Abstract: Objective: To examine the relationships among frailty, social support, and self-efficacy in disabled older individuals and their family caregivers with the objective of providing a foundation for the development of empowerment intervention plans tailored for clinical and community workers. Methods: Based on the actor-partner interdependence model, a convenience sample of 402 disabled older adults-caregiver dyads from 10 communities in Shanghai were surveyed using a general information questionnaire, the Tilburg Frailty Indicator, the General Self-Efficacy Scale, and the Social Support Rating Scale. Correlational analyses were conducted and an actor-partner interdependence model was established. Results: The incidence of frailty among the disabled older adults was 92.8%, significantly higher than the 52.5% incidence among caregivers (P<0.05). The social support scores were (32.69±11.55) for the older adults and (35.54±8.42) for the caregivers. The general self-efficacy scores were (23.50±5.63) and (26.14±7.23) for older adults and their caregivers respectively. Regarding the subject effect, both social support and self-efficacy in disabled older adults and their caregivers had negative impacts on their own frailty levels. As for the object effect, the social support level and self efficacy among disabled older adults moderately influenced the caregiver's frailty, while the caregiver's social support and self-efficacy similarly had negative impacts on disabled older adutls. Significant subject-object effects were observed. Conclusion: The study shows bidirectional interactions among social support, self-efficacy, and frailty in disabled older adults and their caregivers, suggesting that disabled older adults and their caregivers should be considered as a whole. The implementation of dual health empowerment is vital to enhance self-efficacy and social support for both parties to decelerate the progression of frailty.

Key words: disabled elderly; family caregivers; frailty; actor-partner interdependence model; social support; self-efficacy