The protective influence of family support on anxiety, depressive symptoms, and suicidal ideation among elderly Chinese nursing home residents: A study of serial mediation

Abstract

In light of the aging demographic in China, heightened attention is warranted for the mental well-being of elderly individuals. Nevertheless, the prevalence of suicidal ideation among older residents in Chinese nursing homes and the nuanced impact of family support on this phenomenon, mediated by anxiety and depressive symptoms, remain unclear. A cohort of 506 Chinese elderly adults participated in the study. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the 7-item Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms, the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms, and suicidal ideation. A structural equation model (SEM) was employed to execute a serial mediation model. The analysis of 506 elderly adults revealed that 8.1% reported varying levels of suicidal ideation within Chinese nursing homes. The pathway from family support to anxiety symptoms (standardized beta = −0.025, P = .241), family support to depressive symptoms (standardized beta = −0.072, P < .05), and family support to suicidal ideation (standardized beta = −0.082, P < .05) were explored. Additionally, pathways from anxiety symptoms to suicidal ideation (standardized beta = 0.364, P < .001), anxiety symptoms to depressive symptoms (standardized beta = 0.647, P < .001), and depressive symptoms to suicidal ideation (standardized beta = 0.369, P < .001) were examined. This study elucidated the underlying mechanisms connecting family support to suicidal ideation, with depressive symptoms partially mediating this association. Additionally, our discoveries shed light on the partial mediation of anxiety symptoms by depressive factors when it came to the realm of suicidal ideation.