心力衰竭患者-照顾者二元组中睡眠与生活质量的关联及疲劳的中介作用：一种行为者-伙伴相互依赖中介模型
Association between sleep and quality of life in heart failure patient-caregiver dyads and mediation of fatigue: An actor-partner interdependence mediation model.
作者信息
Zhang Jie, Chai Xiaohui, Ye Yi, Zhao Qiuge, Fan Xiuzhen
机构信息
School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Anesthesiology and Surgery, Qingdao Municipal Hospital Group, Qingdao, Shandong, China.
出版信息
J Adv Nurs. 2022 Aug;78(8):2436-2447. doi: 10.1111/jan.15174. Epub 2022 Feb 8.
AIMS
Quality of life is essential to heart failure patients and their family caregivers. This study aimed to examine the mediating role of fatigue in the association between sleep and quality of life in heart failure patient-caregiver dyads.
DESIGN
A cross-sectional descriptive study was conducted from November 2017 to August 2018.
METHODS
A total of 269 heart failure patient-caregiver dyads at two hospitals in China were included. The Chinese version of the Pittsburgh Sleep Quality Index, the Chalder Fatigue Scale and the 12-item Short-Form Health Survey were used to collect data on heart failure patients and their family caregivers. The structural equation model was employed in the dyadic analysis based on the actor-partner interdependence mediation model.
RESULTS
Regarding the actor effects, poor sleep was negatively associated with physical and mental quality of life in heart failure patients and their family caregivers, respectively, and the relationship was mediated by their fatigue. Regarding the partner effects, caregivers' fatigue was positively associated with patients' physical quality of life and mediated the association between caregivers' sleep and patients' physical quality of life.
CONCLUSIONS
Heart failure patients and their family caregivers experience reduced quality of life when they have poor sleep and fatigue, and caregivers' fatigue is related to patients' improved physical quality of life. Hence, dyadic interventions targeting to improving sleep and fatigue may be beneficial to their quality of life.
IMPACT
This study highlights the importance of routinely measuring and managing sleep and fatigue for heart failure patients and their family caregivers. Effective dyadic-based interventions that maintain equal attention to family caregivers should be considered by healthcare providers to maximize the improvement of patients' quality of life.
目的
生活质量对心力衰竭患者及其家庭照顾者至关重要。本研究旨在探讨疲劳在心力衰竭患者-照顾者二元组中睡眠与生活质量之间关联中的中介作用。
设计
于2017年11月至2018年8月进行了一项横断面描述性研究。
方法
纳入了中国两家医院的269对心力衰竭患者-照顾者二元组。采用中文版匹兹堡睡眠质量指数、查尔德疲劳量表和12项简短健康调查问卷收集心力衰竭患者及其家庭照顾者的数据。基于行为者-伙伴相互依赖中介模型，在二元分析中采用结构方程模型。
结果
关于行为者效应，睡眠不佳分别与心力衰竭患者及其家庭照顾者的身体和心理健康生活质量呈负相关，且这种关系由他们的疲劳介导。关于伙伴效应，照顾者的疲劳与患者的身体生活质量呈正相关，并介导了照顾者睡眠与患者身体生活质量之间的关联。
结论
心力衰竭患者及其家庭照顾者在睡眠不佳和疲劳时生活质量会降低，且照顾者的疲劳与患者身体生活质量的改善有关。因此，针对改善睡眠和疲劳的二元干预可能对他们的生活质量有益。
影响
本研究强调了对心力衰竭患者及其家庭照顾者常规测量和管理睡眠及疲劳的重要性。医疗保健提供者应考虑采取有效的基于二元组的干预措施，同等关注家庭照顾者，以最大程度提高患者的生活质量。
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