Influencing factors and path analysis of social frailty among community-dwelling older adults with chronic diseases based on socioecological theory
QIN Yanmei
HAO Yang
SHI Xuefei
LIU Yao
ZHAO Yaning
Abstract：Objective:To analyze the influencing factors and pathways of social frailty among community-dwelling older adults with chronic diseases based on socioecological theory.Methods:A total of 1 450 older adults with chronic diseases were conveniently selected from 15 communities in Tangshan city as study subjects from August 2022 to June 2023.Data were collected using the General Information Questionnaire,Social Frailty Scale(Help,Participation,Loneliness,Financial,Talk,HALFT),Elderly Psychological Capital Scale,Self-Identity Scale,eHealth Literacy Scale,FRAIL Scale,Family Hardiness Index,and Perceived Social Support Scale.Results:Among the 1 450 community-dwelling older adults with chronic diseases,560 exhibited social frailty.The detection rate was 38.6%.The result of logistic regression analysis showed that age,education level,number of chronic diseases,duration of chronic conditions,psychological capital,self-identity,eHealth literacy,physical frailty,physical exercise,living arrangement,family hardiness,emotional support from children,support from friends,accessibility of internet-based healthcare services,community recreational environment,and community elderly support environment were influencing factors of social frailty(P<0.05).The result of path analysis showed that general characteristics and multiple factors within the three socioecological systems directly influenced social frailty.Additionally,within the microsystem,psychological capital indirectly affected social frailty via self-identity,while physical exercise indirectly influenced social frailty via physical frailty.Within the mesosystem,family hardiness indirectly influenced social frailty via psychological capital and self-identity.Emotional support from children indirectly affected social frailty via self-identity.Support from friends indirectly influenced social frailty via self-identity and eHealth literacy.Within the macrosystem,accessibility of internet-based healthcare services indirectly affected social frailty via eHealth literacy,family hardiness,psychological capital,and self-identity.Community recreational environment indirectly influenced social frailty via physical exercise and physical frailty.Community elderly support environment indirectly influenced social frailty via self-identity.Conclusions:The detection rate of social frailty among community-dwelling older adults with chronic diseases was relatively high.It is influenced by multiple interacting factors and pathways encompassed within the socioecological theory.
Keywords：chronic diseaseolder adultssocial frailtyinfluencing factorspath analysissocioecological theory
Publication Date：2025-09-25
Online Publishing Date：2025-09-30(First online date of this platform, not the publication date of the document)
Pages：9( 3066-3074 )