Determinants of Loneliness in Patients With Heart Failure: A Cross-Sectional Study

Background: Loneliness contributes to increased hospitalization and mortality in patients with heart failure (HF). However, the mechanisms underlying the relationship between type D personality and loneliness remain unknown. Objective: In this study, our aim was to examine whether adaptive cognitive emotional regulation strategies (CERS) and resourcefulness mediate the effects of type D personality on loneliness among patients with HF, based on the Theory of Resourcefulness and Quality of Life. Methods: In this cross-sectional study, 216 patients with HF were recruited from 3 hospitals in China between December 2021 and January 2023. Type D personality, adaptive CERS, resourcefulness, and loneliness were assessed using self-administered questionnaires. Serial mediation analysis was conducted using the PROCESS macro in SPSS. Results: Of the 216 patients, 67.59% experienced moderate loneliness and 28.70% experienced high loneliness. Type D personality had a significant direct effect on loneliness. The relationship between type D personality and loneliness was mediated by resourcefulness independently and by adaptive CERS and resourcefulness in serial terms. Conclusions: Interventions aimed at enhancing the use of adaptive CERS and improving resourcefulness may help to alleviate loneliness in patients with HF who have type D personality.