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Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.

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Suicide rate is relatively high among Chinese rural elderly. While there has been some exciting work on reporting and preventing suicide among community-dwelling elderly, only a few published studies have addressed the issues of rural nursing homes in China. This study aimed to investigate the relationship among perceived social support, physical health, and suicidal thoughts of the elderly living in Chinese rural nursing homes. It also examined the moderating effects of social support on the path from physical health to suicidal thoughts of the rural institutional elderly in China. This study investigated 205 participants aged 60 years and above in Chinese rural nursing homes. Participants' suicidal thoughts, perceived social support, and physical health were assessed. This study conducted descriptive analysis, Student's t-test, and Pearson's chi-square test to test how physical health and social support predicted suicidal thoughts, as well as the moderating effects of family's, friends', and others' social support on physical health and suicidal thoughts. Both physical health and perceived social support were significantly related to suicidal thoughts. Perceived social support from family, friends, and significant others moderated the relationship between physical health and suicidal thoughts. Findings of this study suggested that increasing social support and improving physical health would be effective in both suicide prevention and intervention for the residents in Chinese rural nursing homes.

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AimsThe aim of this study was to elucidate whether depressive symptoms mediate the association between insomnia symptoms and health‐related quality of life (HRQOL) and to explore whether insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL among older adults in nursing homes.MethodsOlder adults living in nursing homes (n = 323) completed Athens Insomnia Scale, the 15‐item Geriatric Depression Scale, and the 36‐item Short Form Health Survey. PROCESS for SPSS was used in the mediation model. Logistic regression analysis was conducted to obtain odds ratios (OR) for insomnia symptoms, depressive symptoms, and HRQOL. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index were assessed.ResultsInsomnia symptoms and depressive symptoms were negatively related to HRQOL. Depressive symptoms mediated the relationship between insomnia symptoms and HRQOL. Compared with the older adults without insomnia symptoms or depressive symptoms, those with only depressive symptoms (OR = 8.36, 95% confidence interval (CI): 3.46–20.18) or insomnia symptoms (OR = 2.24, 95%CI: 1.04–4.83) had a lower HRQOL. Also, the co‐presence of insomnia symptoms and depressive symptoms significantly increased the risk of lowering HRQOL (OR = 25.79; 95%CI: 12.72–52.28). The relative excess risk due to interaction, attributable proportion due to interaction, and synergy index were 16.19, 0.63, and 2.88, respectively.ConclusionsDepressive symptoms may play a mediating role between insomnia symptoms and HRQOL. Comorbid insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL. It is vital to focus on elderly nursing home residents with insomnia symptoms and/or depressive symptoms and to adopt interventions.

Patients who are at high risk of depression should be identified and applicable targets should be made for prevention and intervention, in consideration of mental health of patients with chronic atrophic gastritis.