ABSTRACT:
Background While the relationship between negative life events and mental health in general and among the older adults in particular have been well documented, it is not clear whether this relationship holds true among older adults with hypertension, a somatopsychic illness. Furthermore, the existing body of literature on the mediating and moderating mechanisms underlying this relationship is insufficient. Our study aimed to investigate the mediating role of self-efficacy between negative life events and mental health, as well as the moderating role social capital plays in this indirect relationship. Methods Data were drawn from a cross-sectional survey conducted in rural China, where a structured questionnaire was administered among 953 older adults with hypertension. Hierarchical multiple linear regression and Bootstrap analyses were performed to test the hypothesized relationships. Results Our study found that self-efficacy partially mediated the effect of negative life events on mental health (indirect effect = 0.053, 95% confidence interval = [0.035, 0.072]), with the mediating effect accounting for 12.70% of the total effect. In addition, social capital moderated the indirect effect of self-efficacy on the association between negative life events and mental health (β = 0.059, p < 0.05), as well as the direct effect of negative life events on mental health (β = –0.058, p < 0.05). Conclusions These findings highlight that self-efficacy partially mediates the association between negative life events and mental health, while social capital moderates both the direct and indirect effects. Social capital may be a potential target for interventions to improve mental health and to control hypertension among vulnerable older adult populations.