# The mediating role of psychological resilience in the relationship between frailty and self-efficacy among dialysis patients

## TL;DR

This study explores how psychological resilience connects frailty and self-efficacy in dialysis patients.

## Contribution

The novelty lies in identifying psychological resilience as a mediator between frailty and self-efficacy in hemodialysis patients.

## Key findings

- Frailty negatively correlates with self-efficacy and psychological resilience.
- Psychological resilience partially mediates the relationship between frailty and self-efficacy.
- 65% of the effect of frailty on self-efficacy is direct, while 35% is mediated through resilience.

## Abstract

Frailty poses a substantial challenge for patients with hemodialysis (HD), influenced by a multitude of personal and social factors. Building on the theory of Hobfoll’s Conservation of Resources (COR) theory, this study sought to evaluate the correlation between frailty and self-efficacy, as well as psychological resilience among patients undergoing HD treatment.

A cross-sectional study was conducted on 397 HD patients at various hospitals in Xiangyang City, Hubei Province, China. Data was gathered between February and May, 2024 using the Frail Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the self-efficacy scale. The collected data were analyzed using SPSS software, applying both descriptive and inferential statistical methods, as well as conducting mediation effect analysis and structural equation modeling with bootstrapping by Amos 26.0.

The study revealed that the prevalence of pre-frailty and frailty was 26.2% and 38.3%, respectively. The self-efficacy score of the patients was 6.5 (5.0, 8.2) on a scale from 0 to 10. Additionally, the psychological resilience score was 23.0 (20.0, 30.0) on a scale from 0 to 40. The results indicated correlations among psychological resilience, frailty, and self-efficacy in HD patients. Frailty had a negative correlation with self-efficacy (r = -0.166, p < 0.01) and psychological resilience (r = -0.222, p < 0.01). Conversely, self-efficacy and psychological resilience were positively related (r = 0.287, p < 0.01). Psychological resilience, acting as a mediating factor, exhibited an indirect effect size of 35%, while the direct effect size of patient frailty was 65%.

The findings of this study underscore a negative association between frailty and self-efficacy. Furthermore, psychological resilience plays an acceptable mediating role in the relationship between frailty and self-efficacy.