Abstract
AIM: This study aimed to (1) investigate the current status of social isolation, stigma, and return-to-work readiness among young and middle-aged patients with stroke and (2) explore the relationship among the three variables and construct a mediation model to test the mediating role of social isolation in the relationship between stigma and return-to-work readiness. DESIGN: A cross-sectional descriptive study. METHODS: Data collection was conducted among patients 18-60 years of age (N = 154) who visited for the management of stroke. Participants completed a questionnaire measuring social isolation, stigma, and return-to-work readiness. The analysis of data and effect of mediation was tested by the PROCESS for SPSS 25.0. This study was reported following the STROBE guidelines. RESULTS: Stroke stigma was a significant predictor of social isolation (B = 0.0.68, SE = 0.02, t = 27.89, p < 0.000), with a confidence interval (LLCI = 0.63, ULCI = 0.73) excluding zero. Stigma was a significant predictor (c' = -0.140, SE = 0.066, p = 0.035 < 0.05, 95% CI [-0.270, -0.010]) of return-to-work readiness. Social isolation partially mediated the relationship between stigma and return-to-work readiness, with a mediation effect of -0.207, accounting for 59.67% of the total effect. PATIENT OR PUBLIC CONTRIBUTION: This study was informed by young and middle-aged stroke survivors who contributed critical data through their participation. While patients were not directly involved in study design or analysis, their lived experiences with stigma and social isolation during post-stroke rehabilitation provided essential context for interpreting the mediation mechanisms. The findings illuminate actionable pathways to enhance return-to-work readiness, offering healthcare providers strategies to address psychosocial barriers in vocational rehabilitation programmes.