The association between family resilience and learned helplessness among hospitalized older adults with chronic multimorbidity in Xinjiang, China: a latent profile and computer-simulated network analysis

Learned helplessness is common among hospitalized older adults with chronic multimorbidity and is associated with poorer treatment adherence and quality of life. Family resilience may buffer psychological distress, yet the relationship between family resilience and learned helplessness remains poorly understood, particularly in multi-ethnic populations such as those in Xinjiang, China. To identify profiles of family resilience among hospitalized older adults with chronic multimorbidity in Xinjiang, China, and to examine network characteristics of learned helplessness symptoms across different profiles, thereby identifying potential intervention targets for each subgroup. This cross-sectional study evaluated 427 hospitalized older adults with chronic multimorbidity at three tertiary hospitals in Urumqi, Xinjiang, China, from October 2025 to February 2026. Participants completed the Family Resilience Scale and the Learned Helplessness Scale. Latent profile analysis based on family resilience scores was used for stratification. Ising network analysis estimated symptom networks of learned helplessness for each subgroup, with core symptoms identified via centrality indices. Network comparison tests and computer-simulated intervention analyses (NodeIdentifyR algorithm) evaluated intergroup differences and identified optimal intervention targets. Three distinct family resilience profiles were identified: low (29.0%), moderate (43.8%), and high (27.2%). The point estimates of core symptoms differed across profiles: anxiety (HL7) was the most central symptom in the low and high resilience groups, while confusion (HL10) was the most central symptom in the moderate group. However, bootstrapped difference tests revealed no statistically significant differences between any pairs of nodes in the subgroup networks (all P > 0.05), indicating that these centrality rankings should be interpreted as point estimates rather than statistically distinct positions. Computer-simulated interventions identified profile-specific optimal alleviation targets. Network comparison tests revealed significant differences in global strength between the high resilience group and both the low and moderate groups (adjusted P = 0.048 for both comparisons), whereas no significant differences in network structure were found between any of the three pairs (adjusted P > 0.05). Family resilience shows substantial heterogeneity among hospitalized older adults with chronic multimorbidity in Xinjiang, with profile-specific point estimates of core symptoms and global strength differences suggesting potential avenues for personalized psychological care. These findings are exploratory and warrant confirmation in future clinical studies.