Objective: This study aims to understand the experiences of elderly patients in the acute phase of stroke, to determine the factors that predict the level of psychological resilience, and to examine the moderating role of rumination between illness perception and psychological resilience.

Methods: A mixed-method of embedded design was employed in this study. In the qualitative study, 13 elderly patients with acute stroke were interviewed based on semi-structured interview guides and recordings. The data were transcribed, and thematic content analysis was conducted. In the quantitative study, a cross-sectional survey was conducted on 240 elderly acute stroke patients using paper-based questionnaires, and data analysis was performed using SPSS25.0 and AMOS24.0.

Results: From the qualitative analysis, we identified risk factors affecting the psychological status of elderly patients with acute stroke, which can be summarised into four major themes and six categories. The content of the four major themes is: lack of disease cognition, facing disease threats and challenges, prominent psychological issues, sense of disease gain. The content of the six categories is: lack of stroke-related disease knowledge and cognitive bias, single source of disease information; significant sequelae, concern about medical expenses; apparent symptoms of anxiety and depression, disease uncertainty and fear. In the Quantitative analysis, results indicated that illness perception had a direct effect on psychological resilience (β = -0.34, p < 0.01) and rumination (β = 0.51, p < 0.01). Also, rumination was directly related to psychological resilience (β = -0.24, p < 0.01). In addition, illness perception was indirectly related to psychological resilience (β = 0.51*-0.24 = -0.12, p < 0.01) mediated through rumination.

Conclusion: Improving the level of rumination in elderly patients with acute stroke can mitigate adverse Illness perception and enhance psychological resilience. This study provides a theoretical basis for developing relevant intervention measures.

Keywords: acute stroke; elderly patients; illness perception; mixed method; psychological resilience; rumination.

© 2025 John Wiley & Sons Ltd.

目标：本研究旨在了解急性卒中老年患者的经历，确定影响心理韧性水平的因素，并探讨沉思在疾病感知和心理韧性之间的调节作用。

方法：本研究采用了嵌入式混合研究设计。在质性研究部分，基于半结构化访谈指南对13名急性卒中的老年患者进行了采访并录音，然后将数据转录，并进行主题内容分析。在量化研究中，通过纸质问卷对240名急性卒中的老年患者进行了横断面调查，并使用SPSS25.0和AMOS24.0进行了数据分析。

结果：从质性分析中，我们识别了影响急性卒中老年患者心理状态的风险因素，可以概括为四个主要主题和六个类别。四个主要主题的内容是：缺乏疾病认知、面对疾病威胁与挑战、突出的心理问题、疾病获得感；六类内容包括：缺乏卒中相关疾病知识及认知偏差、单一信息来源；显著后遗症、关注医疗费用；明显的焦虑抑郁症状，疾病不确定性与恐惧。在量化分析结果表明，疾病感知对心理韧性有直接的影响（β = -0.34, p

结论：提高急性卒中老年患者水平的沉思可以缓解不利的疾病感知，并增强心理韧性。本研究为开发相关干预措施提供了理论基础。

关键词：急性卒中；老年人；疾病感知；混合方法；心理韧性；沉思。