ArticleBMC geriatrics2026
Unpacking the association of activities of daily living on self-care ability in China's rural empty-nest older adults: the chain mediation of social alienation and psychological resilience.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study investigates the associations among Activities of Daily Living (ADL), social alienation, psychological resilience, and self-care ability in rural empty-nest older adults. It further examines the chain mediating roles of social alienation and psychological resilience in the relationship between ADL and self-care ability.
methodsBetween February 2022 and March 2023, a survey was conducted among 1,025 rural empty-nest older adults in Chaoyang, Liaoning Province, China. A general information questionnaire, the Activities of Daily Living Scale, the Social Alienation Scale, the Psychological Resilience Scale, and the Self-Care Ability Scale were used as research instruments. Data analysis was performed using SPSS 27.0 and the PROCESS v4.1 macro for correlation, regression, and mediation effect analyses.
resultsThe mean scores for ADL, social alienation, psychological resilience, and self-care ability were 21.01 ± 9.51, 42.30 ± 14.05, 129.41 ± 22.79, and 143.54 ± 19.24, respectively. ADL scores were positively correlated with social alienation scores (r = 0.113, p < 0.001) and negatively correlated with both psychological resilience (r = -0.120, p < 0.001) and self-care ability (r = -0.170, p < 0.001). Social alienation was negatively correlated with psychological resilience (r = -0.535, p < 0.001) and self-care ability (r = -0.738, p < 0.001). Psychological resilience was positively correlated with self-care ability (r = 0.780, p < 0.001). Mediation analysis indicated that social alienation and psychological resilience partially mediated the effect of ADL on self-care ability. Specifically, a chain mediation effect of social alienation and psychological resilience was confirmed in the relationship between ADL and self-care ability.
conclusionsADL directly predicts self-care ability among rural empty-nest older adults. Additionally, ADL can indirectly affects self-care ability through the separate mediating effects of social alienation and psychological resilience, as well as through their combined chain mediation effect.
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