Social support as a mediator between social frailty and anxiety and depression in old patients with chronic heart failure: a cross-sectional study

Aim This study investigated the relationship between social frailty, anxiety and depression in old Chronic heart failure (CHF) patients. We paid particular attention to how social support moderated this relationship. Background Old patients with chronic heart failure have severe somatic symptoms, which lead to high levels of social frailty. Understanding the demographic and disease factors, as well as the relationship between social frailty, social support, anxiety and depression, is essential to improve health outcomes in old CHF patients. Methodology A cross-sectional study was conducted on 394 old CHF patients from three tertiary hospitals in China. The study questionnaire included a general information questionnaire, the HALFT scale (social frailty), The MSPSS (social support), and The HADS (anxiety and depression). Hierarchical regression analysis was used to assess the influencing factors of anxiety and depression; the SPSS PROCESS Marco Plug-in was used to conduct mediation analysis. Results The results showed that age, the number of hospitalization and NYHA classification were the influencing factors of anxiety and depression. Social frailty, social support, and anxiety and depression were related, and social support partially mediated the relationship between social frailty and anxiety and depression, with the mediating effect sizes of 13.67% and 10.15%, respectively. Conclusion Our study shows that high levels of social frailty are associated with increased anxiety and depression in old CHF patients. Social support helps to alleviate the adverse effects of social frailty (e.g. lack of social participation and social connections, feelings of loneliness, financial insufficiency) on anxiety and depression. 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 CHF patients, increase the social support system for old adults, and improve patients’ treatment compliance and health outcomes. Reporting Method : The Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed in the study. No Patient or Public Contribution: Recruitment for old CHF patients met the inclusion criteria.