Mediating roles of family functioning and self-efficacy in the relationship between depression and family resilience among kidney dialysis patients

Kidney dialysis patients often experience intensified depression after prolonged maintenance dialysis, which may diminish family resilience. Conversely, family functioning and self-efficacy might bolster resilience by serving as crucial internal resources. The mechanisms through which depression impact family resilience via these resources remain unclear. The present study used a cross-sectional design and included 211 kidney dialysis patients. The study was conducted in Lanzhou, China. The participants were selected through convenience sampling from September 2023 to January 2024. General Information Questionnaire, Depression subscale of the Hospital Anxiety and Depression Scale (HADS), Family Resilience Rating Scale (FRRS), Family APGAR Index (APGAR) and Simplified Coping Style Questionnaire (GSES), were used for data collection. Independent-sample t-tests and one-way ANOVA determined the influential factors using SPSS 27.0. Structural equation modeling, executed with AMOS 24.0 software, validated the mediating effects of family functioning and self-efficacy between depression and family resilience. Family resilience levels among kidney dialysis patients differed significantly by education level, marital status and per capita monthly income. Depression were inversely associated with family resilience. Family functioning (β = 0.22, p < 0.01) and self-efficacy (β = 0.04, p < 0.01) mediated the relationship between depression and family resilience, respectively. This study provides further insights into the psychological mechanism of depression and family resilience in kidney dialysis patients. Caregivers can actively help kidney dialysis patients to reduce depression and improve the family functioning, so as to enhance the family resilience.