Association Between Depression and Subjective Well-being in older patients with Chronic Diseases in Rural Ethnic Areas of Qiannan, Guizhou: The Mediating Role of Social Support

Abstract Objective: To explore the associations among social support, depression, and subjective well-being in older patients with chronic diseases in the rural ethnic regions of Qiannan, Guizhou. Methods: This cross-sectional study enrolled oder patients with chronic diseases in Qiannan, Guizhou between June and September 2022. The social support, depression, and subjective well-being were assessed by a self-developed questionnaire on general information, the social support rating scale (SSRS), the geriatric depression scale (GDS-15), and the Memorial University of Newfoundland Happiness Scale (MUNSH), respectively. Results: A total of 2,156 participants (1,104 males; average age of 71.15±8.04) were included. Their mean SSRS and MUNSH scores were 34.96±7.98 and 27.17±9.48, respectively. The GDS-15 score was 7.23±2.59, with 1529 individuals (70.9%) having depressive symptoms. Multivariate linear regression analysis revealed that mild depression (B = -7.795, 95% CI: -8.437 to -7.153, P < 0.001), moderate to severe depression (B = -11.631, 95% CI: -12.623 to -10.639, P < 0.001), and moderate social support (B = -2.661, 95% CI: -4.063 to -1.259, P < 0.001) were independently associated with subjective well-being. The structural equation model results revealed that the total effect of depression symptoms on subjective well-being in elderly patients with chronic diseases is -0.528, with a direct effect of -0.474 (95% CI: -0.503 to -0.443), accounting for 89.77% of the total effect. The mediating effect of social support on the association between depression and subjective well-being is -0.133 (95% CI: -0.070 to -0.041), constituting 10.23% of the total effect. Conclusions: Older patients with chronic diseases in the rural ethnic areas of Qiannan, Guizhou, exhibited a high prevalence of depressive symptoms and low levels of subjective well-being. Social support partially mediated the association between depression and subjective well-being in this population. Thus, proactive measures are warranted to fortify the social support system for older patients with chronic diseases in Qiannan, Guizhou.