Family Functioning and Depression in Chinese Nursing Home Residents: The Serial Mediating Role of Perceived Stress and Psychological Resilience

OBJECTIVES: This study examined the associations between family functioning and depressive symptoms among older adults in Chinese nursing homes, focusing on the mediating roles of perceived stress and psychological resilience. METHODS: A cross-sectional survey was conducted among 229 older adults from five nursing homes in Southwest China. Standardized instruments were used, including the Family APGAR Index, Geriatric Depression Scale (GDS), Chinese Perceived Stress Scale (CPSS), and the 10-item Connor - Davidson Resilience Scale (CD-RISC-10). RESULTS: < .01). Perceived stress and psychological resilience were found to be significant mediators. The total indirect effect accounted for 49.56% of the overall association.Specifically, perceived stress (12.47%) and psychological resilience (26.91%) each served as independent mediators. A serial mediation pathway through perceived stress and then psychological resilience explained an additional 10.2% of the total effect. CONCLUSIONS: Family functioning was associated with depressive symptoms among institutionalized older adults both directly and indirectly. The serial mediation model highlights potential pathways linking external and internal psychosocial resources to mental health in nursing homes. CLINICAL IMPLICATIONS: Interventions focusing on family support, stress reduction, and resilience enhancement may be relevant to the psychological well-being of older adults in nursing homes.