Bu Na, Leng Min, Cao Guorong, Dou Chao, Hou Rongchun, Lu Xiaohong, Xu Hong
Nurs Res. 2025;74(2):115-122. doi: 10.1097/NNR.0000000000000795. Epub 2024 Nov 19.
Older adults with heart failure often exhibit poor self-care maintenance. Frailty could exacerbate self-care, leading to deteriorating health. Social support and depression may play a role in self-care maintenance in older adults with heart failure combined with frailty. Confirming this potential mechanistic relationship could provide valuable reference for nurses to formulate and improve the targeted intervention strategies and health education programs for older adults with heart failure.
This study analyzed the relationship between frailty and self-care maintenance in older adults with heart failure and determined the sequential mediation effect of social support and depression. Its goal was to provide valuable theoretical insights for formulating targeted clinical nursing interventions for older adults with heart failure.
A cross-sectional study was conducted from July 2023 to February 2024, during which older adults with heart failure were recruited using a convenience sampling method from the cardiovascular department of a tertiary Class A hospital in Qingdao, China. A total of 241 completed the Tilburg Frailty Indicator, the Self-Care of Heart Failure Index, the Social Support Rating Scale, and the Patient Health Questionnaire-9. t -Tests and one-way analysis of variance were used to examine differences in self-care maintenance among participants with distinct characteristics; correlation analysis was used to identify variable relationships within the study. The mediation model was tested using the SPSS PROCESS macro and the bootstrap method.
Frailty was negatively correlated with self-care maintenance, and both social support and depression were significantly related to frailty and self-care maintenance. Social support and depression not only independently mediated the relationship between frailty and self-care maintenance but also exhibited a significant sequential mediation effect.
The frailty of older adults with heart failure and its correlation with self-care maintenance is a complex and multidimensional phenomenon. Frailty not only directly influenced self-care maintenance in participants but also indirectly affected it through the mediating factors of social support and depression. Future research should emphasize innovative, targeted interventions to enhance social support quality and accessibility and alleviate depression, ultimately boosting patients' self-care capabilities and elevating their quality of life.
老年心力衰竭患者往往自我护理维持能力较差。虚弱可能会加剧自我护理问题，导致健康状况恶化。社会支持和抑郁可能在合并虚弱的老年心力衰竭患者的自我护理维持中发挥作用。证实这种潜在的机制关系可为护士制定和改进针对老年心力衰竭患者的靶向干预策略和健康教育计划提供有价值的参考。
本研究分析了老年心力衰竭患者虚弱与自我护理维持之间的关系，并确定了社会支持和抑郁的顺序中介作用。其目的是为制定针对老年心力衰竭患者的靶向临床护理干预措施提供有价值的理论见解。
于2023年7月至2024年2月进行了一项横断面研究，在此期间，采用便利抽样法从中国青岛市一家三级甲等医院的心血管内科招募老年心力衰竭患者。共有241名患者完成了蒂尔堡虚弱指标、心力衰竭自我护理指数、社会支持评定量表和患者健康问卷-9。采用t检验和单因素方差分析来检验具有不同特征的参与者在自我护理维持方面的差异；采用相关分析来确定研究中的变量关系。使用SPSS PROCESS宏和自抽样法对中介模型进行检验。
虚弱与自我护理维持呈负相关，社会支持和抑郁均与虚弱及自我护理维持显著相关。社会支持和抑郁不仅独立中介了虚弱与自我护理维持之间的关系，还表现出显著的顺序中介效应。
老年心力衰竭患者的虚弱及其与自我护理维持的相关性是一个复杂的多维度现象。虚弱不仅直接影响参与者的自我护理维持，还通过社会支持和抑郁的中介因素间接影响。未来的研究应强调创新的靶向干预措施，以提高社会支持的质量和可及性，并减轻抑郁，最终增强患者的自我护理能力，提高其生活质量。
