Mediating effect of coping style between family resilience and demoralization in patients with decompensated cirrhosis

This study aimed to examine the relationship between family resilience and demoralization syndrome (DS) in patients with decompensated cirrhosis and explore the mediating role of coping styles in this association. A survey of 260 patients with decompensated cirrhosis was conducted in the Department of Gastroenterology of a 3 A hospital in Jinan from September 2024 to March 2025 using the Mandarin Version of the Demoralization Scale (DS-MV), Chinese version of the Family Resilience Assessment Scale (FRAS-C) and Medical Coping Style Scale (MCMQ). Descriptive analysis and nonparametric test were performed using Free Statistics software version 2.2. Spearman correlation analysis and regression analysis were conducted with SPSS 27.0. The structural equation model was constructed via AMOS 28.0. The median DS score in patients with liver cirrhosis was 22, with an interquartile range (IQR) of 7-28. The proportion of patients with severe DS was 18.46%. Spearman correlation analysis demonstrated that DS was negatively correlated with family resilience, confrontation, and avoidance and positively correlated with acceptance-resignation (r = -0.668, p < 0.01; r = -0.314, p < 0.01; r = -0.162, p < 0.01; r = 0.540, p < 0.01). Mediation analysis revealed that acceptance-resignation partially mediated the relationship between family resilience and DS, accounting for 35.4% of the total effect (p < 0.001). Acceptance-resignation was identified as a partial mediator of the relationship between family resilience and DS. Therefore, attention should be paid to DS in patients with decompensated cirrhosis. Family resilience can also be used to reduce DS levels.