Abstract:

Objective To explore the status of physical resilience among older adults with multimorbidity and to identify its influencing factors，so as to provide evidence for developing targeted clinical interventions. Methods An explanatory sequential mixed-methods design was adopted. A total of 349 hospitalized older adults with multimorbidity were recruited by convenience sampling from a tertiary hospital in Wuhan between April and June 2025. Data were collected using a general information questionnaire，the Physical Resilience Scale for Older Adults，the Chinese version of the Frailty Scale，the Chinese version of the Depression Scale，the Chinese version of the Perceived Social Support Scale，and the Chinese version of the Positive Aging Scale. From July to September 2025，purposive sampling was used to select 15 participants from the quantitative phase for semi-structured interviews. Traditional content analysis was applied to analyze qualitative data，and a joint display method was used to integrate quantitative and qualitative findings. Results The quantitative results showed that the median physical resilience score of older adults with multimorbidity was 47.0（37.0，57.0） points. Multiple linear regression analysis indicated that age，number of chronic diseases，frailty，perceived social support，and positive aging were significant influencing factors of physical resilience in elderly patients with chronic multimorbidity（P<0.05）. Based on social ecological system theory，3 themes were identified from the qualitative analysis：（1）individual（microsystem） level：the dual role of impaired physiological function and behavioral regulation；（2）family-social（mesosystem） level：the bidirectional effects of structural and functional social support；（3）cultural-environmental（macrosystem） level：the dual regulatory role of sociocultural environmental factors. The mixed-methods integration demonstrated convergence，complementarity，and expansion between quantitative and qualitative findings. Conclusion The physical resilience of older adults with chronic multimorbidity is at a moderately low level and is influenced by multilevel interacting factors. Healthcare professionals should develop individualized intervention strategies based on these influencing factors.

Key words: Chronic Multimorbidity, Physical Resilience, Social Ecological System Theory, Mixed-Methods Research, Geriatric Nursing

摘要：

目的 探讨老年慢性病共病患者的身体复原力现状及其影响因素，为临床制订针对性干预方案提供参考。 方法 采用解释性序列混合研究设计，采用便利抽样法，选取武汉市某三级甲等医院于2025年4—6月住院的349例老年慢性病共病患者为调查对象，采用一般资料调查表、简体中文版老年人身体复原力量表、中文版衰弱筛查量表、简版老年抑郁量表、中文版领悟社会支持量表、中文版积极老龄量表进行调查分析；于2025年7—9月，采用目的抽样法，对量性研究中的15例老年慢性病共病患者进行半结构式访谈，使用传统内容分析法分析访谈资料，采用联合展示法整合量性和质性研究结果。 结果 量性研究结果显示，老年慢性病共病患者的身体复原力得分为47.0（37.0，57.0）分，多元线性回归分析结果显示，年龄、合并慢性病数量、衰弱、领悟社会支持、积极老龄化是老年慢性病共病患者身体复原力的影响因素（P<0.05）。质性研究结果基于社会生态系统理论提炼出3个主题：个体微观层面为生理功能受限与行为调节的双重作用；家庭-社会中观层面为社会支持的结构性与功能性的双重作用；文化环境宏观层面为社会文化环境因素的双调节作用。混合结果显示量性研究结果与质性研究结果表现为收敛、互补和拓展。 结论 老年慢性病共病患者身体复原力处于中等偏下水平，受多层级因素交互影响，建议医护人员根据其影响因素制订个性化的干预措施。

关键词: 慢性病共病, 身体复原力, 社会生态系统理论, 混合研究, 老年人护理