| Objective Based on the Health Ecology Model, this study aims to analyze the influencing factors of demoralization from the subjective experience of stroke patients with hemiplegia, so as to provide a basis for developing multi-level intervention strategies. Methods Purposive sampling was used to select 14 stroke patients with hemiplegia who met the demoralization assessment criteria from the Acupuncture and Rehabilitation Department of a tertiary first-class hospital in Guiyang from December 2025 to February 2026. Semi-structured in-depth interviews were conducted, with data saturation as the termination criterion. The Colaizzi’s seven-step method was applied to analyze the data and extract themes. Results A total of 5 themes and 15 sub-themes were extracted: individual trait level (loss of physical autonomy, multimorbidity and physical aging, disruption of sleep and body rhythm); behavioral and psychological level (catastrophic imagination of rehabilitation, formation of learned helplessness, mainly negative avoidance coping style); interpersonal network level (guilt and sin towards family members, conflict of family roles, social avoidance due to stigma, unmet supportive emotional needs); living environment level (lack of barrier-free environments, insufficient accessibility of rehabilitation resources, heavy economic pressure); policy environment level (policy information barriers, limited policy protection). Conclusion Demoralization in stroke patients with hemiplegia is influenced by multi-level interacting factors. Medical staff should develop comprehensive intervention strategies from multiple perspectives including physical and mental regulation, psychological reshaping, family and social support, and policy guarantee and support, so as to reduce the level of demoralization and improve the quality of life of patients. |