Mediating Role of Resilience in the Relationship between Depression and Perceived Psychological Health in Patients with Heart Failure

Background: Depression is associated with a poor prognosis and reduced quality of life in patients with heart failure. Improving resilience may facilitate lessening the negative consequences associated with depression. However, the role of resilience in the relationship between depression and perceived health status in patients with heart failure remains unknown.

Objectives: To examine the relationships among depression, resilience, and perceived health status in patients with heart failure and to determine whether resilience plays a mediating or a moderating role in the relationship between depression and perceived health status.

Methods: A cross-sectional study design was used. Participants were recruited from cardiology outpatient clinics in hospitals located in Northern Taiwan. Included in the study were 128 community-dwelling and medically stable patients with echocardiographically documented heart failure. Hierarchical multiple regressions were conducted to determine whether depression and resilience predicted perceived physical and psychological health status. The moderating role of resilience was examined by testing the significance of the interaction between depression and resilience. The mediating role of resilience was analyzed using the PROCESS procedure in SPSS.

Results: Depression significantly predicted both perceived physical and psychological health status in patients with heart failure after adjustment for demographic variables, comorbidities, New York Heart Association functional class, and health behaviors (both p < 0.01). Furthermore, resilience mediated the relationship between depression and perceived psychological health (b = −0.05; confidence interval [CI]: −0.01, −0.001) but not that between depression and perceived physical health (b = −0.004; CI: −0.003, 0.003).

Conclusion: Depression is a risk factor for poor perceived health outcomes in patients with heart failure. Interventions addressing resilience may facilitate improving perceived psychological health in depressed patients with heart failure.