Objective:

To investigate the heterogeneity of illness perception among older patients with multimorbidity and assess the mediating effect of family resilience on the relationship between illness perception and emotional distress.

Approach:

• Study Design: 420 multimorbid older patients were recruited from three tertiary hospitals in Xinjiang Province between October 2025 and January 2026.
• Assessment Tools: The Brief Illness Perception Questionnaire, the Chinese version of the Family Resilience Assessment Scale, and the Hospital Anxiety and Depression Scale were utilized.
• Analysis Methods: Latent profile analysis was used to identify illness perception patterns, and bootstrap-based mediation analysis assessed the mediating role of family resilience.

Key Findings:

• Three distinct illness perception profiles were identified: low (32.6%), moderate (47.6%), and high (19.8%) illness perceptions.
• Family resilience partially mediated the relationship between moderate illness perception and anxiety (indirect effect = 0.510, 95% CI: 0.325–0.724) and depression (indirect effect = 0.450, 95% CI: 0.283–0.631).
• Family resilience also partially mediated the relationship between high illness perception and anxiety (indirect effect = 1.263, 95% CI: 0.819–1.739) and depression (indirect effect = 1.114, 95% CI: 0.707–1.555).

Interpretation:

The study demonstrates the heterogeneity in illness perception among older multimorbid patients and the mediating role of family resilience in emotional distress.

Limitations:

• The study is limited to a specific geographic area (Xinjiang, China), which may affect generalizability.
• The cross-sectional design limits causal inferences regarding the relationships between illness perception, family resilience, and emotional distress.

Conclusion:

The findings highlight the need for integrating family resilience improvement in psychological support for chronic patients.