To explore the mediating role of health empowerment in the relationship between emotional resilience and health-promoting behaviors in patients with chronic heart failure (CHF), and to provide a basis for developing targeted rehabilitation interventions.

A total of 235 CHF patients admitted to the Department of Emergency Medicine and the Department of Cardiology of Wuhan First Hospital from January 2022 to January 2025 were selected. According to the inclusion and exclusion criteria, 220 patients were finally included. They were surveyed using the General Information Questionnaire, the Emotional Resilience Scale, the Health Empowerment Scale for Elderly Patients with Chronic Diseases, and the Health-Promoting Lifestyle Profile (HPLP). Partial correlation analysis was performed using SPSS 26.0, and the mediating effect was tested using the macro program Process 4.2.

All 220 CHF patients were included. The scores for emotional resilience, health empowerment, and health-promoting behaviors were 36.41±5.39, 91.89±9.32, and 110.21±7.62, respectively. Partial correlation analysis showed that emotional resilience was positively correlated with health empowerment (r=0.233, P<0.001) and health-promoting behaviors (r=0.399, P<0.001). Health empowerment was also positively correlated with health-promoting behaviors (r=0.439, P<0.001). The mediation analysis results indicated that emotional resilience had a significant positive effect on health empowerment (β=0.402, t=3.535, P<0.05) and on health-promoting behaviors (β=0.564, t=6.428, P<0.001). After adding health empowerment, emotional resilience still exerted a significant positive effect on health-promoting behaviors (β=0.444, t=5.323, P<0.001). Further verification using the Bootstrap method showed that the direct effect of emotional resilience on health-promoting behaviors accounted for 78.7% (95% CI: 0.280-0.608) of the total effect, while the indirect effect accounted for 21.3% (95% CI: 0.046-0.214).

Emotional resilience can directly affect health-promoting behaviors in CHF patients and can also indirectly affect them through health empowerment, so improving patients’ emotions and health empowerment may have a better effect on patients’ health-promoting behaviors.