Nursing Research最新文献

{"title":"Relationship of Health Behaviors and Symptom Status Mediated by Digital Health Literacy in Persons With Heart Failure.","authors":"Esra Nur Dibek, Merve Gulbahar Eren, Havva Sert, İbrahim Kocayİgİt","doi":"10.1097/NNR.0000000000000828","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000828","url":null,"abstract":"<p><strong>Background: </strong>In a digitalized world, accessing disease information through online platforms has become essential in influencing health-promoting behaviors among patients with heart failure. Patients must possess sufficient digital health literacy to obtain accurate and reliable information from digital platforms; however, there is no known data about the mediating role of digital health literacy in the relationship between health behaviors and symptom burden among persons with heart failure.</p><p><strong>Objective: </strong>To examine the relationship between digital health literacy, health behaviors, and symptom status (frequency, severity, and level of discomfort) in persons with heart failure and the mediating role of digital health literacy in the relationship between health behaviors and symptom status.</p><p><strong>Methods: </strong>This cross-sectional, correlational study was conducted between November 2023 and June 2024 with 250 persons diagnosed with heart failure. Data were collected using the Heart Failure Health Behavior Scale, e-Health Literacy Scale, and Heart Failure Symptom Status Scale. Pearson correlation analysis, linear regression, and hierarchical regression analysis with PROCESS Model 4 were used to analyze the continuous variables.</p><p><strong>Results: </strong>Digital health literacy was positively but weakly correlated with health behavior and negatively correlated with symptom status. The mediation analysis revealed that part of the effect of health behaviors on symptom status was mediated by digital health literacy.</p><p><strong>Discussion: </strong>Health behaviors directly affected symptom status and indirectly affected symptom status through digital health literacy. Strategies developed by nurses to enhance digital health literacy could play a critical role in improving the health of persons with heart failure by reducing symptom burden and promoting health behaviors. Research is needed on the influence of various predictors on symptom burden and assessing whether interventions to enhance digital health literacy can improve health outcomes among those with heart failure.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations in Launching an International Multisite Clinical Trial.","authors":"Laura Beth Kalvas, Mallory A Perry-Eaddy, Amy Cassidy, Onella S Dawkins-Henry, Laurie Lee, Lisa A Asaro, David Wypij, Martha A Q Curley","doi":"10.1097/NNR.0000000000000826","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000826","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Adequately powered randomized controlled clinical trials (RCTs) provide the highest level of evidence to support nursing interventions that are thought to improve clinical outcomes. To ensure adequate power, recruitment at multiple study sites is often required. Complexity is exponentiated when RCTs are conducted in multiple settings, especially on an international level. Regardless of logistical challenges, funders typically expect subjects to be enrolled within the first year of funding.Objective: To describe essential elements that must be considered when launching a multisite RCT.Methods: Step-by-step review of essential multisite RCT start-up activities using PROSpect, a nurse-led 50+ site international pediatric critical care RCT, as an exemplar. Essential pre- and post-award activities and organizational structure are discussed. The PROSpect launch timeline, with comparisons between United States (U.S.) and international study site initiation, is presented.Results: In the first two years of PROSpect funding (6/15/18-6/14/20), 54 sites in 13 countries spanning five continents initiated study launch activities and subsequently went on to begin subject screening. Of these, 15 sites (28%) began screening within the first funding year and 29 (54%) within the second year. PROSpect enrolled its first subject prior to the end of the first year of funding. Sites completed launch activities within a median of 295 days of receiving an instructional email delineating study launch steps (IQR: 202, 379; range = 151-1,046). International sites (n = 19) required more time to launch than U.S. sites (n = 35; 448 [360, 785] vs 219 [201, 299] days; p < .001).Discussion: Nurses must provide care that is supported by the best available evidence. Multisite RCTs are complex but provide high-quality evidence and can be managed with prospective systematic organization. In PROSpect, international sites took approximately twice as long to activate as U.S. sites. When developing a study start-up timeline, it is important to adjust milestones to accommodate the complexities of launching international sites and maintain momentum throughout the process, as start-up delays can increase risk of trial failure. This paper contributes to recent efforts to demystify and streamline the multisite RCT start-up process for nurse investigators transitioning from conducting single-site to multisite trials.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited English Proficient Patient and Nurses Experiences with Language Access Services.","authors":"Julie McCulloh Nair, Alex Waad, Brenda Hollingsworth","doi":"10.1097/NNR.0000000000000822","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000822","url":null,"abstract":"<p><strong>Background: </strong>Persons with limited English proficiency may receive inequitable care due to the absence of language services. Despite health equity initiatives, knowledge gaps exist regarding how and when language access needs are identified, acted upon, and which methods are being used.</p><p><strong>Objective: </strong>The purpose of this study was to explore limited English proficient and deaf obstetrical patient and nurses' experiences with language services to improve delivery of culturally competent care.