Prevalence and associated factors of demoralization in stroke patients: a cross-sectional study in China

Irreversible neurological trauma, long-term rehabilitation, physical disability, psychological disorders, heavy medical and financial burdens, and difficulties in reintegration into the community may ultimately lead to demoralization in stroke survivors. However, the prevalence and associated factors of demoralization have yet to be determined in stroke patients.

To identify the prevalence and associated factors of demoralization in stroke patients.

A cross-sectional study using the convenient sampling method was conducted between January 2025 to May 2025. The Mandarin Version of the Demoralization Scale (DS-MV) and the Self-Perceived Burden Scale (SPBS) were used to assess demoralization and self-perceived burden, respectively. General information, including sociodemographic and stroke-related variables, was collected. The independent samples t-test or one-way analysis of variance was used for univariate analysis. Pearson correlation analysis was used to explore the relationships between DS-MV scores and SPBS scores, and multiple linear regression was used to identify the associated factors of demoralization in stroke patients.

This study included 376 stroke patients with a mean DS-MV score of 34.32 ± 11.25. 51.9% of stroke patients had high demoralization. Education (β =-0.217, p< 0.001), comorbidity (β = 0.147, p< 0.001), number of stroke episodes (β = 0.131, p< 0.001), activity of daily living (β = 0.118, p = 0.002), and self-perceived burden (β = 0.601, p< 0.001) were associated with the severity of demoralization in stroke patients.

The prevalence of demoralization in stroke patients is high. Several factors were found to be associated with a higher risk of demoralization, which can potentially be alleviated by targeted interventions. Healthcare providers should integrate demoralization screening into standard stroke care pathways.