Objective To explore the mediating effect of psychological resilience between social isolation and frailty in patients undergoing maintenance hemodialysis (MHD). Methods Using the convenience sampling method, 208 patients receiving MHD treatment in the hemodialysis unit of a tertiary grade A hospital in Guangxi from May to July 2024 were selected as the survey subjects. Questionnaire survey was performed using the General Information Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), the Lubben Social Network Scale-6 (LSNS-6), and the Fried Frailty Phenotype. Pearson correlation analysis or Spearman rank correlation analysis was used to explore the correlations among social isolation, psychological resilience, and frailty in MHD patients, model 4 in the Process macro program was used to analyze the mediating effect of psychological resilience between social isolation and frailty in MHD patients, and the Bootstrap method (resampled 5 000 times) was used for validation. Results A total of 204 patients completed the survey in the end. The scores for MHD patients on the LSNS-6, CD-RISC, and Fried Frailty Phenotype were (12.21±3.43) points, (53.61±11.92) points, and (3.00 [1.00, 4.00]) points, respectively. Correlation analysis results showed: the LSNS-6 score was negatively correlated with the Fried Frailty Phenotype score (rs=-0.673, P<0.01) and positively correlated with the CD-RISC score (r=0.620, P<0.01); the CD-RISC score was negatively correlated with the Fried Frailty Phenotype score (rs=-0.616, P<0.01). Psychological resilience had a partial mediating effect between social isolation and frailty (indirect effect value=-0.207, 95% CI: -0.315 to -0.118), the mediating effect accounting for 31.41% of the total effect. Conclusion Psychological resilience has a partial mediating effect between social isolation and frailty in patients undergoing MHD.

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