Association between psychological resilience and quality of life among middle-aged and older inpatients with chronic diseases: a cross-sectional study

Abstract

Objectives This study aimed to explore the associations between psychological resilience and quality of life in middle- aged and older inpatients with chronic diseases. Additionally, the study investigated the potential mediating role of frailty and depression, as well as the moderating role of successful aging. Methods From October 2021 to February 2022, 348 middle-aged and older inpatients with chronic diseases (≥45 years old) were recruited using a multi-stage stratified random sampling method at an affiliated hospital in Zhejiang Province, China. Data were collected using questionnaires and analyzed using SPSS 25.0 and the PROCESS macro. Statistical significance was set at a two-tailed p < 0.05. Results A total of 348 middle-aged and older inpatients with chronic diseases were included in the analysis. The participants were aged 45–96 years, with a mean age of 63.88 ± 10.49 years; 216 (62.1%) were male and 132 (37.9%) were female. Psychological resilience was significantly associated with quality of life. Three significant mediating pathways were identified: the indirect effect through frailty was 0.0139 (95% CI: 0.0014–0.0300), the indirect effect through depression was 0.0494 (95% CI: 0.0235–0.0809), and the chain indirect effect through frailty and depression was 0.0090 (95% CI: 0.0010–0.0183). Furthermore, successful aging moderated the relationship between frailty and depression. Conclusion Psychological resilience was positively associated with quality of life in middle-aged and older inpatients with chronic diseases. Frailty and depression partially mediated this association, while successful aging moderated the relationship between frailty and depression. These findings highlight the potential value of incorporating psychological resilience into comprehensive care for middle-aged and older patients with chronic diseases, together with the early identification and management of frailty and depression. Future longitudinal and intervention studies are warranted to further clarify these pathways and determine whether integrated resilience-, frailty-, and depression-focused interventions can improve quality of life in this population.