Lebanese patients living with heart failure reported moderate resilience amid ongoing sociopolitical and economic adversity, with self-care maintenance, self-care management, loop diuretic use, and male gender identified as significant predictors of resilience, explaining 36.1% of the variance in resilience scores.
Key Findings
Results
Heart failure patients in Lebanon demonstrated moderate resilience amid prolonged sociopolitical and economic adversity.
Sample included 299 participants with a mean age of 59.95 ± 15.89 years recruited from outpatient clinics and primary healthcare services across several Lebanese geographic regions.
Data were collected between January 2024 and April 2025.
Almost half of the participants were older adults with a mean age of 71.18 ± 6.06 years.
A slightly higher proportion of males than females was observed.
Common comorbidities included hypertension, diabetes, and hyperlipidemia.
Results
Resilience was significantly and positively correlated with all three dimensions of heart failure self-care.
Resilience was positively correlated with self-care maintenance (r = 0.54, p < 0.001).
Resilience was positively correlated with self-care monitoring (r = 0.47, p < 0.001).
Resilience was positively correlated with self-care management (r = 0.53, p < 0.001).
Resilience was negatively correlated with quality of life (r = 0.055, p = 0.53), but this correlation was not statistically significant.
Results
Self-care maintenance, self-care management, gender, and loop diuretic use were significant predictors of resilience in multiple linear regression.
The multiple linear regression model explained 36.1% of the variance in resilience scores.
Higher self-care maintenance scores were associated with higher resilience.
Higher self-care management scores were associated with higher resilience.
Loop diuretic use was associated with higher resilience.
Female gender was associated with lower resilience scores after adjustment.
Results
Participants had moderate depressive symptoms, impaired heart failure-related quality of life, and reduced cardiac function.
Mean left ventricular ejection fraction was 37.52% ± 10.51%, indicating reduced systolic function.
Most participants were classified as New York Heart Association functional class II or III.
Mean scores indicated moderate depressive symptoms and impaired HF-related quality of life.
Arabic-translated and psychometrically tested instruments were used to assess depressive symptoms, self-care, quality of life, and resilience.
Discussion
The study identified patient subgroups at higher risk for lower resilience, specifically females and those with weaker self-care behaviors.
Female gender was independently associated with lower resilience after multivariable adjustment.
Weaker self-care maintenance and management were associated with lower resilience.
The authors recommend identifying patients at high risk for faltered resilience to guide nursing practice.
Findings are described as applicable to the Lebanese context and to similar resource-constrained or crisis-affected settings.
What This Means
This research suggests that people living with heart failure in Lebanon — a country facing ongoing economic collapse and political instability — show moderate levels of resilience, meaning a moderate ability to cope and adapt despite their illness and surrounding hardships. Among 299 heart failure patients recruited from clinics across Lebanon, the study found that those who were better at managing their own health on a daily basis (such as monitoring symptoms, taking medications, and adjusting their care when needed) also tended to be more resilient. This relationship was consistent and statistically strong across all three dimensions of self-care measured.
When the researchers looked at which factors most strongly predicted resilience, they found that better self-care behaviors — specifically self-care maintenance and self-care management — along with being male and using loop diuretics (a common type of water pill used in heart failure treatment) were all independently associated with higher resilience. Together, these four factors explained about 36% of the differences in resilience scores between patients. Notably, female patients had lower resilience scores even after accounting for other factors, suggesting they may face additional challenges in coping with illness in this context.
This research suggests that strengthening self-care skills in heart failure patients could be a practical way to support their resilience, especially in settings affected by crisis or limited resources. Nurses and healthcare providers may be able to identify patients most at risk for poor coping — such as women or those with poor self-care behaviors — and provide targeted support. The findings are intended to be relevant not only for Lebanon but also for other countries dealing with similar social, economic, or political challenges.
Deek H, Massouh A, Shatila W. (2026). Predictors of Resilience Among Patients Living With Heart Failure Amid Escalating Sociopolitical Challenges: A Cross-Sectional Approach.. Nursing open. https://doi.org/10.1002/nop2.70816