</p><p><strong>Methods: </strong>This mixed-methods study occurred in two phases. In phase 1, demographic and language service data were collected via surveys that were deployed to obstetric patients with limited English proficiency. In phase 2, nurses' experiences with interpretive services were explored via three focus groups to identify facilitators and barriers to care. Quantitative data were analyzed using descriptive analysis methods, while qualitative data were analyzed using grounded theory methods.</p><p><strong>Results: </strong>Fifty participants receiving obstetric services who had limited English proficiency participated in phase I. Language services were positively rated with a noted preference for in-person interpreters. Participants identified unique barriers, but felt comfortable discussing concerns, stating nurses listened to them, treated them with courtesy, kindness, and respect. In phase II, 16 nurse participants identified two major themes: evidence of barriers to accessibility, convenience, and consistency of language access services; and increased need for cultural and linguistic competence.</p><p><strong>Discussion: </strong>Findings indicate in-person interpreters are most effective and capture cultural nuances often missed when using a phone/iPad during patient encounters. Language service delivery at various points of care requires further consideration to ensure consistent use during patient encounters. Future research should explore digital health language interventions, while nurses' suggestions to decrease language service barriers should be used to develop policies and programs designed to better meet linguistic needs.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectory of Infant Problematic Feeding Symptoms: Study Protocol.","authors":"Suzanne M Thoyre, Jinhee Park, Jamie Crandell, Hayley Estrem, Kathleen Knafl, John Wimmer","doi":"10.1097/NNR.0000000000000772","DOIUrl":"10.1097/NNR.0000000000000772","url":null,"abstract":"<p><strong>Background: </strong>Infants with developmental risk factors are more likely to have feeding problems and develop chronic feeding disorders. Early detection and understanding of the progression of problematic feeding and its relationship with a child's biological functioning and the family feeding environment will enhance effective symptom management and development of interventions to prevent pediatric feeding disorders.</p><p><strong>Objectives: </strong>The New Through Two (NewThru2) feeding study protocol is described. Study aims are to (a) characterize symptoms of problematic feeding and trajectories of symptoms from predischarge from neonatal intensive care through 24 months of age, (b) determine the relationship of child biological function at discharge with symptom characteristics and trajectories, (c) describe the child's feeding environment and its relationship to symptoms from discharge through 24 months, and (d) determine the relationship between problematic feeding symptoms and growth and developmental outcomes.</p><p><strong>Methods: </strong>NewThru2 is a prospective, longitudinal, mixed-method study following over 200 infants who received care in a neonatal intensive care unit and were identified as at risk for compromised development. The study follows enrolled infants through 24 months of age. Symptoms of problematic feeding are measured predischarge by clinical observation and medical record review and postdischarge by parent report. Biological function is measured by medical history and cardiorespiratory and autonomic nervous system function during feeding prior to discharge. Child feeding environment is measured by strategies parents use to manage feeding, the effect of feeding on the parent and family, and the use of feeding services. A subset of parents is interviewed to achieve a contextual understanding of the family feeding environment. Child outcome measures include parent-reported feeding skills and clinician-reported growth and neurodevelopment.</p><p><strong>Discussion: </strong>The results of this study will improve understanding of pediatric feeding disorders during a time of development sensitive to adequate nutrition and with infants at risk for developmental delays or impairments.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"150-154"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Evidence That Higher Daytime Melatonin Levels Correlate With Poor Nighttime Sleep Efficiency in Older Adults Living With Dementia.","authors":"David J Kennaway","doi":"10.1097/NNR.0000000000000776","DOIUrl":"https://doi.org/10.1097/NNR.0000000000000776","url":null,"abstract":"","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":"74 2","pages":"E15"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Area Deprivation and Patient Complexity Predict Low-Value Healthcare Utilization in Persons With Heart Failure.","authors":"Kathryn M Ledwin, Sabrina Casucci, Suzanne S Sullivan, Sharon Hewner","doi":"10.1097/NNR.0000000000000794","DOIUrl":"10.1097/NNR.0000000000000794","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a debilitating condition affecting over 6.7 million adults in the United States. Social risks and complexity, or personal, social, and clinical aspects of persons' experiences, have been found to influence healthcare utilization and hospitalizations in persons with HF. Low-value utilization, or irregular outpatient visits with frequent emergency room use, or hospitalization is common among persons with complex conditions and social risk and requires further investigation in the HF population.</p><p><strong>Objectives: </strong>The purpose of this research was to assess the influence of complexity and social risk on low-value utilization in persons with HF using machine learning approaches.