Effect of mental state on sleep quality in patients receiving maintenance hemodialysis: A multiple mediation model of hope and family function

Abstract

The objective of this study was to investigate the current situation of sleep quality in patients receiving maintenance hemodialysis (MHD), and whether hope and family function play a mediating role between negative emotions and sleep quality. The Athens Insomnia Scale, Hospital Anxiety and Depression Scale, Herth Hope Index and Family Adaptation, Partnership, Growth, Affection and Resolve (APGAR) Index were used to investigate 227 MHD patients. The correlations among study variables were analyzed by Pearson correlation analysis. Structural equation model was used to construct and evaluate the mediation model. The sleep quality score of 227 patients receiving MHD was (7.57 ± 4.74), anxiety score was (4.36 ± 4.02), depression score was (5.91 ± 4.37), hope score was (34.64 ± 7.21), family function score was (6.21 ± 2.90). The negative emotions can directly predict sleep quality (β = 0.17, P = .046), positively predict sleep quality through hope (β = 0.12, P = .017), positively predict sleep quality through family function (β = 0.20, P < .001), and positively predict sleep quality through the chain mediating of hope and family function (β = 0.10, P < .001). The total effect size was 71.19%. It is concluded that negative emotions had a direct impact on the sleep quality of patients receiving MHD, and that improving the levels of family function and hope can help them sleep better.

Figure 1.

Study hypothesis chart.

Figure 2.

The mediating effect of hope and family function in the relationship between mental state and sleep quality in maintenance hemodialysis patients (standard coefficients).