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 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