To explore the chain mediating effect of self-efficacy and hope in stigma and loneliness among patients with traumatic paraplegia and provide scientific theoretical guidance for effective nursing intervention for these patients in clinical practice.

Totally 307 patients with traumatic paraplegia who were admitted to the Department of Orthopedics of Jiangsu Taizhou People's Hospital from June 2017 to May 2021 were selected by convenience sampling and investigated with the general information questionnaire, General Self-efficacy Scale (GSES), Herth Hope Index (HHI), Social Impact Scale (SIS), and UCLA Loneliness Scale. Pearson correlation was used to analyze the relationship between self-efficacy, hope, stigma, and loneliness. Amos 21.0 was used to construct a structural equation model (SEM) and test the mediating effect. A total of 307 questionnaires were distributed in this study, and 292 were recovered, accounting for a recovery rate of 95.11%. After excluding the questionnaires with more than 10% regular answers and missing items, 289 valid questionnaires were obtained, and the effective recovery rate was 94.14% (289/307) .

There were significant differences in the total score of UCLA Loneliness Scale among patients with different gender, age, marital status, family relationship, and bedridden conditions (P<0.05). The total score of self-efficacy among the 289 patients with traumatic paraplegia was (25.54±3.37) ; the total score of hope was (27.73±3.66) ; the total score of stigma was (65.97±8.35) ; the total score of loneliness was (53.82±6.78). Pearson correlation analysis showed that loneliness was positively correlated with stigma (P<0.05), and negatively correlated with self-efficacy and hope (P<0.05). The mediating effect of stigma on loneliness in patients with traumatic paraplegia was established, and the total indirect effect accounted for 46.39% of the total effect, of which the specific mediating effects of self-efficacy and hope accounted for 19.91% and 19.12%, respectively. The chain mediating effect of self-efficacy and hope between stigma and loneliness accounted for 7.37%.

The scores of self-efficacy, hope, stigma, and loneliness in patients with traumatic paraplegia are all at moderate levels. Loneliness is positively correlated with stigma, and negatively correlated with self-efficacy and hope. The chain mediating effect of self0effect between self-efficacy and hope between stigma and loneliness is established, suggesting that stigma can adjust hope through self-efficacy, and ultimately affect loneliness. While paying attention to patient' stigma, clinical medical and nursing staff should pay attention to evaluating self-efficacy and hope levels and take targeted measures to reduce the impact of stigma on loneliness.

Paraplegia; Stigma; Loneliness; Self-efficacy; Hope; Relevance; Chain mediating effect