General Self-efficacy And Frailty In Elderly Hospitalized Patients With Chronic Diseases: The Mediating Role Of Loneliness

ObjectivesThis study aimed to investigate the status of general self-efficacy,loneliness and frailty in hospitalized older people with chronic diseases;to analyse the correlation between general self-efficacy,loneliness and frailty in hospitalized older people with chronic diseases;and to explore the role of loneliness in mediating the relationship between general self-efficacy and frailty in hospitalized older people with chronic diseases.By exploring the relationship between the three and the mechanism of action,we provide an empirical basis for the construction of the frailty intervention programme for hospitalized older people with chronic diseases.Methods1.Theoretical research: From the perspective of psychological variables,based on previous studies,social cognition theory and frailty identity crisis theory,the role of general self-efficacy on frailty in elderly hospitalized patients with chronic diseases was constructed.2.Empirical study: elderly patients aged 60 years and above hospitalized with chronic diseases from April 2022 to July 2022 were selected for the study using a convenience sampling method.A cross-sectional survey of general self-efficacy,loneliness and frailty among older adults hospitalized with chronic illnesses was conducted using a self-designed general information questionnaire,the General Self-Efficacy Scale,the UCLA Loneliness Scale and the Frailty Scale.SPSS 26.0 was used for statistical description,independent samples t-test,Spearman bivariate correlation analysis and binary logistic multi-factor analysis.Structural equation modelling between general self-efficacy,loneliness and frailty was constructed using the PROCESS Macro Model 4 software,a bias-corrected bootstrap method developed by Dr Andrew F.Hayes.Significance tests for mediating effects were conducted using a non-parametric percentile bootstrap method.ResultsOf the 231 study participants,126(54.5%)were male and 105(45.5%)were female,with an age range of 60-95 years.A total of 133 cases(57.6%)were frailty,and98 cases(42.4%)were non-frailty.Elderly hospitalized patients with chronic diseases had a total score of 2.5(2.0,2.9)for self-efficacy and 36(30,46)for loneliness.Spearman correlation analysis revealed that general self-efficacy was negatively correlated with frailty(r =-0.676,p < 0.01)and loneliness(r =-0.604,p < 0.01),and loneliness was positively correlated with frailty(r = 0.650,p < 0.01).The results of the mediating effect test showed that the total effect of general self-efficacy on frailty was-0.658,and the indirect effect was-0.207,with a 95% confidence interval(-0.350 to-0.096)excluding 0,indicating that the mediating effect of loneliness between general self-efficacy and frailty was valid.The results of the model after the inclusion of the loneliness variable showed that the direct effect of general self-efficacy on frailty remained statistically significant(B =-0.451,p < 0.001),indicating that loneliness partially mediated the relationship between general self-efficacy and frailty,with loneliness explaining 31.5% of the total effect of general self-efficacy on frailty.ConclusionThe incidence of frailty in elderly hospitalized patients with chronic diseases is at a high level and there are many factors affecting this group of patients.While paying attention to patients’ physical diseases and health,psychological factors should not be ignored.This study empirically demonstrated the effect of general self-efficacy on frailty,and the mediating model constructed clarified some of the psychological mechanisms of loneliness between general self-efficacy and frailty in elderly inpatients with chronic diseases.