Depression and social frailty in elderly patients receiving maintenance hemodialysis: multiple mediating roles of bidirectional social support and personal mastery

作者：Neng Wang, Guoqing Wang, Xuefen Wang, Dejiao He · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1647396 · 被引用次数：2 · 研究领域：Dialysis and Renal Disease Management、Frailty in Older Adults、Chronic Disease Management Strategies

Objective This study aimed to investigate the multiple mediating roles of bidirectional social support and sense of personal mastery in the relationship between depression and social frailty among elderly patients undergoing maintenance hemodialysis (MHD). Methods A cross-sectional survey was conducted among 248 elderly MHD patients from two tertiary hospitals in Wuhan, China. Data were collected using a general information questionnaire, the Social Vulnerability Index, the Geriatric Depression Scale-5 (GDS-5), the Brief Two-Way Social Support Scale, and the Personal Mastery Scale. Structural Equation Modeling (SEM) was performed using AMOS 28.0. Results The mean scores were as follows: depression (1.91 ± 1.67), bidirectional social support (38.49 ± 8.43), personal mastery(21.51 ± 4.95), and SVI (0.49 ± 0.19). Depression was positively correlated with social frailty ( r = 0.716, p < 0.01), whereas both personal mastery and bidirectional social support were negatively correlated with social frailty ( r = −0.721, −0.760, both p < 0.01). Mediation analysis indicated that bidirectional social support and sense of personal mastery partially mediated the relationship between depression and social frailty, with a total indirect effect size of 0.524, accounting for 67.96% of the total effect. Conclusion Social frailty among elderly MHD patients is at a moderate level, with 27.02% experiencing moderate to severe social frailty. The prevalence of d...