Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support

This study aims to understand the relationship between psychological resilience and social support in family resilience and demoralization syndrome (DS) in decompensated cirrhotic patients and verify whether there is a parallel mediation effect. A cross-sectional design was adopted, and a questionna...

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Main Authors: Haixia Gao, Gang Mao, Xuelian Gu, Hui Wang, Jianhua Niu, Lei Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Psychology
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1623122/full
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author Haixia Gao
Gang Mao
Xuelian Gu
Hui Wang
Jianhua Niu
Lei Liu
author_facet Haixia Gao
Gang Mao
Xuelian Gu
Hui Wang
Jianhua Niu
Lei Liu
author_sort Haixia Gao
collection DOAJ
description This study aims to understand the relationship between psychological resilience and social support in family resilience and demoralization syndrome (DS) in decompensated cirrhotic patients and verify whether there is a parallel mediation effect. A cross-sectional design was adopted, and a questionnaire was administered to 260 patients with decompensated cirrhosis in Jinan, Shandong Province, China. The Mandarin Version of the Demoralization Scale (DS-MV) was used to assess DS. Spearman’s correlation was used to analyze the relationship between family resilience, DS, psychological resilience, and social support, and predictors of DS were explored using multiple linear regression. Parallel mediation effect analysis was performed using a bootstrap test. The proportion of patients with severe DS was 18.46% of those with decompensated cirrhosis. Spearman correlation analysis demonstrated that DS was negatively correlated with psychological resilience, family resilience, and social support (r = −0.738, p < 0.01; r = −0.668, p < 0.01; r = −0.405, p < 0.01). Multiple linear regression analysis showed that psychological resilience (β = −0.477, p < 0.001), family resilience (β = −0.364, p < 0.001), and social support (β = −0.108, p = 0.01) could influence DS of decompensated cirrhotic patients. Bootstrap analysis confirmed a significant parallel mediation effect of psychological resilience and social support (95% CI: −0.999 to −0.499), accounting for 51.93% of the total effect. Family resilience had a significant direct effect (95% CI: −0.995 to −0.356), accounting for 48.07% of the total effect. Therefore, attention should be paid to DS in decompensated cirrhotic patients. Family resilience, psychological resilience, and social support can be used to decrease the level of DS.
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spelling doaj-art-6fdb869077b147bca30cc7dd4924361b2025-08-20T02:51:59ZengFrontiers Media S.A.Frontiers in Psychology1664-10782025-08-011610.3389/fpsyg.2025.16231221623122Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social supportHaixia Gao0Gang Mao1Xuelian Gu2Hui Wang3Jianhua Niu4Lei Liu5School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Critical Care Medicine, The Fourth People’s Hospital of Jinan, Jinan, ChinaMedical Insurance Office, The Third People’s Hospital of Jinan, Jinan, ChinaDepartment of Rheumatology and Immunology, The Fourth People’s Hospital of Jinan, Jinan, ChinaDepartment of Hematology, The Fourth People’s Hospital of Jinan, Jinan, ChinaDepartment of Gastroenterology, The Fourth People’s Hospital of Jinan, Jinan, ChinaThis study aims to understand the relationship between psychological resilience and social support in family resilience and demoralization syndrome (DS) in decompensated cirrhotic patients and verify whether there is a parallel mediation effect. A cross-sectional design was adopted, and a questionnaire was administered to 260 patients with decompensated cirrhosis in Jinan, Shandong Province, China. The Mandarin Version of the Demoralization Scale (DS-MV) was used to assess DS. Spearman’s correlation was used to analyze the relationship between family resilience, DS, psychological resilience, and social support, and predictors of DS were explored using multiple linear regression. Parallel mediation effect analysis was performed using a bootstrap test. The proportion of patients with severe DS was 18.46% of those with decompensated cirrhosis. Spearman correlation analysis demonstrated that DS was negatively correlated with psychological resilience, family resilience, and social support (r = −0.738, p < 0.01; r = −0.668, p < 0.01; r = −0.405, p < 0.01). Multiple linear regression analysis showed that psychological resilience (β = −0.477, p < 0.001), family resilience (β = −0.364, p < 0.001), and social support (β = −0.108, p = 0.01) could influence DS of decompensated cirrhotic patients. Bootstrap analysis confirmed a significant parallel mediation effect of psychological resilience and social support (95% CI: −0.999 to −0.499), accounting for 51.93% of the total effect. Family resilience had a significant direct effect (95% CI: −0.995 to −0.356), accounting for 48.07% of the total effect. Therefore, attention should be paid to DS in decompensated cirrhotic patients. Family resilience, psychological resilience, and social support can be used to decrease the level of DS.https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1623122/fulldecompensated cirrhotic patientsdemoralization syndromefamily resiliencepsychological resiliencesocial supportparallel mediation effect
spellingShingle Haixia Gao
Gang Mao
Xuelian Gu
Hui Wang
Jianhua Niu
Lei Liu
Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
Frontiers in Psychology
decompensated cirrhotic patients
demoralization syndrome
family resilience
psychological resilience
social support
parallel mediation effect
title Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
title_full Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
title_fullStr Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
title_full_unstemmed Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
title_short Family resilience and demoralization in decompensated cirrhosis: parallel mediation of psychological resilience and social support
title_sort family resilience and demoralization in decompensated cirrhosis parallel mediation of psychological resilience and social support
topic decompensated cirrhotic patients
demoralization syndrome
family resilience
psychological resilience
social support
parallel mediation effect
url https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1623122/full
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