Abstract / Summary
Demoralization was found to seriously harm patients‘ disease outcomes and quality of life, and could even lead to suicidal ideation and shorten life expectancy. Understanding the level of demoralization in stroke patients and exploring its mechanism wasconsidered not only conducive to improving the physical and mental health of patients, but also beneficial to reducing many pressures on the social medical system. Limited research had been conducted to explore demoralization and its influencing factors among stroke patients. This was a cross-sectional research design of stroke patients in a tertiary hospital in Shantou using a convenience sampling method from March 2024 to December 2024. The obtained data were analyzed through descriptive statistics and Spearman’s correlation coefficient, and Amos 24.0 software was used to construct the structural equation model and estimate the path coefficients. Stroke patients were at a high level of demoralization (score ≥ 30). The results of multi-factor analysis showed that self-perceived burden, social support, psychological resilience, positive evaluation and negative evaluation were the influencing factors of the demoralization among stroke patients ( P < 0.05). Structural equation model fitting results: χ2/df = 1.765, RMSEA = 0.057, GFI = 0.995, AGFI = 0.948, CFI = 0.998 and TLI = 0.983. Path analysis showed that the direct effects of self-perceived burden, social support, psychological resilience, positive evaluation and negative evaluation on the level of demoralization were 0.065, -0.405, -0.355, -0.0323 and 3.501, respectively. Social support could indirectly affect the level of demoralization through psychological resilience, self-perceived burden and positive evaluation ( P < 0.05). The current status of demoralization among stroke patients was not optimistic. This study identified four influencing factors for demoralization in stroke patients and identified the pathways between them. This provided new evidence and direction for future research to explore effective measures to reduce the level of demoralization in stroke patients. In clinical practice, effective measures should be taken to reduce patients’ self‑perceived burden, provide adequate social support, strengthen disease‑related health education and targeted psychological counseling, and encourage and guide patients to change negative cognitions, thereby achieving the goal of effectively reducing the level of demoralization.