Nursing care as a pathway to resilience in older adults with chronic illness

Purpose Increased life expectancy has contributed to the growth of the elderly population. As this population has at least one chronic disease, more work needs to be done on illness management. This study aims to examine the relationships between self-management resilience and perceived nursing care within the society-to-cells resilience framework and explore the mediating role of perceived nursing care among older adults with chronic illness. Design/methodology/approach A cross-sectional, correlational study design was used. The study was conducted between April and September 2024 with 527 older adults receiving nursing care. Data were collected using the Chronic Disease Self-Management Scale, Brief Resilience Scale and Patient Perception of Hospital Experience with Nursing Care Scale. Pearson correlation and mediation analyses (PROCESS macro-Model 4) were performed. Findings Participants demonstrated above-average self-management and good levels of resilience and perceived nursing care. Significant positive correlations were identified among self-management, resilience and perceived nursing care (r = 0.447–0.563, p < 0.01). Self-management had a significant direct effect on perceived nursing care (β = 0.449, p < 0.01). Both self-management (β = 0.354, p < 0.01) and perceived nursing care (β = 0.393, p < 0.01) significantly predicted resilience. Mediation analysis showed that perceived nursing care partially mediated the relationship between self-management and resilience. Research limitations/implications These findings support the society-to-cells resilience theory by demonstrating that perceived nursing care is a key mechanism linking self-management and resilience in older adults with chronic illnesses. Strengthening patient-centered nursing care may enhance resilience and improve chronic disease outcomes in aging populations. Originality/value This study provides empirical support for the society-to-cells resilience theory by demonstrating that perceived nursing care plays a partial mediating role in the relationship between self-management and resilience among older adults with chronic illnesses. The findings highlight that both internal resources, such as self-management and external resources, particularly nursing care, are integral to fostering resilience in this population. Perceived nursing care not only directly supports self-management but also indirectly enhances resilience by strengthening patients’ adaptive capacities.