老年慢性心力衰竭患者社会脆弱性与生活质量的关联：家庭支持不足与社会网络的序贯多重中介效应
Association between social frailty and quality of life in older patients with chronic heart failure: sequential multiple mediating effects of family insufficiency and social networks.
作者信息
Huang Junting, Liu Xiaobo, Wang Duolao, Luan Xiaorong, Yao Wanxia
机构信息
School of Nursing and Rehabilitation, Shandong University, Jinan, China.
Nursing Department, Yan'an University Affiliated Hospital, Yan'an, Shaanxi, China.
出版信息
Front Med (Lausanne). 2025 Jul 22;12:1639935. doi: 10.3389/fmed.2025.1639935. eCollection 2025.
BACKGROUND AND OBJECTIVES
Older patients with chronic heart failure have severe somatic symptoms, which lead to high levels of social frailty and loss of quality of life. Understanding the demographic and disease factors of quality of life and its relationship with social frailty is beneficial to overall health for older patients with chronic heart failure. This study aims to explore the relationship between social frailty and quality of life in older patients with chronic heart failure and to verify whether family insufficiency and social networks moderate this relationship.
METHODS
A multi-centre cross-sectional study was conducted on 443 older patients with chronic heart failure from three tertiary hospitals in China. The study questionnaire included a general information questionnaire, the HALFT scale (social frailty), the Family APGAR Index (family insufficiency), the LSNS-6 (social networks), and the MLHFQ (quality of life). Hierarchical regression analysis was used to assess the factors influencing quality of life; the SPSS PROCESS Marco Plug-in was employed to conduct mediation analysis.
RESULTS
The results showed that age, the number of hospitalizations, and NYHA classification influenced the quality of life in older patients with chronic heart failure. Social frailty, family insufficiency, and social networks were related, and family insufficiency and social networks mediated the relationship between social frailty and quality of life, with mediating effect sizes of 25.87, 99.5 and 58.97%, respectively.
CONCLUSION
This study shows that high levels of social frailty are associated with reduced quality of life in older patients with chronic heart failure. Decreasing family insufficiency and extending social networks help alleviate social frailty's adverse effects on the quality of life in older patients with chronic heart failure.
背景与目的
老年慢性心力衰竭患者存在严重的躯体症状，导致社会脆弱性水平高且生活质量下降。了解生活质量的人口统计学和疾病因素及其与社会脆弱性的关系，对老年慢性心力衰竭患者的整体健康有益。本研究旨在探讨老年慢性心力衰竭患者社会脆弱性与生活质量之间的关系，并验证家庭功能不足和社会网络是否调节这种关系。
方法
对来自中国三家三级医院的443例老年慢性心力衰竭患者进行了一项多中心横断面研究。研究问卷包括一般信息问卷、HALFT量表（社会脆弱性）、家庭APGAR指数（家庭功能不足）、LSNS-6（社会网络）和MLHFQ（生活质量）。采用分层回归分析评估影响生活质量的因素；使用SPSS PROCESS Marco插件进行中介分析。
结果
结果显示，年龄、住院次数和纽约心脏协会（NYHA）分级影响老年慢性心力衰竭患者的生活质量。社会脆弱性、家庭功能不足和社会网络相互关联，家庭功能不足和社会网络介导了社会脆弱性与生活质量之间的关系，中介效应大小分别为25.87%、99.5%和58.97%。
结论
本研究表明，社会脆弱性水平高与老年慢性心力衰竭患者生活质量降低相关。减少家庭功能不足和扩大社会网络有助于减轻社会脆弱性对老年慢性心力衰竭患者生活质量的不利影响。
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