Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents

Abstract

Objectives

Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support.

Methods

Residents (N = 538; Aged$\mathrm{ }\ge 60\mathrm{years};$ 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects.

Results

Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011–0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005–0.167]). Support from family and nursing home staff moderated the direct (path c’) and indirect path (path b) of the mediation model, respectively.

Conclusions

Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.

Highlights

• We evaluated suicidal ideation in mainland Chinese nursing home residents

• Loneliness and suicidal ideation were partially mediated by resilience

• Social support moderated the effect of loneliness and resilience on suicidal ideation

• The results were self-reported and are not generalizable to all of China

• Resilience and social support can buffer against suicidal ideation among residents

Keywords:

• Suicidal ideation
• loneliness
• resilience
• social support
• nursing home

Acknowledgements

The authors are grateful for the financial support from the program of China Scholarship Council (No. 201906220150).

Disclosure statement

None.

Authors’ contributions

Formulated the research questions: KW YS JJ JZ. Designed the study: KW YS. Performed the experiments: DZ XZ RW. Analyzed the data: DZ RW . Wrote the article: DZ.

Institutional board review

This study was approved by the institutional review board of Shandong University (Granted Number: LL-201501070).

Role of the funding source

The funding sources had no involvement in study design, data collection, analysis, and interpretation, paper writing, and decision to submit to the present journal.

Table 1. Comparisons of characteristics between participants with and without suicidal ideation (N = 538).

Additional information

Funding

This work was supported by Teaching, Research Key Project of Shandong University Cheeloo College of Medicine (Grant No. qlyxjy-201706) and China Scholarship Council (File No. 201906220150).