Resilience and anxiety and depression as mediators between social frailty and health outcome in hospitalized heart failure patients

Objectives This study investigated the relationship between social frailty, resilience, anxiety and depression, and quality of life in heart failure (HF) hospitalized patients. We focused on how resilience, anxiety and depression moderated this relationship. Methods A cross-sectional study was conducted on 443 old CHF patients from three tertiary hospitals in China. The study questionnaire included a general information questionnaire, the HALFT scale (social frailty), the CD-RISC-10 (resilience), The HADS (anxiety and depression), and the MLHFQ (health-related quality of life). Hierarchical regression analysis was used to assess the influencing factors of health-related quality of life; the SPSS PROCESS Marco Plug-in was used to conduct mediation analysis. Results The results showed that age, the number of hospitalizations, and NYHA classification influenced the quality of life in HF hospitalized patients. Social frailty, resilience, and anxiety and depression were related, and resilience and anxiety and depression mediated the relationship between social frailty and quality of life, with mediating effect sizes of 45.95% and 64.94%, respectively. Conclusion Our study shows that high levels of social frailty are associated with reduced quality of life in HF hospitalized patients. Decreasing anxiety and depression and extending resilience help alleviate social frailty's adverse effects on quality of life. In addition to focusing on patients’ somatic symptoms and treatments, physicians and nurses should also pay attention to the impact of psychosocial factors on the adverse health outcomes of HF patients, increase the social support system for old adults, and improve patients’ treatment compliance and health outcomes.