Objective To construct a discharge plan guided by the Individual and Family Self Management Theory (IFSMT), and explore its effect in patients with cerebral hemorrhage.

Methods Eighty patients with cerebral hemorrhage were selected, and randomly divided into the observation group and control group (40 cases in each group). The control group received the routine discharge guidance, while the observation group received a discharge plan based on IFSMT guidance. The following up data was collected at 1 and 3 months after discharge. The differences in the discharge readiness scale (RHDS), caregiver burden scale (ZBI), daily living ability (Barthel index) and disease acceptance scale (AIS) between two groups were compared before and after intervention.

Results Before discharge, the individual status, adaptability, anticipatory support and total score of RHDS in the observation group were higher than those in control group (P ＜ 0.01). At discharge, except for the economic burden (P > 0.05), the scores of each dimension of ZBI in the observation group were lower than those in the control group (P ＜ 0.01).

Conclusions The discharge plan based on IFSMT guidance can effectively improve the RHDS of patients with cerebral hemorrhage, reduce the ZBI of caregivers, improve the Barthel index and AIS of patients, and effectively enhance the rehabilitation effect of patients for providing a reasonable reference plan for transitional care of ICH patients.