</p><p><strong>Methods: </strong>Supervised machine learning, tree-based predictive modeling was conducted on an existing data set of adults with HF in the eight-county region of Western New York for the year 2022. Decision tree and random forest models were validated using a 70/30 training/testing data set and k -fold cross-validation. The models were compared for accuracy and interpretability using the area under the curve, Matthews correlation coefficient, sensitivity, specificity, precision, and negative predictive value.</p><p><strong>Results: </strong>Area deprivation index, a proxy for social risk, number of chronic conditions, age, and substance use disorders were predictors of low-value utilization in both the decision tree and random forest models. The decision tree model performed moderately, whereas the random forest model performed excellently and added hardship as an additional important variable.</p><p><strong>Discussion: </strong>This is the first known study to look at the outcome of low-value utilization, targeting individuals who are underutilizing outpatient services. The random forest model performed better than the decision tree; however, features were similar in both models, with area deprivation index as the key variable in predicting low-value utilization. The decision tree was able to produce specific cutoff points, making it more interpretable and useful for clinical application. Both models can be used to create clinical tools for identifying and targeting individuals for intervention and follow-up.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"136-143"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Academies Recommendations for Transformative Change in Women's Health Research at the National Institutes of Health.","authors":"Veronica Barcelona","doi":"10.1097/NNR.0000000000000803","DOIUrl":"10.1097/NNR.0000000000000803","url":null,"abstract":"<p><strong>Background: </strong>Due to significant gaps in knowledge around women's health, Congress commissioned the National Academies of Sciences, Engineering, and Medicine (National Academies) to conduct a consensus study on funding allocation, workforce needs, and priority research areas for the National Institutes of Health (NIH).</p><p><strong>Objectives: </strong>This manuscript summarizes the key points of the new National Academies report on women's health research for NIH, presents the relevance and importance for nursing research, and briefly discusses the need for increased representation of nurse scientists on National Academies panels.</p><p><strong>Methods: </strong>Beginning in the Fall of 2023, a multidisciplinary panel of 17 experts was convened by National Academies to address gaps in women's health research at NIH. The committee was tasked to identify research priorities for NIH-funded research with a focus on conditions that are female specific, are more common in women, or affect women differently. In addition, the committee was asked to make recommendations on NIH training and education to strengthen the women's health research workforce; changes to NIH structural, systems, and review processes; and allocation of funding to more equitably reflect the burden of disease among women.</p><p><strong>Results: </strong>The committee found that, from 2013 to 2023, only 8.8% of NIH research dollars focused on women's health research and that basic knowledge about women's physiological, hormonal fluctuations, and chromosomal differences is lacking. Data are also needed to better understand diseases that are female specific, are more common in women, or affect women differently. The committee made eight recommendations for transformative change at NIH related to women's health research.</p><p><strong>Discussion: </strong>Overall, the report describes the need for transformative change at NIH to advance the science on women's health research and improve outcomes. This includes a comprehensive approach and recommendations that would double the NIH's investment in women's health research, enhance accountability, and provide rigorous oversight, prioritization, and integration of women's health research across NIH.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"87-90"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and Health Outcomes of Emerging Adults With Type 1 Diabetes: A Mixed-Methods Study.","authors":"Amani Al Bayrakdar, Houry Puzantian, Samar Noureddine, Huda Abu-Saad Huijer, Mona Nasrallah, Kevin L Joiner, Pamela Martyn-Nemeth, Hala Tfayli","doi":"10.1097/NNR.0000000000000781","DOIUrl":"10.1097/NNR.0000000000000781","url":null,"abstract":"<p><strong>Background: </strong>Emerging adults with type 1 diabetes are at risk of poorer diabetes-related health outcomes than other age groups. Several factors affecting the health and experiences of the emerging adults are culture and healthcare specific.</p><p><strong>Objectives: </strong>The aim of this study was to explore the experience of emerging adults living with type 1 diabetes in Lebanon, describe their diabetes self-care and diabetes-related health outcomes (HbA1c and diabetes distress), and identify the predictors of these outcomes.</p><p><strong>Methods: </strong>A convergent mixed-methods design was used with 90 participants aged 18-29 years. Sociodemographic, clinical data, and measures of diabetes distress, social support, and self-care were collected. Fifteen emerging adults participated in individual semistructured interviews. Multiple linear regression was used to determine predictors of diabetes outcomes. Thematic analysis was used to analyze qualitative data. Data integration was used to present the mixed-methods findings.</p><p><strong>Results: </strong>The study sample had a mean HbA1c of 7.7% ( SD = 1.36), and 81.1% reported moderate to severe diabetes distress levels. The participants had good levels of diabetes self-care and high levels of social support. HbA1c was predicted by insulin treatment type, age at diagnosis, and diabetes self-care; while diabetes distress was predicted by diabetes knowledge, blood glucose monitoring approach, and diabetes self-care. \"Living with type 1 diabetes during emerging adulthood: the complex balance of a chemical reaction\" was the overarching theme of the qualitative data, with three underlying themes: \"Breaking of bonds: changes and taking ownership of their diabetes,\" \"The reactants: factors affecting the diabetes experience,\" and \"Aiming for equilibrium.