Multidimensional Impact of Stigma on Discharge Readiness in Patients with Stroke and Research on Health Care Strategies

doi:10.3969/j.issn.1674-3245.2025.04.034

Abstract：Objective To assess the level of stigma among patients with stroke and analyze its relationship with discharge readiness and coping styles, providing reference for developing personalized discharge management and rehabilitation support strategies. Methods A prospective study was conducted from September 2024 to February 2025, including 120 stroke patients treated at Daxing District People's Hospital in Beijing. The patients' stigma (using the Social Impact Scale), discharge readiness (using the Discharge Readiness Scale), and coping styles (using the Medical Coping Modes Questionnaire) were assessed through questionnaires. The impact of stigma on discharge readiness and coping styles was analyzed. Results Among the 120 stroke patients, there were 82 males (68.33%) and 102 Han Chinese (85.00%), with 84 married individuals (70.00%). Most patients had a junior high school or senior high school education; their occupations mainly included farmers and workers; the distribution of urban and rural residents was balanced. Most patients had staff medical insurance or rural cooperative medical insurance, with income levels concentrated between 2000–3000 yuan, and most were still employed. The stigma score of stroke patients was (56.66±8.11) points. The total score and dimensions such as social rejection, economic discrimination, internal shame, and social isolation were all higher than the normative model (P<0.05). The total score of discharge readiness was (89.05±13.88) points, ranging from 35 to 118 points, with an average score of (7.44±1.12) points, indicating a moderate level. The coping style scores of stroke patients were lower than the normative model in the 'confrontation' dimension (P<0.05), but higher in the 'avoidance' and 'yielding' dimensions (P<0.05). Pearson correlation analysis showed that except for economic discrimination, internal shame, and social isolation, other dimensions of stigma were significantly negatively correlated with discharge readiness (P<0.05). The stigma dimensions were significantly negatively correlated with confrontation scores and significantly positively correlated with yielding and avoidance scores (P<0.05). Conclusion Stigma has a significant impact on discharge readiness and coping styles in stroke patients. Improving stigma and strengthening interventions related to discharge readiness can help promote patient recovery and improve quality of life.