The impact of a PERMA model-based positive psychology intervention on fear of stroke recurrence: a randomized controlled trial.

Introduction: This study aimed to examine the effects of a positive psychological intervention, grounded in the PERMA model, on fear levels, psychological capital, overall well-being, and quality of life among stroke patients.

Methods: A single-blind, two-arm randomized controlled trial with a repeated measures design was conducted at the Affiliated Hospital of Jiangnan University from January to December 2023. A total of 125 patients experiencing fear of stroke recurrence were randomly assigned to either the intervention group ( = 63), which received a positive psychological intervention based on the PERMA model, or the control group ( = 62), which received standard care. We assessed fear levels, psychological capital, well-being, and quality of life at baseline (T0), on the day of discharge (T1), 2 weeks post-discharge (T2), and 4 weeks post-discharge (T3). The scores of the two groups were compared post-intervention using the Generalized Estimation Equation (GEE) model to analyze the effects of time, group membership, and their interaction.

Results: The intervention group showed statistically significant improvements compared to the control group, including reduced fear levels (T2:  = -2.094,  = 0.038; T3:  = -2.207,  = 0.029), increased psychological capital (T2:  = 2.053,  = 0.042; T3:  = 2.820,  = 0.006), enhanced well-being (T2:  = 2.037,  = 0.044; T3:  = 2.761,  = 0.007), and better quality of life (T2:  = 2.083,  = 0.039; T3:  = 2.453,  = 0.016) at both T2 and T3. Additionally, significant time-related changes were observed in fear levels, psychological capital, well-being, and quality of life (χ2 = 45.275,  < 0.001; χ2 = 37.848,  < 0.001; χ2 = 48.255,  < 0.001; χ2 = 34.231,  < 0.001, respectively). Notably, the interaction effects were statistically significant for well-being ( < 0.05).

Discussion: The PERMA-based intervention had a short-term positive effect, reducing fear levels while enhancing psychological capital, well-being, and quality of life among stroke patients.

Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=230313.