Impact of social alienation on self-care ability in rural older adults through psychological resilience and subjective wellbeing

BACKGROUND: The present study is intended to examine the multiple mediating roles of psychological resilience and subjective well-being in the relationship between social alienation and self-care ability in old age among rural empty-nest older adults. METHODS: From February 17, 2021, to April 20, 2023, a questionnaire survey conducted using a multistage stratifed sampling method among 425 rural empty-nest older adults (60 years and over). These participants were recruited from a rural areas of Liaoning Province, China. The questionnaire included the Social Alienation Scale, the Psychological Resilience Scale, the Subjective Well-being Scale, the Self-care Ability In Old Age Scale. A descriptive analysis was performed to characterize the sample. Linear regression was utilized to evaluate the relationship between social alienation and self-care ability in old age. PROCESS macro (Model 6) was used to analyze the multiple mediated effects of psychological resilience and subjective well-being. RESULTS: Social alienation exerted a remarkable direct effect on the self-care ability in old age among rural empty-nest older adults (β = -0.678, 95% CI = -0.750- -0.607), which represented 56.45% of the total effect. Through three significantly mediated pathways indirectly affect the self-care ability in old age: (1) through the psychological resilience pathway (β = -0.431, 95% CI = -0.515- -0.350), which represented 35.89% of the total effect; (2) through the subjective well-being pathway (β = -0. 044, 95% CI = -0.089- -0.010), which represented 3.67% of the total effect; and (3) through both the psychological resilience and subjective well-being pathway (β = -0.048, 95% CI = -0.073- -0.029), which represented 3.99% of the total effect. The total mediating effect was 43.55%. CONCLUSION: Psychological resilience and subjective well-being mediate the relationship between social alienation and self-care ability in old age among rural empty-nest older adults. Therefore, healthcare professionals and stakeholders should be concerned about the psychological resilience status and mental health of rural empty-nest older adults, strengthen their attention to subjective well-being, and adopt necessary targeted intervention measures to enhance the psychological resilience and subjective well-being of rural empty-nest older adults.