AUTHOR=Wang Neng , Wang Guoqing , Wang Xuefen , He Dejiao 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1647396

DOI=10.3389/fmed.2025.1647396

ISSN=2296-858X

ABSTRACT=ObjectiveThis 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).MethodsA 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.ResultsThe 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.ConclusionSocial frailty among elderly MHD patients is at a moderate level, with 27.02% experiencing moderate to severe social frailty. The prevalence of depressive symptoms was 53.6%. Depression significantly predicts social frailty, while bidirectional social support and personal mastery serve as partial mediators. Enhancing these psychosocial factors may help reduce the risk or severity of social frailty in this population.