Perceived social support and psychological resilience as mediators between social frailty and the frailty of older patients with heart failure: a cross-sectional study

Objective: This study explores the level of frailty and the factors that influence elderly HF inpatients. It also examines the correlation between social frailty, perceived social support, and psychological resilience. It verifies psychological resilience and perceived social support as mediators between social frailty and frailty. 

Method: This cross-sectional study collected four hundred fifty-six questionnaires from Northeast China, Northwest China and South China. The research assessment tools include the FRAIL scale (frailty), MSPSS scale (perceived social support), CD-RISC10 (psychological resilience), and HALFT scale (social frailty). Data analysis was performed using multiple regression analysis and the SPSS PROCESS Macro plug-in Model 6 and Model 4. 

Results: Female (β = 0.085, p = 0.036), number of hospitalizations (β = 0.342, p < 0.001), and NYHA class (β = 0.325, p = 0.004) were risk factors for frailty in elderly HF inpatients. Frailty was found to be at a medium-high level, negatively correlated with perceived social support (ρ=-0.471, p < 0.01) and psychological resilience (ρ=-0.670, p < 0.01), and positively correlated with social frailty (ρ = 0.596, p < 0.01). Psychological resilience and perceived social support mediated the relation between social frailty and frailty, with an indirect effect of 27.18%, 10.49%, and 24.19%, respectively, all partial mediation. 

Conclusion: NYHA class, number of hospitalizations, and female sex are indicators of the frailty level of elderly HF patients. Social frailty, psychological resilience, and perceived social support are interrelated. Psychological resilience and perceived social support are mediators in the relation between social frailty and frailty.