\" The integrated mixed-methods results revealed one divergence between the qualitative and quantitative findings related to the complexity of the effect of received social support.</p><p><strong>Discussion: </strong>The suboptimal health of the emerging adults despite good self-care highlights the importance of addressing cultural and healthcare-specific factors such as diabetes knowledge and public awareness, social support, and availability of technology to improve diabetes health. Findings of this study can guide future research, practice, and policy development.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"98-107"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing PhD Students for Tenure-Track Faculty Positions.","authors":"Mary K Killela, Harry Adynski, Gillian Adynski, Elizabeth Allen Myer, Cassandra Dictus, Leah Morgan, Hayden Hmiel, Jessica Williams","doi":"10.1097/NNR.0000000000000791","DOIUrl":"10.1097/NNR.0000000000000791","url":null,"abstract":"<p><strong>Background: </strong>With an increasing number of nursing faculty approaching retirement, it is critical to prepare PhD students to take on tenure-track faculty roles. There are a multitude of competing time demands for nursing faculty, and one way that PhD students can prepare for faculty roles is leading team-based science with their peers during their predoctoral program.</p><p><strong>Objectives: </strong>The aim of this study was to describe the process of PhD students leading an independent research project, in addition to their dissertation work, which aimed to incorporate the tripartite mission-scholarship, teaching, and service.</p><p><strong>Methods: </strong>This paper outlines the components of the PhD-student-led project as well as provides recommendations for leadership and schools of nursing as well as sponsors interested in funding this type of work.</p><p><strong>Results: </strong>Students were able to conduct independent research using diverse research approaches, practice mentoring skills, and provide service and helpful information about the nursing workforce to their academic clinical partner. A key component of this relationship building was incorporating a clinical fellowship during the PhD program for students that directly aided the transition from BSN to PhD programs.</p><p><strong>Discussion: </strong>PhD students learned valuable lessons about time management and collaborating in a team setting with peers. We recommend schools of nursing seek funding opportunities for PhD students to conduct independent team science, encourage academic partnerships with affiliated medical centers and public health settings, and facilitate peer mentorship across cohorts.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"E11-E14"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and Self-Care Maintenance Mediated by Social Support and Depression in Older Adults With Heart Failure.","authors":"Na Bu, Min Leng, Guorong Cao, Chao Dou, Rongchun Hou, Xiaohong Lu, Hong Xu","doi":"10.1097/NNR.0000000000000795","DOIUrl":"10.1097/NNR.0000000000000795","url":null,"abstract":"<p><strong>Background: </strong>Older adults with heart failure often exhibit poor self-care maintenance. Frailty could exacerbate self-care, leading to deteriorating health. Social support and depression may play a role in self-care maintenance in older adults with heart failure combined with frailty. Confirming this potential mechanistic relationship could provide valuable reference for nurses to formulate and improve the targeted intervention strategies and health education programs for older adults with heart failure.</p><p><strong>Objectives: </strong>This study analyzed the relationship between frailty and self-care maintenance in older adults with heart failure and determined the sequential mediation effect of social support and depression. Its goal was to provide valuable theoretical insights for formulating targeted clinical nursing interventions for older adults with heart failure.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from July 2023 to February 2024, during which older adults with heart failure were recruited using a convenience sampling method from the cardiovascular department of a tertiary Class A hospital in Qingdao, China. A total of 241 completed the Tilburg Frailty Indicator, the Self-Care of Heart Failure Index, the Social Support Rating Scale, and the Patient Health Questionnaire-9. t -Tests and one-way analysis of variance were used to examine differences in self-care maintenance among participants with distinct characteristics; correlation analysis was used to identify variable relationships within the study. The mediation model was tested using the SPSS PROCESS macro and the bootstrap method.</p><p><strong>Results: </strong>Frailty was negatively correlated with self-care maintenance, and both social support and depression were significantly related to frailty and self-care maintenance. Social support and depression not only independently mediated the relationship between frailty and self-care maintenance but also exhibited a significant sequential mediation effect.</p><p><strong>Discussion: </strong>The frailty of older adults with heart failure and its correlation with self-care maintenance is a complex and multidimensional phenomenon. Frailty not only directly influenced self-care maintenance in participants but also indirectly affected it through the mediating factors of social support and depression. Future research should emphasize innovative, targeted interventions to enhance social support quality and accessibility and alleviate depression, ultimately boosting patients' self-care capabilities and elevating their quality of life.</p>","PeriodicalId":49723,"journal":{"name":"Nursing Research","volume":" ","pages":"115-122"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}