To explore the parallel mediation role of hope and self-esteem between loneliness and depression of the disabled elderly in the community, and to provide scientific reference for promoting the mental health of them.

From January to May 2022, 335 disabled elderly were selected by convenient sampling method from 5 communities in Xi′an, that had continuous care cooperation with First Affilicated Hospital, Air Force Medical University, including Xiyaofang Community, Dianjian Community, Shanqi Wanshou Community, Changle West Road Community and Dongyaofang Community. General information questionnaire, short form geriatric depression scale(GDS-15), short-form of the University of California, Los Angeles loneliness scale (ULS-8), Herth hope index (HHI) and Rosenberg self-esteem scale (RSES) were employed to conduct the questionnaire survey. A total 335 questionnaires were distributed, and 325 valid questionnaires were recovered, with the valid recovery rate of 97%. Pearson correlation analysis was applied to correlation analysis among variables, Harman single factor test was used for common method deviation test, and the PROCESS v4.0 developed by Hayes was used for linear regression analysis and Bootstrap analysis.

A total of 325 elderly people with disabilities were effectively surveyed, 180 males and 145 females, 232 with mild disabilities, accounting for 71.4%; 79 with moderate disabilities, accounting for 24.3%; and 14 with severe disabilities accounting for4.3%. Scores on the GDS-15, ULS-8, HHI and RSES for the disabled elderly in the community were (6.16±3.89), (16.41±5.44), (34.09 ± 6.66) and (29.58 ± 5.32) points respectively. Correlation analysis showed that loneliness was positively correlated with depression, the difference was statistically significant (r=0.687, P<0.05), and was negatively correlated with hope and self-esteem, the differences were statistically significant (r=-0.694, -0.612; P<0.05). Hope and self-esteem were negatively correlated with depression, the differences were statistically significant (r=-0.755, -0.660; P<0.05). The mediating effect analysis showed that the total effect value of loneliness on depression was 0.490, 95%CI was 0.434-0.547. The total mediating effect value was 0.291, 95%CI was 0.233-0.352, accounting for 59.39% of the total effect. The mediating effect value of hope was 0.216, 95%CI was 0.155-0.275, accounting for 44.08% of the total effect. The mediating effect value of self-esteem was 0.075, 95%CI was 0.049-0.225, accounting for 15.31% of the total effect. The direct effect value of loneliness on depression was 0.199, 95%CI was 0.132-0.267, accounting for 40.61% of the total effect.

Loneliness can directly predict depression, or it can indirectly predict depression through the parallel mediating role of hope and self-esteem. Community managers should therefore early identify the loneliness of the disabled elderly in the community and call for family, community and even society to give them adequate companionship, care and support, while valuing the role of hope and self-esteem in reducing depression.