Preferences of Stroke Survivors for Mental Health Service: A Discrete Choice Experiment
Bowen Liu1,2, Meili Wang3, Yinxia Dou3
1School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
Aim:
To investigate stroke survivors' preferences and preference heterogeneity regarding mental health services in China.
Design:
A cross-sectional study design was employed.
Methods:
A discrete choice experiment was conducted to elicit preferences for mental health services among 322 stroke survivors recruited from three tertiary hospitals in Henan Province. Six key attributes were identified through literature review, qualitative interviews and expert consultation: service content, delivery method, group size, provider type, session duration and out-of-pocket expenses. Mixed logit and latent class models were used to analyse preferences and explore heterogeneity.
Reporting Method:
This study followed the STROBE checklist.
Results:
Patients showed a strong preference for less expensive services, smaller group sizes and shorter session durations. Services provided by clinical nurses and delivered face-to-face were also preferred, although delivery mode was less influential overall. Emotion regulation was the most favoured content type. Latent class analysis revealed three distinct preference groups: a general-oriented group, a face-to-face prioritized group (primarily older patients) and a personalization-focused group (primarily higher-income patients). Patient age, income level and prognosis were significant factors influencing preference heterogeneity.
Conclusion:
Mental health service preferences among Chinese stroke survivors vary considerably. Out-of-pocket costs, group size and session length are key determinants of choice. Tailoring service delivery to reflect patient preferences, such as offering nurse-led, cost-effective and flexible interventions may enhance acceptance and adherence. Policymakers and healthcare administrators should integrate preference-based strategies into stroke care planning to improve psychological outcomes.
Patient Or Public Contribution:
Stroke patients were involved as participants in this study for data collection.
Impact:
Mental health service content, delivery method, group size, service providers, duration of each session and out-of-pocket expenses have an impact on mental health service preferences of stroke patients. Mental health services whose content is emotion regulation, face-to-face, small group (3-5 participants), provided by clinical nurses and with a single session lasting 15 to 30 min are more likely to be accepted by patients. There is heterogeneity in mental health services for stroke patients, and this study highlights the importance of tailored mental health services.
