Dual-Trajectory Analysis of Resourcefulness and Social Support in Middle- Aged and Young Stroke Patients

Background: With the rising incidence of stroke among younger populations and the high prevalence of post-stroke depression (PSD), this study examined dual trajectories of resourcefulness and social support in first-ever stroke patients aged 18–59 years. The aim was to clarify their dynamic interaction and inform precision strategies for PSD prevention. Methods: Using purposive sampling, 324 first-ever stroke patients hospitalized in three tertiary hospitals in Henan Province (November 2024–October 2025) were followed at four time points: during the stable hospitalization phase and at 1-, 3-, and 6-months post-discharge. Group-based trajectory modeling (GBTM, Stata 18) was used to identify distinct trajectories of resourcefulness and social support. Conditional and joint probability analyses, together with multinomial logistic regression, were performed to examine the associations between trajectory groups and influencing factors. Results: Four resourcefulness trajectories were identified: persistently low (31.4%), moderate but declining (30.3%), high but fluctuating recovery (22.1%), and consistently high (16.2%). Social support also demonstrated three trajectories: moderate–low stability (18.1%), moderate–high rapid decline (49.8%), and high fluctuating recovery (32.1%). Strong coupling existed between the two: 58.7% of individuals with persistently low resourcefulness were also in the rapidly declining support group, while 79.6% of those with consistently high resourcefulness belonged to the high-support recovery group. Older age (≥46 years), self-payment, impaired BADL, low income, and low education increased the risk of low-trajectory membership. Conversely, having a college degree or above increased the likelihood of being in the highest trajectories of both resourcefulness and social support by 8.4 and 11.1 times, respectively, compared with primary education. Conclusion: Resourcefulness and social support in middle-aged and young stroke patients demonstrate heterogeneous and dynamic development with clear reciprocal reinforcement. Single-point assessments are insufficient. Stage-specific interventions tailored to trajectory characteristics should be prioritized, especially for “dual-low” individuals, to disrupt negative spirals, lower PSD risk, and improve recovery outcomes.