-0.544;P＜0.01),and mental resilience was positively correlated with functional exercise compliance(r=0.574,P＜0.01).Mental resilience played a partial mediating role between fear of recurrence and functional exercise compliance(β=-0.268,P＜0.05),and the mediating effect accounted for 45.5%.Conclusions The fear of recurrence in stroke patients can affect the compliance of functional exercise not only directly,but also indirectly through psychological resilience.

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国家自然科学基金青年基金项目（72104221）；河南省重点研发与推广专项（科技攻关）项目（232102310170）；郑州大学大学生创新创业训练计划项目（2024cxcy283）