The status and determinants of demoralization in stroke patients: a cross-sectional study in China

Background: Irreversible neurological trauma, long-term rehabilitation, disability, psychological issues, costly medical and financial burden, and difficulties in reintegration into the community may ultimately lead to demoralization in stroke survivors. However, the status and determinantsof demoralization in stroke patients are still unknown. Aim: To analyze the current status of demoralization in stroke patients, and explore factorsthat influenced demoralization in relation to demographic and stroke characteristics, and self-perceived burden. Methods: A cross-sectional study using the convenient sampling method was conducted to select the research objects of stroke patients who were inpatients in a general public hospital in Hangzhou, Zhejiang Province. The survey period was from January 2025 to May 2025. The Mandarin Version of the Demoralization Scaleand the Self-Perceived Burden Scale were used to assess demoralization and self-perceived burden, respectively. General information, including demographic data and stroke characteristics, was collected. The data was analyzed using SPSS 25.0 software. Results: This study included 376 stroke patients with a mean DS-MV score of 34.32 ± 11.249. Of these, 26 (6.9%) had mild demoralization, 296 (78.7%) had moderate demoralization, and 54 (14.4%) had severe demoralization. Considering a DS-MV score > 30 for detection,51.9% of stroke patientshad demoralization. Education level, comorbidity, number of stroke incidences, activity of daily living, and self-perceived burden level were the important factors associated with the severity of demoralization in stroke patients. Conclusions: Stroke patients exhibit a notable prevalence and severity of demoralization. Healthcare professionals should develop targeted interventions after stroke by considering sociodemographic (education level) and stroke characteristics (comorbidity, number of stroke incidences, and activity of daily living) and reducing self-perceived burden. Furthermore, stroke patients at high risk of demoralization should be promptly monitored.