The Impact of Social Support on Quality of Life in Patients with Osteoporotic Vertebral Compression Fractures After Surgery: A Longitudinal Study with mental resilience as a mediator

Anqi Wang¹Yongyao Shen¹Di Tang²Jianghan Zhao³Shuo Yang⁴Haiqin Fang⁵Yongjin Guo^1,2*Liying Jiang^1,6*

• ¹Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai Municipality, China
• ²Department of health management, College of Public health, Shanghai University of Medicine and Health Sciences, Shanghai, China
• ³Department of Prevention Medicine, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
• ⁴Department of Health Inspection and Quarantine, College of Medical technology, Shanghai University of Medicine and Health Sciences, Shanghai, China
• ⁵Department of Nutrition Division, China National Center for Food Safety Risk Assessment, Beijing, Beijing Municipality, China
• ⁶Jiading Central Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China

Background: Although surgical intervention is the most efficacious approach for improving Osteoporotic Vertebral Compression Fractures (OVCFs) status, postoperative Health-Related Quality of Life (HRQoL) can be influenced by a multitude of factors from the perspective of ecological and social systems. The study was to examine HRQoL in postoperative OVCFs patients and to further explore the correlations among HRQoL, mental resilience, and social support through a longitudinal study in China. Methods: This study assessed the HRQoL, mental resilience, and social support of patients at baseline 1 day post-surgery (T0), 6 month post-surgery (T1), and 12 months post-surgery (T2) through questionnaire evaluation. A total of 155 postoperative OVCFs patients completed the baseline survey, with 150 and 140 participants completing the follow-up surveys at T1 and T2, respectively. Pearson correlation analyses were conducted to explore the correlation at each time point. We employed the parallel process model to investigate the complex correlations among social support, life quality and mental resilience as time went over. The latent growth curve mediation model was utilized to test the potential mediating role of mental resilience on the correlation between social support and HRQoL. Results: Improved mental resilience, as well as increased social support, contributes to the enhanced HRQoL over time. There was a positive correlation trend between HRQoL, mental resilience, and social support (all P<0.01). Besides, gender might propose a great influence on the level of life quality, with females representing a faster development rate of mental resilience than males (P<0.05). Mediation analysis suggested that mental resilience mediated the association between social support and life quality (indirect effect of intercept=0.572, P=0.003, 95%CI (0.280, 0.773); indirect effect of slope=0.168, P=0.002, 95%CI (0.061, 0.401). Conclusion: The enhancement of postoperative social support in patients with OVCFs is beneficial for the improvement of HRQoL, and this association appears to be mediated by mental resilience. Evaluation and intervention of social support and mental resilience are necessary to improve postoperative HRQoL for patients.